Marji Erickson Warfield - Academia.edu (original) (raw)

Papers by Marji Erickson Warfield

Neuropsychiatry, 2013

Rising autism prevalence rates have lent urgency to e orts to improve outcomes for individuals wi... more Rising autism prevalence rates have lent urgency to e orts to improve outcomes for individuals with autism spectrum disorder (ASD). Stakeholders have focused, in particular, on the transition to adulthood that can occur over a range of ages, typically between 18 and 22 years, and often corresponding to when the youth nishes secondary school. This represents a particularly vulnerable time, as the entitlements of the children's service system end and young adults with ASD and their families encounter fragmented and underfunded systems of care. Research across multiple domains -education, vocational training and employment, social support and community involvement, housing and healthcare -reveals poor outcomes for this population during the transition to adulthood, suggesting that the current models of school-based transition planning are not meeting

Background. Clinicians, scientists, and policy makers are increasingly taking interest in the lon... more Background. Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn.

Journal of Autism and Developmental Disorders, 2015

We conducted in-depth case studies of 10 health care professionals who actively provide primary m... more We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this care. Qualitative data were gathered by phone using a structured interview guide and analyzed using the framework approach. Challenges to providing care were identified at the systems, practice and provider, and education and training levels. Solutions and interventions targeting needed changes at each level were also proposed. The findings have implications for health care reform, medical school and residency training programs, and the development of best practices.

Monographs of the Society for Research in Child Development, 2001

Monographs of the Society for Research in Child Development, 2001

Monographs of the Society for Research in Child Development, 2001

Early Intervention, 2004

... Marji Erickson Warfield, Penny Hauser-Cram, Marty Wyngaarden ... Most studies on the effectiv... more ... Marji Erickson Warfield, Penny Hauser-Cram, Marty Wyngaarden ... Most studies on the effectiveness of early intervention (EI), however, have focused on child outcomes (Bailey, et al., 1998), espe-cially cognitive performance (eg, Dunst and Trivette, 1994). ...

Monographs of The Society for Research in Child Development, 2001

PEDIATRICS, 2005

Background. Clinicians, scientists, and policy makers are increasingly taking interest in the lon... more Background. Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn.

Monographs of the Society for Research in Child Development, 2001

Medical Education, 2001

Objective To assess the interest, perceptions, and needs of primary care physicians with regard t... more Objective To assess the interest, perceptions, and needs of primary care physicians with regard to of®ce-based precepting of medical students.

Maternal and Child Health Journal, 2006

To extend what is known about parent reports of their child's need for sp... more To extend what is known about parent reports of their child's need for specialty medical and related services, unmet need, and specific types of access problems among children with special health care needs (CSHCN). Using data from a 1998-1999 20-state survey of families of CSHCN, we examined differences in parent report of need for services by child characteristics, investigated parent report of unmet need and access problems by service area and number of services needed, and estimated the likelihood of four access problems and unmet need by child, family, and health insurance characteristics. Overall, the sample children had numerous service needs, although the prevalence of need varied by service type and child characteristics. Reports of unmet need were greater for older children and for children with multiple service needs, unstable health care needs or a behavioral health condition, parents who were in poor health or had more than a high school education, and families whose insurance coverage was inconsistent or lacked a secondary plan. Reports of access problems were greatest for mental health and home health services. The two most prevalent access problems were finding a skilled provider and getting enough visits. The results underscore the importance of finding new ways to link children with behavioral health problems to mental health services, implementing coordinated care and the other core dimensions of the medical home concept, increasing the number of specialty pediatricians and home health providers, and expanding coverage for a wider range of mental health services.

Maternal and Child Health Journal, 2012

To investigate the health care experiences of children with autism spectrum disorder, whether the... more To investigate the health care experiences of children with autism spectrum disorder, whether they have unmet needs, and if so, what types, and problems they encounter accessing needed care. We address these issues by identifying four core health care services and access problems related to provider and system characteristics. Using data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) we compared children with autism spectrum disorder with children with special health care needs with other emotional, developmental or behavioral problems (excluding autism spectrum disorder) and with other children with special health care needs. We used weighted logistic regression to examine differences in parent reports of unmet needs for the three different health condition groups. Overall unmet need for each service type among CSHCN ranged from 2.5% for routine preventive care to 15% for mental health services. After controlling for predisposing, enabling and need factors, some differences across health condition groups remained. Families of children with autism spectrum disorder were in fact significantly more at risk for having unmet specialty and therapy care needs. Additionally, families of children with autism spectrum disorder were more likely to report provider lack of skills to treat the child as a barrier in obtaining therapy and mental health services. Disparities in unmet needs for children with autism suggest that organizational features of managed care programs and provider characteristics pose barriers to accessing care.

Journal of Intellectual Disability Research, 2006

Background This study examines the contribution of the marital relationship to the well-being of ... more Background This study examines the contribution of the marital relationship to the well-being of both mothers and fathers of children with developmental disabilities. Parent well-being is conceptualized in terms of mental health, parenting stress and parenting efficacy. Methods These analyses are based on data from  families participating in the Early Intervention Collaborative Study, an ongoing longitudinal investigation of the development of children with disabilities and the adaptation of their families. Multidimensional assessment techniques were used to collect data from married mothers and fathers and their child with a disability. Mother and father data were analysed separately using parallel hierarchical regression models. Results For both mothers and fathers, greater marital quality predicted lower parenting stress and fewer depressive symptoms above and beyond socio-economic status, child characteristics and social support. In relation to parenting efficacy, marital quality added significant unique variance for mothers but not for fathers. For fathers, greater social support predicted increased parenting efficacy. Child behaviour was also a powerful predictor of parental well-being for both mothers and fathers. Conclusion The findings support the importance of the marital relationship to parental well-being and illustrate the value of including fathers in studies of children with developmental disabilities.

Journal of Developmental & Behavioral Pediatrics, 1999

This study documents the extent to which child-related and parenting stress vary during the early... more This study documents the extent to which child-related and parenting stress vary during the early childhood period among mothers of children with developmental disabilities. The degree to which specific aspects of the family environment predict stress levels measured at age 3 years and 5 years, after controlling for child characteristics and family income, is also investigated. The Parenting Stress Index was completed by 79 mothers of children with developmental disabilities at three time points: (1) within 1 month of the child's entry into an early intervention program (T1); (2) within 1 month of the child's third birthday (T3); and (3) within 1 month of the child's fifth birthday (T5). Data on child characteristics and family income as well as measures of the family environment (i.e., negative life events, cohesion, and family support) were gathered at both T1 and T3. Repeated measures analysis of variance was used to assess whether there was significant change in the child-related and parenting stress scores across the three time points. Two sets of hierarchical regression equations were also analyzed. The first examined which child, family, and family environment characteristics assessed at T1 predicted stress at T3. The second identified the predictors of T5 stress based on independent variables measured at T3. Child-related stress increased significantly across the three time points, whereas parenting stress remained fairly stable. By age 5 years, one-third of the mothers had child-related stress scores above the clinical cutoff point. Regression analyses revealed the importance of the family environment in predicting both stress outcomes. The only statistically significant predictor of child-related stress at T3 was family cohesion, whereas parenting stress at T3 was predicted by income, cohesion, and family support. The predictors of both child-related and parenting stress at T5 were the same. Greater family cohesion and fewer negative life events predicted lower stress scores at T5. The significant increase in child-related stress during the early childhood period warrants attention by pediatricians, educators, and other professionals who must evaluate the needs of families of children with disabilities for supportive services. Aspects of the family environment were shown to be critical and consistent determinants of both child-related and parenting stress throughout the early childhood period. This finding suggests that pediatricians, in particular, must assess more than simply the diagnosis or the cognitive impairment of the child with a disability to make informed decisions about the frequency with which they should see particular families and whether referral to other services is necessary.

Journal of Applied Developmental Psychology, 1997

(42 with Down syndrome, 37 with motor impairment, and 36 with developmental delays) were observed... more (42 with Down syndrome, 37 with motor impairment, and 36 with developmental delays) were observed in a total of 115 classrooms. Categories for coding children's behaviors in mastery tasks, social activities with peers, and compliance with teachers were recorded by trained observers, blind to the study hypotheses using a modified time sampling procedure. Composite scores representing

Journal of Applied Developmental Psychology, 1995

This study compares the classroom social and task-mastery behaviors of two groups of 3-year-old c... more This study compares the classroom social and task-mastery behaviors of two groups of 3-year-old children with disabilities (n = 49 with Down syndrome and n = 33 with mild to moderate mental retardation) with two groups of typically developing children (n = 41 at 2 years old and n = 47 at 3 years old). Both samples of children with disobilities demonstrated lower levels of task mastery skills in comparison to typically developing children. The social behaviors of both samples of children with disabilities were more advanced thon the 2-year-old comparison sample but less advanced thon the 3-year-olds. Children with developmental disabilities were more involved in interactions with teachers thon typically developing children. Children with Down syndrome exhibited some differences, especially in social interaction, in comparison to children with other forms of mental retardation.

Mental Retardation, 1997

The congruence between mothers' and teachers' ratings of mastery motivation among... more The congruence between mothers' and teachers' ratings of mastery motivation among 3-year-old children with mental retardation was investigated. The extent to which maternal and teacher ratings of task persistence at entry to preschool are predictive of observed mastery behaviors at age 5 was tested. Results indicate that mothers rated their children's task persistence behaviors higher than did teachers. Further, once the child's cognitive level and teacher ratings were controlled for statistically, maternal ratings of the child's mastery behaviors were predictive of the child's task mastery performance 2 years subsequent. Implications for educational planning were discussed.

Neuropsychiatry, 2013

Rising autism prevalence rates have lent urgency to e orts to improve outcomes for individuals wi... more Rising autism prevalence rates have lent urgency to e orts to improve outcomes for individuals with autism spectrum disorder (ASD). Stakeholders have focused, in particular, on the transition to adulthood that can occur over a range of ages, typically between 18 and 22 years, and often corresponding to when the youth nishes secondary school. This represents a particularly vulnerable time, as the entitlements of the children's service system end and young adults with ASD and their families encounter fragmented and underfunded systems of care. Research across multiple domains -education, vocational training and employment, social support and community involvement, housing and healthcare -reveals poor outcomes for this population during the transition to adulthood, suggesting that the current models of school-based transition planning are not meeting

Background. Clinicians, scientists, and policy makers are increasingly taking interest in the lon... more Background. Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn.

Journal of Autism and Developmental Disorders, 2015

We conducted in-depth case studies of 10 health care professionals who actively provide primary m... more We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this care. Qualitative data were gathered by phone using a structured interview guide and analyzed using the framework approach. Challenges to providing care were identified at the systems, practice and provider, and education and training levels. Solutions and interventions targeting needed changes at each level were also proposed. The findings have implications for health care reform, medical school and residency training programs, and the development of best practices.

Monographs of the Society for Research in Child Development, 2001

Monographs of the Society for Research in Child Development, 2001

Monographs of the Society for Research in Child Development, 2001

Early Intervention, 2004

... Marji Erickson Warfield, Penny Hauser-Cram, Marty Wyngaarden ... Most studies on the effectiv... more ... Marji Erickson Warfield, Penny Hauser-Cram, Marty Wyngaarden ... Most studies on the effectiveness of early intervention (EI), however, have focused on child outcomes (Bailey, et al., 1998), espe-cially cognitive performance (eg, Dunst and Trivette, 1994). ...

Monographs of The Society for Research in Child Development, 2001

PEDIATRICS, 2005

Background. Clinicians, scientists, and policy makers are increasingly taking interest in the lon... more Background. Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn.

Monographs of the Society for Research in Child Development, 2001

Medical Education, 2001

Objective To assess the interest, perceptions, and needs of primary care physicians with regard t... more Objective To assess the interest, perceptions, and needs of primary care physicians with regard to of®ce-based precepting of medical students.

Maternal and Child Health Journal, 2006

To extend what is known about parent reports of their child's need for sp... more To extend what is known about parent reports of their child's need for specialty medical and related services, unmet need, and specific types of access problems among children with special health care needs (CSHCN). Using data from a 1998-1999 20-state survey of families of CSHCN, we examined differences in parent report of need for services by child characteristics, investigated parent report of unmet need and access problems by service area and number of services needed, and estimated the likelihood of four access problems and unmet need by child, family, and health insurance characteristics. Overall, the sample children had numerous service needs, although the prevalence of need varied by service type and child characteristics. Reports of unmet need were greater for older children and for children with multiple service needs, unstable health care needs or a behavioral health condition, parents who were in poor health or had more than a high school education, and families whose insurance coverage was inconsistent or lacked a secondary plan. Reports of access problems were greatest for mental health and home health services. The two most prevalent access problems were finding a skilled provider and getting enough visits. The results underscore the importance of finding new ways to link children with behavioral health problems to mental health services, implementing coordinated care and the other core dimensions of the medical home concept, increasing the number of specialty pediatricians and home health providers, and expanding coverage for a wider range of mental health services.

Maternal and Child Health Journal, 2012

To investigate the health care experiences of children with autism spectrum disorder, whether the... more To investigate the health care experiences of children with autism spectrum disorder, whether they have unmet needs, and if so, what types, and problems they encounter accessing needed care. We address these issues by identifying four core health care services and access problems related to provider and system characteristics. Using data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) we compared children with autism spectrum disorder with children with special health care needs with other emotional, developmental or behavioral problems (excluding autism spectrum disorder) and with other children with special health care needs. We used weighted logistic regression to examine differences in parent reports of unmet needs for the three different health condition groups. Overall unmet need for each service type among CSHCN ranged from 2.5% for routine preventive care to 15% for mental health services. After controlling for predisposing, enabling and need factors, some differences across health condition groups remained. Families of children with autism spectrum disorder were in fact significantly more at risk for having unmet specialty and therapy care needs. Additionally, families of children with autism spectrum disorder were more likely to report provider lack of skills to treat the child as a barrier in obtaining therapy and mental health services. Disparities in unmet needs for children with autism suggest that organizational features of managed care programs and provider characteristics pose barriers to accessing care.

Journal of Intellectual Disability Research, 2006

Background This study examines the contribution of the marital relationship to the well-being of ... more Background This study examines the contribution of the marital relationship to the well-being of both mothers and fathers of children with developmental disabilities. Parent well-being is conceptualized in terms of mental health, parenting stress and parenting efficacy. Methods These analyses are based on data from  families participating in the Early Intervention Collaborative Study, an ongoing longitudinal investigation of the development of children with disabilities and the adaptation of their families. Multidimensional assessment techniques were used to collect data from married mothers and fathers and their child with a disability. Mother and father data were analysed separately using parallel hierarchical regression models. Results For both mothers and fathers, greater marital quality predicted lower parenting stress and fewer depressive symptoms above and beyond socio-economic status, child characteristics and social support. In relation to parenting efficacy, marital quality added significant unique variance for mothers but not for fathers. For fathers, greater social support predicted increased parenting efficacy. Child behaviour was also a powerful predictor of parental well-being for both mothers and fathers. Conclusion The findings support the importance of the marital relationship to parental well-being and illustrate the value of including fathers in studies of children with developmental disabilities.

Journal of Developmental & Behavioral Pediatrics, 1999

This study documents the extent to which child-related and parenting stress vary during the early... more This study documents the extent to which child-related and parenting stress vary during the early childhood period among mothers of children with developmental disabilities. The degree to which specific aspects of the family environment predict stress levels measured at age 3 years and 5 years, after controlling for child characteristics and family income, is also investigated. The Parenting Stress Index was completed by 79 mothers of children with developmental disabilities at three time points: (1) within 1 month of the child's entry into an early intervention program (T1); (2) within 1 month of the child's third birthday (T3); and (3) within 1 month of the child's fifth birthday (T5). Data on child characteristics and family income as well as measures of the family environment (i.e., negative life events, cohesion, and family support) were gathered at both T1 and T3. Repeated measures analysis of variance was used to assess whether there was significant change in the child-related and parenting stress scores across the three time points. Two sets of hierarchical regression equations were also analyzed. The first examined which child, family, and family environment characteristics assessed at T1 predicted stress at T3. The second identified the predictors of T5 stress based on independent variables measured at T3. Child-related stress increased significantly across the three time points, whereas parenting stress remained fairly stable. By age 5 years, one-third of the mothers had child-related stress scores above the clinical cutoff point. Regression analyses revealed the importance of the family environment in predicting both stress outcomes. The only statistically significant predictor of child-related stress at T3 was family cohesion, whereas parenting stress at T3 was predicted by income, cohesion, and family support. The predictors of both child-related and parenting stress at T5 were the same. Greater family cohesion and fewer negative life events predicted lower stress scores at T5. The significant increase in child-related stress during the early childhood period warrants attention by pediatricians, educators, and other professionals who must evaluate the needs of families of children with disabilities for supportive services. Aspects of the family environment were shown to be critical and consistent determinants of both child-related and parenting stress throughout the early childhood period. This finding suggests that pediatricians, in particular, must assess more than simply the diagnosis or the cognitive impairment of the child with a disability to make informed decisions about the frequency with which they should see particular families and whether referral to other services is necessary.

Journal of Applied Developmental Psychology, 1997

(42 with Down syndrome, 37 with motor impairment, and 36 with developmental delays) were observed... more (42 with Down syndrome, 37 with motor impairment, and 36 with developmental delays) were observed in a total of 115 classrooms. Categories for coding children's behaviors in mastery tasks, social activities with peers, and compliance with teachers were recorded by trained observers, blind to the study hypotheses using a modified time sampling procedure. Composite scores representing

Journal of Applied Developmental Psychology, 1995

This study compares the classroom social and task-mastery behaviors of two groups of 3-year-old c... more This study compares the classroom social and task-mastery behaviors of two groups of 3-year-old children with disabilities (n = 49 with Down syndrome and n = 33 with mild to moderate mental retardation) with two groups of typically developing children (n = 41 at 2 years old and n = 47 at 3 years old). Both samples of children with disobilities demonstrated lower levels of task mastery skills in comparison to typically developing children. The social behaviors of both samples of children with disabilities were more advanced thon the 2-year-old comparison sample but less advanced thon the 3-year-olds. Children with developmental disabilities were more involved in interactions with teachers thon typically developing children. Children with Down syndrome exhibited some differences, especially in social interaction, in comparison to children with other forms of mental retardation.

Mental Retardation, 1997

The congruence between mothers' and teachers' ratings of mastery motivation among... more The congruence between mothers' and teachers' ratings of mastery motivation among 3-year-old children with mental retardation was investigated. The extent to which maternal and teacher ratings of task persistence at entry to preschool are predictive of observed mastery behaviors at age 5 was tested. Results indicate that mothers rated their children's task persistence behaviors higher than did teachers. Further, once the child's cognitive level and teacher ratings were controlled for statistically, maternal ratings of the child's mastery behaviors were predictive of the child's task mastery performance 2 years subsequent. Implications for educational planning were discussed.