Child First
Last Revised: October 30, 2025
- Issue Areas
- Early childhood Health and well-being
Program overview
Reducing environmental risk factors: Child First (Child and Family Interagency, Resource, Support and Training) is a home visiting program involving therapeutic intervention for children living in environments where they have a high likelihood of developing learning, emotional, and developmental problems or experiencing abuse and neglect.
Focusing on early intervention: Child First is designed for families who have experienced significant obstacles, like poverty, abuse, neglect, mental health, or substance use issues, with at least one child between 0 and 5 years old. The program structure is based on evidence that children's earliest relationships impact healthy development and their likelihood for future success. Families are typically referred to the program by local medical providers or social service programs. Child First is run by Changent, a national non-profit organization in connection with local implementation partners, which are typically hospitals or health and family related social organizations.
Connecting with families: Each family is assigned a two-person care team consisting of a masters-level mental health clinician and a care coordinator. The program attempts to match families with a team that reflects their language preferences and ethnic diversity in order to build trust and encourage participation.
Implementing a two-part treatment: At-home meetings between families and their treatment team take place weekly for 45-90 minutes. During these sessions the clinicians provide individualized therapy based on family needs to improve parent-child relationships and help parents better understand their children's behaviors. Care coordinators connect families to community resources to reduce stressors and improve well-being. Interventions take place over the course of 6 months to a year, depending on family need.
- Cost per Participant
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$7,285 per family (in 2017 dollars).
- Location
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Active across 33 locations in 7 states.
A single study with a rigorous design provides some evidence that the Child First program improved children's language and behavioral development and mothers’ mental health.
- A 2011 randomized controlled trial found that after one year of Child First, children were 68% less likely to have concerning language development and behavioral problems, and mothers were 64% less likely to report “clinically-concerning levels of psychological distress” relative to those from families that did not participate in the program. Three years after program completion, participants were 33% less likely to have been involved with child protective services over potential child mistreatment.
Delivering services at home: Most Child First programming is delivered at the home of enrollees. This makes it easier for disadvantaged families to participate, as they do not need transportation to sessions or to arrange childcare for non-participating children during that time period. Similarly, it may reduce stigma as home visits, relative to travelling to a specific location where the program is delivered, is more discrete. Further, because therapy often covers specific behaviors that occur in the home, they may be easier to address in that environment.
Establishing trust between staff and families: For therapy to be effective, Child First participants need to be honest with practitioners and thus the program focuses on building trusting relationships between staff and families. This is done by ensuring that services are provided in the language of families choosing and that care teams reflect the ethnic diversity of the family when possible. Additionally, written child development materials were also provided at a 6th grade reading level to ensure participating parents could access them. These features help build understanding and may encourage more openness, making the program more effective.