Treatment Response among Preschoolers with EBP: The Role of Social Functioning

The purpose of the study was to identify profiles of social functioning for preschoolers with externalizing behavior problems (EBP) and examine how profiles are predictive of response to a behavioral treatment program. 139 preschoolers with EBP participated in an 8-week Summer Treatment Program for Pre-Kindergartners (STP-PreK). Latent profiles of social functioning were created from parent and teacher rated atypicality and social skills scales, along with child performance on an emotion knowledge and hostile attribution task. Baseline and treatment outcomes included behavioral, academic, and executive functioning measures. Latent profile analyses resulted in two profiles (e.g., average and low) marked by differences in social skills, emotion knowledge and rates of atypical behaviors. Children in the low social functioning group had higher teacher rated hyperactivity and attention problems at baseline (d = .44 & 1.07), as well as lower IQ (d = .39). Children in the low social functioning group also had poorer treatment response as they had lower executive functioning scores (β = −.17, p < .05) at the completion of treatment. IQ moderated the association between social functioning profiles and behavioral treatment outcomes, such that lower social functioning was only associated with higher rates of attention problems for children with average IQ. Findings highlight the differential impact of social functioning in predicting treatment outcomes.