Leading change to create an integrated PreK-3rd education and connect early learning programs with the K-12 system is not easy. Superintendents require courage to take the first step, persistence and political skills to encourage organizational and community engagement, and a relentless focus on results to measure progress and build momentum. As a growing number of districts initiate and implement PreK-3rd efforts, how should superintendents lead the change? What are their key challenges? What is the pivotal role of the superintendent? How long does it take to show results? The disciplined leadership of three superintendents--Jerry Weast, Bette Hyde, and Mark Johnson--from three very different school districts--Montgomery County Public Schools in Maryland, Bremerton School District, in the state of Washington, and Nooksack Valley School District, also in Washington--answer these questions. Weast, Hyde, and Johnson all work with different constituents, school boards, and communities, yet their courage, persistence, and focus in building integrated and excellent PreK-Grade 12 systems are producing similarly exceptional outcomes. With over 141,000 students on the outskirts of the nation's capital, Montgomery County Public Schools boasts 90 percent of exiting Kindergartners ready to learn, 89 percent of Third Graders reading proficiently, 86 percent of high school graduates going to college, and a double-digit narrowing of achievement gaps in every grade. In the midsized Bremerton School District, located across Puget Sound from Seattle, Hyde saw the percentage of Fourth Graders meeting state reading standards rise every year up from 59 percent in 2003, to 74 percent by 2009; that same year, 66 percent of entering Kindergarteners knew their letters--an increase of 62 percentage points in eight years. Finally, in rural Nooksack Valley, Johnson's decade-long leadership resulted in 77 percent of Fourth Graders and 88 percent of Tenth Graders reading at state standard by 2009. This paper presents three key steps for PreK-3rd leadership. (Contains 8 notes and 34 online resources.)