Document Type

DNP - Open Access

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Dannica Callies


Purpose: Positive Behavioral Interventions and Support (PBIS) is an evidence-based three-tiered framework that supports children and their behavioral needs including emotional behaviors. Emotional behavioral problems (EBP) seen at an early age have a major connection to their preschool setting and a significant effect on future long-term mental and physical health outcomes. 11
Methods: Preintervention, teachers completed PBIS and Teacher Observations of Classroom Adaptation-Checklist (TOCA-C) training. The teachers evaluated and assigned each student to a PBIS tier group using TOCA-C. Tier appropriate interventions were then implemented. TOCA-C was used 3 months post intervention to reevaluate each months post intervention to reevaluate each student and reassign a tier group. Pre and post intervention behaviors were compared using the Wilcoxon Signed Rank test.
Results: PBIS greatly improved concentration, while having some positive results in prosocial behavior, emotion regulation problems, internalizing problems, and family involvement.
Discussion: Continued PBIS adoption and implementation may lead to more positive child emotional regulation, enhancing the children's long-term mental and physical health.
Implications for Practice: Identifying mental health needs at an early age, consistent staff training, and early adoption of PBIS can correct emotional behavioral problems, which can lead to negative academic and social consequences.

Library of Congress Subject Headings

Preschool children -- Mental health.
Behavior modification.
Emotions in children.

Number of Pages



South Dakota State University


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