The Child Psychology/Pediatric Neuropsychology Track is oriented towards the intern seeking to specialize in the assessment and treatment of neurodevelopmental disorders and the cognitive and behavioral sequelae of medical illness in children and adolescents. Through completion of rotations that emphasize consultation to pediatric health services, professional practice and research in pediatric neuropsychology, and the development of expertise in working with complex neurodevelopmental conditions, the intern will be prepared for advanced postdoctoral training in Pediatric Neuropsychology, Child Psychology, and/or Pediatric Psychology.
The Child Psychology/Pediatric Neuropsychology intern will have the opportunity to develop and refine clinical skills with both inpatients, as part of a consultation-liaison rotation, and outpatients, through rotations within Child Psychiatry and its specialty clinics, and through a rotation with the Developmental and Behavioral Pediatrics section. The intern also has the opportunity to become a LEND (Leadership Education in Neurodevelopmental Disorders) interdisciplinary fellow, as part of their training in collaborative clinical practice and research.
Patients assessed and treated by the intern may or may not present with primary psychopathology; some cases will be more medically based, with co-occurring psychosocial or educational concerns. Typically, patients will range in age from early childhood through late adolescence, and represent diverse cultural and ethnic backgrounds. Opportunities for psychological and neuropsychological assessment exist across the rotations. Intervention approaches will emphasize interpersonal, family systems, behavioral, and cognitive-behavioral therapies.
The intern will complete two required rotations over the course of the year, including Pediatric Neuropsychology and Pediatric Psychosocial Consultation-Liaison. The other two rotations may be selected from among the variety of opportunities that exist within Child & Adolescent Psychiatry, Adult Psychiatry, or the broader medical center (for example, a previous intern selected to complete a rotation with the International Adoption Evaluation Program, a joint clinical service between the Sections of Developmental and Behavioral Pediatrics and Pediatric Infectious Disease). Additionally, the intern will carry a caseload of outpatient psychotherapy patients; these cases will be varied, and may concern both internalizing and externalizing difficulties, as well as issues of adjustment to medical and psychiatric illness. Interns will be primarily supervised by child psychology faculty, with additional supervision provided by child psychiatrists within the Department.
The Child Psychology/Pediatric Neuropsychology intern participates in weekly interdisciplinary clinical case conference, where patients are discussed from the perspective of psychiatry, psychology, and other specialties involved in the treatment of the child. Additional didactics include a series of child mental health seminars, held at the beginning of the academic year; a seminar on Cognitive-Behavioral Therapy with Children and Adolescents; and attendance at the relevant clinic-based seminars throughout the year (i.e., the Pediatric Clinical Neuroscience Seminar or the Eating Disorders Seminar); in addition to departmental grand rounds and colloquia.
Available Rotations include:
Pediatric Neuropsychology Rotation
The Pediatric Neuropsychology Rotation offers training in conducting brief and comprehensive evaluations of children and adolescents with suspected or known neurocognitive dysfunction. Referrals are received from inpatient and outpatient pediatrics services, including Psychiatry, Neurosurgery, Oncology, Neurology, Infectious Disease, Rheumatology, and General Pediatrics, and from schools and professionals across the Chicagoland community. The intern will learn to address referral questions through guidance in test selection, administration, and interpretation. Experience in the communication of results, diagnosis, and recommendations for intervention to families and other professionals is also obtained. In terms of collaboration with the medical and psychiatry services, experience in differential diagnosis, comprehensive assessment of comorbid concerns, and the use of appropriate pharmacological and behavioral interventions is provided. Additionally, collaboration with school districts and outside agencies around intervention programming is an opportunity included on this rotation. This rotation is directed by Dr. Scott Hunter and additional supervision will be provided by Dr. Megan Scott.
Neurodevelopmental disorders rotation
The Neurodevelopmental Disorders Rotation offers specialized training in the assessment of autism spectrum disorders (ASD) as well as neuropsychological evaluation of children and adolescents with other neurodevelopmental and genetic disorders. This is a multidisciplinary evaluation and consultation clinic in which patients are evaluated by team members from subspecialties including Psychiatry, Developmental and Behavioral Pediatrics, and Pediatric Neuropsychology. The intern will learn to interview families around important developmental milestones and key symptoms in ASD. Interns will have the opportunity to observe and gain clinical training in the administration and interpretation of the Autism Diagnostic Observation Schedule-2. Given the broad range of behavioral and cognitive presentation of patients in this clinic, interns will receive guidance in behavior management strategies to utilize during test session. The intern will gain experience in test selection, administration, interpretation of evaluation results, as well as providing feedback to families and other professionals regarding diagnostic impressions and recommendations. Given the multidisciplinary nature of this clinic, interns have the opportunity to participate in initial diagnostic evaluations conducted by psychiatry fellows as well as sit in on ongoing follow-up and medication management visits. The intern will attend weekly neuropsychology didactics as well as weekly case conference in ND Clinic while on this rotation. Dr. Megan Scott. directs this rotation in collaboration with Dr. Sharon Hirsch. Additionally, as noted earlier, the intern can participate in the LEND fellowship program, a joint teaching program between the University of Chicago and the University of Illinois at Chicago’s Institute on Disability and Human Development (UIC IDHD). This program is funded in part by the Maternal and Child Health Branch of the National Institutes of Health (NIH).
Pediatric Psychosocial Consultation-Liaison Service
The Pediatric Psychosocial Consultation-Liaison Rotation provides the intern with opportunities to participate actively in the assessment and intervention of psychological concerns that accompany medical illness and treatments. Both inpatient and outpatient experiences will be available with this rotation, with an emphasis placed on assessment, diagnosis, consultation, and brief intervention. The intern will attend weekly Consultation-Liaison Rounds while on this rotation. Dr. Tina Drossos directs this rotation, in collaboration with Dr. Khalid Afzal
Kovler Diabetes Center Rotation
The Kovler Diabetes Center Rotation focuses on providing health and wellness psychological screening for patients with diabetes. Interns in this rotation will have the opportunity to work in a multi-disciplinary (endocrinologists, diabetes educators, residents, medical students, nurses) clinic setting within which they are embedded. They will work collaboratively with endocrinologists and receive referrals to see patients (children through adults with Type I and Type II diabetes) during their endocrinology clinic visit. Interns then conduct a brief psychological screening for the purpose of identification of any mental health problems that may need further psychological assessment, and helping patients identify potential problems and assisting them with appropriate recommendations and referrals. Interns are expected to provide the endocrinologists with verbal feedback after screening a patient as well as complete a brief written report. There is also an opportunity to provide very brief psychological treatment for patients. This treatment is time-limited for 3-4 sessions in clinic and for very specific problems (i.e. behavioral activation for depression, relaxation for anxiety, exposure for anxiety or specific phobia, psychoeducation). Patients may still need to be referred after these brief sessions. Interns in this rotation will also be required to attend and present at 2-3 multi-disciplinary case presentations throughout the year. This rotation is directed by Dr. Tina Drossos.
MALS Clinic Rotation
The MALS Clinic Rotation involves conducting presurgical evaluations. Median Arcuate Ligament Syndrome (MALS) is a condition that is thought to arise from an increased proximity of the diaphragmatic crura to the celiac vessels. Individuals with MALS often demonstrate post-prandial abdominal pain, nausea, and diarrhea. These symptoms can become chronic and may lead to significant weight loss. Treatment of MALS involves the surgical release of the median arcuate ligament. To our knowledge, our medical center is the only hospital in the country that employs a multidisciplinary treatment approach for this population that includes pre and post-surgical psychological evaluations. The intern working with the MALS team will be responsible for weekly assessments of adolescent and adult candidates for Median Arcuate Ligament Syndrome surgery This 1.5 hour evaluation will consistent of a psychosocial interview, including questions related to quality of life and coping strategies as well as an assessment of DSM-IV diagnoses (e.g. depression, anxiety, eating disorders), and questionnaires. Interns will also complete weekly follow-up assessments each of approximately 30 minutes duration. This assessment is also part of an IRB approved protocol and thus, there are research opportunities available to interested trainees. Interns will be required to write up reports summarizing these assessments and present cases at bi-weekly multi-disciplinary rounds with the surgical team (surgeons, nurse practitioners, pain service and psychology). In order to be eligible to participate in this rotation, interns must be available on Tuesday mornings. Dr. Tina Drossos is also the supervisor for this rotation.
Adolescent Eating Disorders
The Adolescent Eating Disorders Rotation offers specialized training in the assessment and treatment of Anorexia and Bulimia Nervosa, binge eating disorder, Feeding and Eating Disorders Not Otherwise Classified and obesity. Treatment modalities utilized in this clinic include cognitive behavioral therapy (individual and group), family based therapy for the eating disorders, and psychological and/or surgical treatment for obesity. The intern will work collaboratively with the treatment team and attend weekly didactics. Drs. Daniel le Grange and Andrea Goldschmidt provide primary supervision and training for this rotation.
Parent-Child Interaction Therapy (PCIT) Clinic
Parent-Child Interaction Therapy (PCIT) Clinic offers training in one of the most effective treatments known for children with primary or secondary disruptive behavior problems between the ages of 2 and 6 years. Via video observation and Bluetooth device, PCIT provides caregivers real-time coaching on changing negative caregiver-child patterns by improving the relationship between caregivers and their children, and establishing and maintaining consistent discipline practices. This rotation includes a didactic series on the founding theories of PCIT (attachment, behavior, and social learning theories), as well as basic play therapy skills and parent training skills. Interns also learn the structured behavioral coding system for parent-child interactions used during diagnostic evaluations and weekly sessions. Following the didactic series, interns conduct PCIT with families while receiving a combination of live supervision, group supervision, and individual supervision. PCIT core competencies in child-directed skills, parent-directed skills, coding reliabilities, “coaching” skills, and basic clinical skills are assessed throughout the rotation. Opportunities for clinical supervision of externs, consultation with other providers, and presentations may be available. Dr. Christina Warner-Metzger, PCIT International Certified Master Trainer, provides primary supervision and training for this rotation.
The Pediatric Sleep Disorders Clinic is directed by Dr. Lisa Medalie. This rotation will include assessment and treatment of patients with Behavioral Insomnia of Childhood and other behaviorally related sleep disorders such as Circadian Rhythm Disorder, Inadequate Sleep Hygiene and Poor CPAP Adherence. Interns will become familiar with interpretation of sleep logs and actigraphy. They will become proficient at providing behavioral treatment for pediatric insomnia and poor CPAP adherence, consulting to medical professionals whose patients have sleep disorders, participating in multidisciplinary clinics and providing referrals as necessary.
A Research Rotation within the Pediatric Neuropsychology program is an available option for the internship year. The Pediatric Neuropsychology Service is actively engaged in a series of collaborative clinical studies addressing neurocognitive and behavioral development and functioning in children and adolescents undergoing interventions for intractable epilepsy, childhood cancers, and HIV/AIDS, and in understanding the relationship between executive function development and risk in youth who are homeless. Additionally, studies addressing the efficacy of pharmacological interventions for learning and attentional difficulties associated with Neurofibromatosis and complex partial epilepsy are underway. The intern can work on already established projects, or alternatively, develop a specific question concerning patient populations evaluated by the Pediatric Neuropsychology Service, in conjunction with Dr. Scott Hunter. Data analysis, presentation preparation, and manuscript writing are all opportunities available as part of this rotation.
At the end of the internship year, the intern completing the Child Psychology/Pediatric Neuropsychology Track will have mastered the following specific competencies:
Be able to make use of a broad repertoire of evidence-based assessment and intervention skills suitable for improving the functioning of youngsters and adolescents with developmental, psychiatric, and medical disorders.
Effectively assess and then diagnose complex neurodevelopmental and psychological disorders, and share this information with a multidisciplinary team and the child’s family.
Identify and implement empirically supported interventions for internalizing and externalizing difficulties in children, both outpatients, and inpatients seen on the Consultation-Liaison service rotation.
Effectively collaborate with school, families, and other professionals concerning appropriate strategies for learning and behavioral development.
Apply an understanding of psychological principles to the treatment of youngsters with medically based disorders, to promote effective adjustment and reintegration to daily life.