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INTRODUCTION: School teachers play an important role in instilling positive behavior changes among school children. School children at an early age group of 2–7 years face challenges and need extra support. Utilization of psychological interventions via school teachers for oral health promotion is minimal. The present study was done to determine the impact of counseling and reinforcement by school teachers on children for a follow-up period of 1 year. MATERIALS AND METHODS: A quantitative research on 58 randomly selected children for a follow-up of one year was conducted to determine the prevalence of preoperational characteristics in school children. The tools to determine characters in preoperational children consisted of classical cognitive experiments followed by behavior counseling intervention. The interventional group received reinforcement with school teachers for a follow-up of one year. RESULTS: The assessment of the three characteristics revealed a prevalence of ego centralism, centration, and lack of conservation and reversibility in 84.4%, 89.6%, and 89.6% children, respectively. A significant difference in behavior change was seen in children who received behavior counseling and reinforcement. CONCLUSION: The present study concluded that Piaget's characteristics were consistent for a follow-up period of one year.