Currently, for the 2020-2021 training year, our internship is recruiting for five interns, including three in the Special Health Needs Track, and one in each the Autism and Neuropsychology Track positions. While differences exist regarding the specific activities based on track, each provides opportunities to refine assessment, intervention, and consultation skills with children with special health care needs and their families. Each track ensures experiences that foster the opportunity to develop intermediate to advanced knowledge, skills, and competencies aligned with the program's overarching aim. Note that the primary difference across tracks is in the Major Rotations. These, described below, comprise one full day per week of clinical training (with writing and prep, ~25% of weekly time). The remainder of the training experience varies very little across tracks.
Three interns participate in this track, which emphasizes training experiences with the broadest spectrum of youth with special health care needs. It is ideal for interns who are interested in specializing in pediatric/child psychology yet desire diverse experiences in terms of types of patients seen and clinical care offered. Interns completing this track participate in three four-month rotations.
LEND Assessment Clinic
This rotation involves intensive and interdisciplinary evaluations of children with a variety of special needs. Referral questions often include cognitive delays, academic concerns, behavioral difficulties, emotional problems, social concerns, speech delays, poor motor skills, and medical disorders. Psychology interns, along with their supervisor, conduct in depth assessments and parent/child interviews, and collaborate with other professionals in a fast-paced clinical setting. As many as eight disciplines may be involved in the one-day clinic. Interns also serve as case coordinator, chair staff meetings, and conduct parent conferences/feedback sessions. Staffing and parent conferences conclude the day and the entire process is completed within six to eight hours. The intern typically completes one or two assessments during the clinic, which occurs one day a week. Follow-up activities may occur outside of the clinic day.
Interns participate in one or several pediatric clinics serving children with complex and/or chronic medical conditions. Training most often occurs through the Diabetes Center, which is a lifespan, multidisciplinary center designed to provide coordinated, state-of-the-art care to individuals with diabetes (participation in the Diabetes Clinic is preferred and emphasizes pediatric patients). Other possibilities of training context may be negotiated, including through the Survivor's Clinic, an interdisciplinary long-term follow-up clinic for youth who have survived cancer;Hemophilia Clinic, a multidisciplinary program offering care and coordination for individuals with hemophilia and other bleeding disorders;and Healthy Lifestyles clinic, a multidisciplinary evaluation and education clinic for youth who are overweight or obese. Interns, along with their supervisor, provide services including assessment of psychosocial status, consultation with medical and other allied health professionals, and/or on-going assistance to youth and their families.
Focus of services is on well-being of the youth and optimizing individual and family functioning. Ongoing services may emphasize issues such as adjusting to having a chronic medical condition, incorporating prescribed medical regimen into day-to-day life, and addressing psychosocial issues related to one's chronic medical condition. Note that this major rotation typically is paired with the Inpatient Consultation minor rotation. As such, interns are able to collaboratively decide whether they wish to devote increased time to inpatient or outpatient pediatric psychology training activities.
Interns participate in a full day of "psychology only" assessment including one comprehensive assessment and possibly an additional appointment for a diagnostic interview or feedback session. Children are typically referred to evaluate questions of ADHD, learning disability, developmental disability, and/or mental health or behavioral concerns. Most of these patients receive a cognitive and achievement (academic) evaluation as well as an evaluation of behavioral and emotional functioning. However, this clinic is arranged to provide many types of psychological assessment based on the individual's needs and may include measures of memory, executive function and attention-specific measures. Goals of this rotation include promoting increased skills and independence with choosing appropriate assessment measures based on specific referral questions, expanding the number and types of assessment measures familiar to a trainee, diagnostic interviewing and providing feedback to families, making appropriate diagnoses and recommendations, and writing professional reports. Trainees also are encouraged to learn about and participate in administrative aspects of evaluation including working with scheduling coordinator, school teachers, and referring providers, and billing issues. Because child psychology evaluations are a common part of practice for independent practitioners, this rotation is designed to refine existing evaluation skills so that interns leave prepared to complete comprehensive psychological evaluations independently.
This track emphasizes training in care for individuals with, or suspected of having, Autism Spectrum Disorder (ASD). The intern completing this track completes a one day per week major rotation over the entire year, which emphasizes evidence-based interdisciplinary diagnostic evaluation (including differential diagnosis). While the focus is on youth referred for a question of ASD, the intern's experiences ensure proficiency in differential diagnosis, effective team-based care, and intervention that translate across special health care conditions. Minor rotations will afford opportunities for more diverse clinical training. The Autism Track is particularly well-suited for interns who have either (a) a very strong background in ASD and would like to maintain a foothold in that domain while diversifying their training most of the week or (b) some experience with ASD evaluation who would like to enhance their skills in this domain while maintaining broad-based training in health care psychology.
As part of the Autism Program, five age-grouped diagnostic clinics serve children one year of age through adult suspected of having Autism Spectrum Disorder (ASD) or related conditions. Interdisciplinary evaluations include psychology, developmental pediatrics and/or psychiatry, occupational therapy, audiology and speech and language pathology. The primary focus of evaluation is the differential diagnosis of ASD and co-morbid conditions within the context of family-friendly treatment planning. Trainees learn autism-specific (e.g., Autism Diagnostic Observation Schedule), developmental (e.g., Mullen Scales of Early Learning), intellectual and nonverbal assessment tools, as well as rating scales to assess adaptive skills, mood/anxiety, executive functioning, etc.
This track emphasizes neuropsychological evaluation with children with a variety of special health care needs. Patients include youth with known or suspected congenital or acquired brain insults and/or abnormalities. The intern completing this track completes a one day per week major rotation over the course of the year that emphasizes development and mastery of in depth neuropsychological assessment to help patients, families, and other providers (e.g., physicians) better understand neurocognitive status of pediatric patients. Minor rotations will afford opportunities for more diverse clinical training.
The Division of Psychology neuropsychological service emphasizes initial neuropsychological assessment and follow-up of children with known neurological conditions (e.g., epilepsy, spina bifida), acquired neurological insult (e.g., traumatic brain injury) and high risk for insult (e.g., those experiencing treatment for cancer). In depth neuropsychological evaluations are completed outpatient. Brief screening occurs through both outpatient and inpatient care. Further, interns develop comprehensive, yet practical, recommendations for intervention, and communicate those to other hospital professionals and families of patients seen.
Approximately 6 months of clinical training emphasizes neuropsychological evaluations with patients with known or suspected traumatic brain injury. The other 6 months emphasizes evaluations with patients with current or former treatment for cancer.