Lowell, D. I., Carter, A. S., Godoy, L., Paulicin, B., & Briggs‐Gowan, M. J. (2011). A randomized controlled trial of Child FIRST: A comprehensive home‐based intervention translating research into early childhood practice. Child development82(1), 193-208.

Citation Year
Used in Implementation Reports
Study Participants

Children were eligible if they were between 6 and 36 months of age; had a positive screening for social-emotional/behavioral problems on the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) and/or the parent screened high for psychosocial risk; and lived in a permanent caregiving environment in Bridgeport, Connecticut. Of 642 families completing screens, 464 passed the screening, 254 consented to the study, and 157 were randomized (stratified by age, BITSEA score, and family psychosocial risk). There were 78 children in the Child FIRST intervention group and 79 in the usual care comparison group at baseline, 64 (intervention) and 67 (comparison) at the six-month follow-up, and 58 (intervention) and 59 (comparison) at the 12-month follow-up. Fifty-nine percent of mothers in the study were Hispanic, 30 percent were African American, 8 percent were Caucasian, and 4 percent were of another race/ethnicity.


This study took place in Bridgeport, Connecticut.

Home Visiting Services

The Child FIRST model has two core components. The first is a connection to a “system of care,” a community-based, comprehensive, coordinated set of services, including early education, health care, and other social services. Second, the program offers a psychotherapeutic approach to promote nurturing caregiving. Services were offered in the home. Two staff members, a clinician and care coordinator, were assigned to each family. The clinician was responsible for therapeutic assessment and intervention with the child and parent and the care coordinator facilitated family engagement in community services. Weekly visits lasting 45 to 90 minutes were made jointly or individually, as needed by the family.

Comparison Conditions

Comparison families (the usual-care group) continued to receive usual care from the study’s recruitment sites: the Bridgeport Hospital Pediatric Primary Care Center and the Supplementary Nutrition Program for Women, Infants, and Children.

Staff Characteristics and Training

The clinical team assigned to each family included a master’s-level developmental/mental health clinician and an associate’s- or bachelor’s-level care coordinator/case manager. The care coordinator/case manager typically had the same racial or ethnic background as the family and spoke the family’s chosen language.

Author Affiliation

Darcy I. Lowell, a study author, is the founder and executive director of Child FIRST.

Funding Sources

Starting Early Starting Smart Prototype (Substance Abuse and Mental Health Services Administration, 9886); Robert Wood Johnson Foundation (60068)

Citation short
Lowell, D. I., Carter, A. S., Godoy, L., Paulicin, B., & Briggs-Gowan, M. J. (2011)
Confounding Factors
Baseline Equivalence
Not Applicable
Not applicable
Screening Decision
Passes screens
Design Detail
Randomized controlled trial