Child First is a home-visiting intervention for young children aged 0 to 5 who are at risk of emotional problems, developmental delay, and abuse and neglect. It is delivered jointly by a therapist and care coordinator/key worker for approximately 55 weeks.
The information above is as offered/supported by the intervention provider.
0 to 3 years old
Individual
Child First is a home-based, therapeutic intervention targeting families with a child aged between 0 and 5 years old where there are serious concerns about the child’s safety and developmental wellbeing.
Child First bridges universal, targeted, and specialist/intensive services to provide a tailored package of support to meet the unique needs of each family. Child First is delivered by two practitioners: a care-coordinator (who could be a key worker) who connects families to community-based services as part of their family-driven plan; and a mental health professional – typically a qualified psychologist or social worker – who provides therapeutic support during weekly home visits.
Child First begins with a comprehensive needs assessment of each family’s specific strengths and weaknesses. Motivational interviewing is used during these first visits to actively engage and recruit parents to the intervention. Practitioners also learn strategies for recruiting parents who initially refuse intervention participation.
The results of the needs assessment are used to inform a plan that is jointly agreed by the family and practitioners. Weekly home visits then commence for a period of six to 18 months. Each visit lasts between 60 to 90 minutes, depending on the family’s needs and the number of family members present. During these sessions, family members typically receive Child Parent Psychotherapy from the mental health professional. Additional hands-on support is provided by the other practitioner who helps families connect with community services and offers general mentoring advice.
Prenatal through to five years old at the onset of services
Young children at risk of emotional problems, developmental delay, and abuse and neglect.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Experiences of maltreatment, trauma, and ongoing family stress during the early years increases the risk of poor outcomes in childhood and adolescence.
Science-based assumption
Sensitive parenting reduces the risk of child maltreatment and increases children’s resilience to family stress and traumatic events in early childhood.
Science-based assumption
Parents experiencing high levels of stress are more likely to have difficulty responding sensitively to their child’s needs and are at greater risk of child maltreatment.
Intervention
Parents are supported to manage their stress
Parents are supported to respond sensitively to their child’s needs.
Short-term
Reduced parental stress
Improved parental mental health
Increased parental sensitivity
Improved parent–child relationship.
Medium-term
Improved child language
Improved child behaviour
Reduced child maltreatment risk.
Long-term
Child remains safely with the family
Improved child wellbeing at home and at school.
Families with a child five years old or younger, where there are concerns about child maltreatment or the child’s developmental wellbeing.
Child First is delivered by a care coordinator and mental health professional via weekly home visits that last for six to 18 months, depending on the family’s needs.
The mental health professional provides therapeutic support to the family consistent with the Child Parent Psychotherapy model.
The Care Coordinator provides the parent with ‘reflective care’ coordination. This includes helping the parent implement the agreed plan and providing hands-on assistance for:
A mental health/developmental clinician or mental health/child development clinician with a master’s qualification or higher in psychology or social work. The second practitioner is a care coordinator with qualifications comparable to a key worker.
Both practitioners receive a minimum of 12 days of in-person training as part of a year-long Learning Collaborative (LC):
It is recommended that practitioners are supervised by one host agency supervisor and an intervention developer supervisor.
Contact person: Serena Curry
Organisation: Child First
Email address: info@childfirst.org
Website/s: www.childfirst.org
https://homvee.acf.hhs.gov/models/child-first#Evidenceofmodeleffectiven-E
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
Child First’s most rigorous evidence comes from an RCT conducted in the United States consistent with Foundations’ Level 3 evidence strength criteria. The study identified statistically significant reductions in child maltreatment and improvements in children’s early language and behaviour.
Child First can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Improved child language
Immediately after treatment
Improvement index
Interpretation
Study
Improved child behaviour
Immediately after treatment
Improvement index
Interpretation
Study
Reduced child maltreatment
24 months after completing the intervention
Improvement index
Interpretation
Study
| Identified in search | 2 |
| Studies reviewed | 2 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 2 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 1 |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 157 multi-risk families with a child between the ages of 6 and 36 months living in the Bridgeport, Connecticut community. |
| Race, ethnicities, and nationalities |
|
| Population risk factors |
|
| Timing |
|
| Child outcomes | 12 months post-baseline
36 months post-baseline
|
| Other outcomes |
|
| Study rating | 3 |
| Citations | Lowell, D., Carter, A., Godoy, L., Paulicin, B. & Briggs-Gowan, M. (2011) A RCT of Child First: A comprehensive home-based intervention translating research into early childhood practice. Child Development. 82, 193–208. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies:
Crusto, C., Lowell, L., Paulicin, B., Reynolds, J., Feinn, R., Friedman, S. & Kaufman, J. (2008) Evaluation of a wraparound process for children exposed to family violence. Best Practices in Mental Health. 4, 1–16.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
Click here for more information.
Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus.
Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
Click here for more information.
