Pediatric Clinical Neuropsychology

Goals

The Pediatric Clinical Neuropsychology track is an experience in diagnostic Neuropsychology using clinical interviewing and a flexible battery approach. Interns will become competent in the administration, scoring, and interpretation of neuropsychological instruments for the purposes of assisting in differential diagnosis, assessment of treatment effectiveness and treatment planning.

Interns will become comfortable with the consultative role that neuropsychologists play when working with schools, pediatricians, neurologists and neurosurgeons as well as various mental health professionals and other medical professionals.

Placement

Neuropsychology interns work within the Neuropsychology Division of the Department of Behavioral Health. Interns work directly with staff psychologists and have regular interactions with other trainees including practicum students, postdoctoral fellows, and psychiatry residents.

Patients

Referrals for pediatric neuropsychological evaluations are received from neurology, psychiatry, pediatrics and family practice. The pediatric neuropsychology staff also works with the Autism Clinic and receives many referrals from that service. Reasons for referral include diagnostic clarification related to acquired brain injury, pervasive developmental disorders, learning and language disorders, seizure disorders, and neurobehavioral disorders. Pediatric evaluations are focused on differential diagnosis, developmental progress, and recommendations for medical treatment, educational intervention and behavior management.

Theoretical approach

The diagnostic procedures follow a flexible battery approach that is often used for clinical research.

Responsibilities

Interns will be responsible for all aspects of the inpatient/outpatient neuropsychological evaluations conducted (including interview, test administration, report writing, and providing feedback) within the course of the internship year. Typically, the pediatric neuropsychology intern will have 2 neuropsychological testing days per week, in addition to the minors described below. Interns will also be responsible to attend both general psychology didactics and neuropsychology specific didactics as outlined below. The remaining time available is often used for administrative purposes (scoring of files, report writing, and clinical supervision).

Minor rotations

The intern in Pediatric Neuropsychology will complete two minor rotations. Across the internship year, the intern will spend approximately 4 hours per week in direct patient care delivering cognitive rehabilitation treatment for referred children and adolescents. Approximately once per month, the pediatric neuropsychology intern will staff the Center for Autism and Developmental Disabilities clinic along with the staff neuropsychologist. The intern may also have an opportunity to select an additional minor to round out his/her experience, such as general outpatient mental health or select from an adult health psychology rotation (i.e., normal pressure hydrocephalus clinic, trauma surgery, ambulatory internal medicine/primary care, transplant surgery, bariatric surgery, sleep medicine, anesthesia pain, general oncology, and ENT oncology).

Supervision

Interns work directly with our staff pediatric neuropsychologists for individual supervision. Each testing is reviewed by the staff member in detail. Staff takes a developmental approach to supervision, making supervision more intensive at the beginning of the year. There is a minimum of 2 hours of weekly individual supervision. Interns have the opportunity for interdisciplinary experiences by working with psychiatric and other residents who rotate through the neuropsychology service as a part of their training, as well as their once monthly work in the Autism Clinic. Interns from all tracks also participate in a one-hour, weekly group supervision with the Director of the Psychology Internship Program. Interns will rotate presenting a case paired with a question or topic for discussion for the group.

Didactics

Core neuropsychology didactics consist of a lecture series, 12-week neuroanatomy course taught by one of the staff neuropsychologists, and a weekly practical seminar for the last two-thirds of the year (case conferences, fact findings, trainee presentations). A general psychology internship didactic curriculum is also attended once weekly. Additionally, interns will be able to attend the Department of Neurology’s neuroscience/grand round lecture series and brain cutting as schedules permit.

Outcome/evaluation

The Pediatric Neuropsychology intern will be evaluated in a number of ways. Primarily, outcome is evaluated on clinical progress via individual supervision. Additionally, one of the staff neuropsychologists will review progress more formally with each intern on a quarterly basis. Interns will also be responsible for a topical presentation during our practical seminar series. Interns are also required to present at our case conference and participate in fact-finding examinations, though interns are not formally evaluated regarding internship progress on these examinations as they are intended to introduce the intern to ABPP examination procedures in clinical neuropsychology. Finally, interns will participate in a final oral outcome evaluation, during which they will present a case to two neuropsychologists in an examination meant to model after the case presentation aspect of the ABPP oral examination in clinical neuropsychology.