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Presentation given by Darcy Lowell, MD at the 2010 RWJF LFP Annual Meeting in St. Paul, MN This presentation will build on the new scientific knowledge about early brain development, looking at how we can translate these findings into community-based best practices in our work with children and families. We will also look at how our new understanding of the effect of “toxic” stress on the young, developing brain can inform our communications to staff, community stakeholders, and especially to funders. We will explore lessons learned from Child FIRST, a former LFP project that implemented a model early childhood system of care to decrease the incidence of serious emotional disturbance, developmental and learning problems, abuse and neglect among high-risk families in inner-city Bridgeport, CT
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Child FIRST: Results of Randomized Controlled TrialChild FIRST Intervention demonstrated strong, statistically significant outcomes when compared to Usual Care Controls:
• Child FIRST children were significantly less likely to have language problems. (Odds ratio = 4.2)
• Child FIRST children were significantly less likely to have aggressive and defiant behaviors. (Odds ratio = 4.8)
• Child FIRST mothers had significantly lower levels of depression and mental health problems.
• Child FIRST families were significantly less likely to be involved with child protective services (by parent report). (Odds ratio = 4.1)
• Child FIRST family members had a marked increase in access to services (91% vs. 33%).
Child Mental Health
ITSEA Externalizing Symptoms
13
14
15
16
17
18
19
Pre-treatment 6 months 12 months
Tota
l Sym
ptom
s
Child FIRST
Usual Care
Child Language Problems
0%
5%
10%
15%
20%
25%
30%
35%
Pre-treatment 6 months 12 months% w
ith L
angu
age P
robl
ems Child FIRST
Usual Care
Development of Language Problems Over Time
Maternal Mental Health
Treatment Effect on Total Maternal Symptoms (BSI)
20
25
30
35
40
Pre-treatment 6 months 12 months
Tota
l Sym
ptom
s Child FIRST
Usual Care
Maternal Depression
Depressive Symptoms on the CES-D
13
14
15
16
17
18
19
20
21
Pre-treatment 6 months 12 months
Tota
l Sym
ptom
s Child FIRST
Usual Care
Clinical Cutpoint
Access to Services
Service Access
0102030405060708090
100
Pre-treatment 6 months 12 months% o
f Ser
vice
s N
eede
d th
at W
ere
Acc
esse
d
Child FIRST
Usual Care
