Early Childhood Wraparound

Early Childhood Wraparound
A woman holding a little girl toddler, both are smiling and are outside in the sun

What Is Early Childhood Wraparound?

Early Childhood Wraparound is a family-driven planning and team-based process for families struggling to raise a young child with an identified mental health concern or where there is a risk that the child may develop a significant mental health concern. The process is led by Early Childhood Wraparound Coordinators who are fully trained in wraparound, child development, and community resources for families with young children.

Early Childhood Wraparound uses the same approach as FAST Forward, with a few minor changes to ensure the process is focused on a child who may be too young to talk about their strengths, needs, and goals. The Early Childhood Wraparound Coordinator works with the caregiver to focus on their hopes and concerns regarding their child, including: 

  • Identifying the family’s strengths. 
  • Creating their vision. 
  • Creating a Plan of Care.
  • Forming a team to connect and coordinate services and supports.

Who Is Early Childhood Wraparound For?

Early Childhood Wraparound is for families who have a young child, ages birth through 5, with a significant mental health concern or who is at risk because their caregiver is experiencing their own mental health or substance misuse issues or because the family is involved in multiple systems (such as the Division of Children, Youth, and Families, mental health, special medical services, among others).

Why Do We Need Early Childhood Wraparound?

Studies show that lifelong health and development are related, in part, to the care they received and what they experienced when they were young children. It is also true that some infants and children have temperaments that are more challenging than others. A secure, warm, responsive, and predictable relationship with at least one caregiver is critical to a child’s positive well-being and development. Research shows that when a child experiences multiple traumatic or abusive events in childhood, they are more likely to develop depression, cardiovascular disease, cancer, substance misuse, and drug abuse and engage in more risk-taking behaviors later in adolescence and adulthood. 

According to the NH Division for Children, Youth and Families’ (DCYF) 2020 Data Book, in 2020, 377 babies and young children in New Hampshire under the age of 4 were placed into out-of-home care, and in 2019, 418 babies were born drug-exposed due to substance use. Placement out of the home at an early age or exposure to substances at birth are just two situations that could have a harmful impact on a baby or young child. Understanding this is critical to strengthen the capacity of the family/caregiver to attach to their infant or young child, create an environment in the home that is emotionally and physically safe, and connect to supports to address their needs. Early Childhood Wraparound is designed to do just that.

Is Early Childhood Wraparound Effective?

Early Childhood Wraparound uses the same process as NH FAST Forward, modified to account for the child's young age. Once you have been found eligible, a staff member from one of the state’s care management entities, NFI or Connected Families NH, will contact you within 48 hours to find out more about your situation, other providers you are involved with, and if there are any immediate safety needs or other concerns. If there are immediate concerns, a staff member will help you set up a safety plan. You will be matched with a trained Early Childhood Wraparound Coordinator who will contact you within a few days and begin to meet with your family. The Coordinator will discuss the Wraparound process and what to expect. 

What Can I Expect if I Receive Early Childhood Wraparound?

There are 4 parts to the wraparound process. 

  1. HELLO is when the coordinator gets to know you and talks with you about your family’s history,
    A clamshell infographic of the four stages of wraparound, Hello starts on the outside, then going inward there is Help, Healing, and Hope is in the center
    strengths, extended family or other social supports, and the services involved, and helps you create a positive vision for your child and family. If your family has immediate safety needs, the coordinator will work with you on a safety plan to ensure your child is safe and that your home is stable.
  2. During HELP the coordinator will work with you to assemble a team of people who are important to your vision, and you will start meeting regularly. Based on your vision, the team will help you create a plan with specific steps, outlining who will do what, and talk about what it will look like for your family when things get better. You and your team will also create a plan to ensure your child is safe and secure. This can take a few meetings, but being specific about who is doing what is important. 
  3. HEALING is when you and your team members are working on their parts of the plan. You and your team will meet as often as needed to ensure progress or adjust the plan if needed.
  4. HOPE is when you will begin planning to end your involvement in wraparound. You will celebrate with your team and map out who will support you going forward.

Visit the FAST FORWARD page for a more detailed explanation of the 4 parts of wraparound.

It is crucial to involve the child or youth in the wraparound process. Early Childhood Wraparound includes the child by ensuring the caregivers are supported to provide the care their infant or young child needs. The Early Childhood Wraparound Coordinator is trained to focus the family and team efforts on helping the infant or young child, especially when they cannot speak for themselves.

Who Provides Early Childhood Wraparound?

New Hampshire’s 2 Care Management Entities provide Early Childhood Wraparound:

Referral forms are available on the NFI North and Connected Families NH websites.

How to access Early Childhood Wraparound:

Anyone can refer a youth or family to Early Childhood Wraparound. You can apply by contacting an Intake and Eligibility Coordinator at the NH Bureau of Children’s Behavioral Health (BCBH) with an email or call them at 603-271-5075.

Once the referral is received, the Intake and Eligibility Coordinator will schedule a time with you to complete the intake together over the phone or by Zoom/Virtual (takes around 45 to 50 minutes). Once completed, the Eligibility Coordinator will discuss the next steps with you.

Additional Resources:

Learn more:
Stroul, B. et al. (2014). Return on investment in systems of care for children with behavioral health challenges. Washington, DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health.

Clinton, J., Feller, A. F., & Williams, R. C. (2016). The importance of infant mental health. Paediatrics & child health21(5), 239–241. https://doi.org/10.1093/pch/21.5.239

To learn more about infant mental health, visit the Center of Excellence for Infant and Early Childhood Mental Health Consultation