Child FIRST Develops an Evidence-Based Early Childhood Intervention

Dates of Project: July 2005 through December 2016

Field of Work: Early childhood intervention for very vulnerable children and their families

Problem Synopsis: Research on early brain development has found that the stress present in a young child's environment can damage that child's developing brain. Children growing up in poverty, living in substandard housing in rough neighborhoods, with a mother or other parent figure overwhelmed by life demands, or with significant health issues, experience high levels of stress on a daily basis. To improve the potential of these very vulnerable children requires addressing system issues and promoting a secure attachment between parent and child.

Synopsis of the Work: Using a two-pronged approach based on current brain science, Child FIRST, located in Connecticut:

  • Connects families to appropriate services and resources, thereby decreasing environmental stress.
  • Through home visitation and other supports, facilitates a nurturing parent-child relationship and secure attachment, which protects the child's developing brain from damage.

Key Results

Results from the first randomized controlled trial of Child FIRST show clinical effectiveness.

  • Compared with similar children receiving usual care, children receiving services from Child FIRST:

    • Were 68 percent less likely to have language problems
    • Were 42 percent less likely to have aggressive and defiant behaviors
  • Child FIRST mothers had 64 percent lower levels of depression and/or mental health problems than mothers receiving usual care.

  • Compared with similar families, families receiving services from Child FIRST:

    • Were 39 percent less likely to be involved with child protective services
    • Had a 98 percent increase in access to community services and supports

We want to change the way people think about working with very high-risk families, and to be part of the national conversation about how we can do it differently."—Darcy Lowell, MD, executive director, Child FIRST

Child FIRST has demonstrated cost-effectiveness. The cost of its home-based intervention and care coordination is about $6,800 per family of four, compared to a cost of $700,000 to $900,000 for a year of psychiatric hospitalization for one child.

In October 2012 the federal Health Resources and Services Administration at the Department of Health and Human Services designated Child FIRST as one of nine (now 12) Evidence-Based Home Visiting Service Delivery Models eligible for replication funding from the Maternal, Infant, and Early Childhood Home Visiting Program.

Child FIRST has expanded to serve the 15 Department of Children and Families Areas in Connecticut.

It has received 28 individual inquiries from 19 different states about the program. Of these, as of April 2015, plans are underway for replication in North Carolina and in Palm Beach County, Fla.

They have figured out how to not just do mental health but to do mental health within the context of a social-economic framework, with depth. ... you rarely see all that combined. [Child FIRST] combines it.”—Elaine Zimmerman, executive director of the Connecticut Commission on Children

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Results from the first randomized controlled trial of Child FIRST show clinical effectiveness.