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The goal of this project was to examine the effects of adapted peer tutoring on social interactions and early language and literacy skills of preschool-age children who were English language learners. Adapted Peer Tutoring (APT) was the treatment for this study. Quasi-experimental group comparison design was applied. Two inclusive preschool classrooms were randomly selected as the experimental group and two other two classrooms were the comparison group. A total of 75 children participated in this study. The ELLs from the experimental group demonstrated significant improvement than their peers from the comparison group in positive social interaction behaviors, receptive language, and print knowledge. The total effect indicated that children’s social interaction behaviors moderately mediated the APT effectiveness on language acquisition.