Child First is an intensive, early childhood, two-generation, home visiting intervention that works with a community’s most vulnerable young children (prenatal through age five years) and their families. Child First identifies children at risk of behavioral or learning problems and works with their families to address multiple risk factors such as poverty, trauma and exposure to violence, abuse and neglect, depression, substance use, and homelessness. Child First is based on two core components: 1) a comprehensive and coordinated system-of-care approach to provide individualized support and services to the child and family, and 2) relationship-based approaches to enhance nurturing and positive development. Child First is delivered in the family home to increase engagement and participation. The program is provided by a two-member team, consisting of a care coordinator and a licensed mental health clinician, referred to as a child development specialist. Families and the Child First team work together to develop a comprehensive plan that includes treatment activities and goals, supports, and services. The care coordinator connects families with community-based services addressing challenges relating to health, mental health, early childhood, and education, and with other social supports. The clinician is trained to provide trauma-informed, child–parent psychotherapy to build parenting skills and develop a more nurturing and responsive relationship between the parent and child. The Child First team works with families for 6 to 12 months through home visits of between 60 to 90 minutes. During the first month of the intervention, the assessment phase, the Child First team makes twice-weekly home visits. During the remaining months of the intervention phase, one or both of the Child First team members conduct weekly home visits or more, as needed.