This multiple baseline design study examined the effects of a Tier 3 early literacy intervention on low-income preschool children’s phonological awareness (PA). Seven preschool children who did not make progress on identifying first sounds in words during a previous Tier 2 intervention participated in a more intensive Tier 3 intervention. Children listened to stories and participated in early literacy activities led by an interventionist for approximately 15 min, 3 to 4 days per week for up to 8 weeks. Weekly progress monitoring data showed that five of seven children made progress on first sound identification as a result of the Tier 3 intervention. Children who made progress on first sound identification generally demonstrated gains on more distal measures of PA. Results demonstrate the potential benefit of providing children with multiple tiers of instruction to facilitate academic success.