A Randomized Controlled Trial of Child FIRST: A Comprehensive Home-Based Intervention Translating Research Into Early Childhood Practice


  • We are grateful for the generous funding support awarded to the first author by the Starting Early Starting Smart Prototype (Substance Abuse and Mental Health Services Administration, 9886) and the Robert Wood Johnson Foundation (60068). We deeply appreciate the many generous, insightful, and committed individuals who have contributed to success and evaluation of this program: Judith Solomon, Joseph Woolston, Edward Zigler, Marianne Barton, Kimberly McCarthy, Julian Ford, Karen Steinberg, June Malone, Charles Tisdale; and the Child FIRST clinical and research staff (Gloria Delgado, Monica Fox, Allison Van Hof, Cyndy Holt, Elizabeth Lewis, Adriana Lorduy, Gerdine St. Juste, Monica Trudell, Carolyn Vargas-Rivera, Michele White, and Susan Zuanelli).

concerning this article should be addressed to Margaret Briggs-Gowan, Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030. Electronic mail may be sent to mbriggsgowan@uchc.edu.


This randomized, controlled trial was designed to document the effectiveness of Child FIRST (Child and Family Interagency, Resource, Support, and Training), a home-based, psychotherapeutic, parent–child intervention embedded in a system of care. Multirisk urban mothers and children, ages 6–36 months (= 157) participated. At the 12-month follow-up, Child FIRST children had improved language (odds ratio [OR] = 4.4) and externalizing symptoms (OR = 4.7) compared to Usual Care children. Child FIRST mothers had less parenting stress at the 6-month follow-up (OR = 3.0), lower psychopathology symptoms at 12-month follow-up (OR = 4.0), and less protective service involvement at 3 years postbaseline (OR = 2.1) relative to Usual Care mothers. Intervention families accessed 91% of wanted services relative to 33% among Usual Care. Thus, Child FIRST is effective with multirisk families raising young children across multiple child and parent outcomes.