Child First

Child First

Treating children's toxic stress at home

Stable and nurturing relationships are the cornerstone of a child’s emotional well-being and the foundation for their language and cognitive development. Scientific research shows that young children living in environments with high levels of stress—toxic stress—like maternal depression, intimate partner violence, extreme poverty, or substance abuse—can damage their young developing brains. Disrupting brain architecture at such a young age can lead to a lifetime of major problems in emotional, behavioral, mental and physical health.

Child First is an evidence-based model that uses home visits and a network of community services to prevent the devastating effects of early childhood adversity. The model aims to identify children and families with serious challenges (at the earliest possible time) and connect them to well-integrated community-based resources to help them deal with the source of the stress directly: from basic needs like food and housing to issues like depression or intimate partner violence. The program, which began in Bridgeport, Connecticut, is unique among home-visiting models because it features a skilled mental health specialist as a leading part of the team.

A randomized controlled trial showed that Child First has a significant and lasting impact on both children and families. Maternal depression goes way down. Kids behave better and are more emotionally secure. There is improvement in language development among children—a predictor of greater success later in school. These results convinced Connecticut to expand the model throughout the state, and current RWJF funding is helping with this expansion. Over the next year, Child First will also be spreading its model to other states for the first time.


Child First

917 Bridgeport Avenue
Shelton,CT 06484

(203) 538-5222

Remarks from Jamie Bussel, Program Officer, Vulnerable Populations

Jamie Bussel

"Child First is an intensive mental health intervention that takes on some of the most vulnerable kids exhibiting the most serious mental and emotional problems. This model of intensive, early child home visits and wrap-around services is showing it’s possible to shield children from the brain-damaging effects of toxic stress. With Child First, children’s behavior improves, depression reduces, and language development advances. This cooperative, family-based clinical program is moving mountains and is ready to bring their model to scale."

Research Documents

A Randomized Controlled Trial of Child First

This trial demonstrated statistically significant and clinically effective results that Child First counteracts risk factors for emotional disturbance, developmental and learning disabilities, abuse and neglect.

Quick Facts from This Study

  • Child First children were 42% less likely to have aggressive and defiant behaviors.
  • Child First mothers had 64% lower levels of depression and/or mental health problems.
  • Child First families were 39% less likely to be involved with child protective services.


Remarks from Darcy Lowell, M.D., Founder and Executive Director, Child FIRST

ChildFIRST - Darcy Lowell headshot

"Everything a child does has meaning. In very young children, what we have come to call “acting out” is really a cry for help. Serious emotional and psychological problems, developmental delays, and learning disabilities in very young children, are often linked to family stress—such as poverty and violence. We must not overlook the troublesome behavior and rush to simply “fix” it, but respond to the underlying factors that are generating it. By working with children and families in their homes, we are fostering healthy relationships between parents and children, and creating a safer and healthier overall environment for the child.”

An Evidence-Based Model

The Health Resources and Services Administration (HRSA) designated Child First as one of 12 home-visiting models that meet the HHS criteria for evidence-based models.

Child First: A Program to Help Very Young At-Risk Children

This chapter of To Improve Health and Health Care, Volume XV, focuses on Child First, a family-based intervention to prevent mental health problems in high-risk mothers and young children.

In the news

California Assemblyman Hosts Discussion on Strengthening Youth Trauma Care

April 6, 2014 – A hearing at the Los Angeles Public Library on the subject of trauma informed care of young people highlighted Child First, a revolutionary home visiting service that uses a trauma informed evidence-based approach to help kids who have behavioral problems and their parents.

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Bridgeport Hospital Opens New Gyn Clinics and Ambulatory Medicine Unit

April 6, 2014 – Bridgeport Hospital recently opened new gynecologic oncology and urogynecology specialty clinics and new quarters for its MedEase ambulatory medicine unit, which was last occupied by Bridgeport Hospital’s acclaimed Child FIRST early childhood intervention program.

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Progress in the War on Poverty

January 11, 2014 – America’s war on poverty turned 50 this week, and a variety of programs, including Child First, have had a clear impact and great success.

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