Track 1: Pediatric Neuropsychology- Neurology
(Match Number 8121)
This track provides general training in pediatric neuropsychology with a focus on neurologic/genetic populations. Under supervision, the resident will complete two outpatient evaluations per week. The resident will also accompany a faculty member to a half-day, multidisciplinary clinic each week with the goal of developing brief interview and consultation skills. While the resident will see a wide range of referrals over the course of the 2 years, the program is structured to provide more focused experiences during specific 6-month rotations. During each rotation, the resident will receive more referrals with children with those specific diagnoses and will be supervised by faculty with particular expertise in that area. They will also attend multidisciplinary clinics appropriate to those rotations.
Rotations and descriptions are as follows:
Genetics Clinic: During this rotation, the resident will complete outpatient evaluations through the Division of Neurology with children with a variety of genetic and metabolic disorders, including neurofibromatosis, PKU, 22q deletion syndrome, and XY chromosome variations. The resident will also participate in interdisciplinary clinics for children with tuberous sclerosis, neurofibromatosis, Turner syndrome, and 22q11.2 deletion syndrome and provide consultation to medical teams.
Stroke Clinic: Residents will participate in comprehensive neuropsychological evaluations of patients who have experienced a variety of different types of strokes (e.g., ischemic, hemorrhagic, or cerebral sinus venous thrombosis). Patients are seen acutely or for long-term follow-up.
General Rotation: Residents will complete comprehensive neuropsychological evaluations with patients presenting with a variety of different medical disorders (e.g., neuroimmunological disorders, epilepsy, oncology, metabolic diseases, genetic disorders, etc.).
Rehabilitation: During the 6-month rehabilitation rotation, the Neurology resident’s primary training experiences will be a combination of comprehensive outpatient evaluations and neuropsychological consultation for children and teenagers with mild TBI through the multidisciplinary concussion clinic. The general outpatient evaluations will focus on a variety of rehabilitation conditions (e.g., moderate/severe TBI, anoxic/hypoxic injuries, encephalitis, spina bifida, cerebral palsy). The concussion clinic experience will focus on learning an abbreviated assessment model to evaluate postconcussive difficulties and guide treatment planning, as well as working with physicians and community providers regarding return to play and school management decisions. The resident will learn the natural clinical course of mild TBI, the various issues that can complicate recovery, and the role of performance/symptom validity testing in mild TBI evaluations. The resident will also have an opportunity to work on the hospital’s Neurotrauma/Rehabilitation Inpatient Unit and be involved in two developmentally-focused specialty clinics: International Adoption Clinic (IAC) and Non-Accidental Brain Injury Care Clinic (NABICC).
Epilepsy: The resident’s focus will be on assessing children with epilepsy. This includes pre- and post-surgical evaluations, evaluations of children with epilepsy who are not surgical candidates, and possible participation in fMRI preparation, Wada testing, and language mapping. The resident will attend weekly epilepsy clinics and participate in neurobehavioral assessment of children and families on the Epilepsy Monitoring Unit. Residents will attend Epilepsy Conference to gain experience in providing physicians information to assist with their treatment decisions and exposure to the various modalities and issues that are considered during surgical decision making. The use of focused, specific assessment to answer discrete clinical questions is emphasized.
Neuro-Oncology: The resident will have the opportunity to assess children with hematologic/oncologic disorders, including brain tumors and leukemia. The resident will also conduct pre- and post-bone marrow transplant evaluations. In addition, the resident will have the opportunity to attend multidisciplinary clinics for newly diagnosed and long-term survivors.
Cardiology: Residents will have the opportunity to complete neuropsychological evaluations with children with various complex congenital heart conditions and/or heart transplantation. In addition, multidisciplinary clinic experience may be provided, including consultation with families of children with single ventricle post-Fontan, and/or developmental assessment of infants and toddlers with complex heart conditions.
Resident’s choice: During this rotation in the final 6 months of the fellowship, the resident is encouraged to select an area of specialty to gain additional clinical experiences.
Track 2: Pediatric Neuropsychology- Rehabilitation
(Match Number 8122)
This track provides general training in pediatric neuropsychology with an emphasis on rehabilitation-relevant populations and conditions, including mild TBI/concussion, moderate/severe TBI, anoxic/hypoxic injuries, encephalitis, spina bifida, and cerebral palsy. Under supervision, the resident will complete approximately 2-4 comprehensive outpatient neuropsychological evaluations per month. In addition to these experiences, the resident will participate in 3 different rehabilitation rotations. These rotations will include more intensive focus on specific patient populations. The resident will gain experience working with abbreviated assessment models and will have the opportunity to work on outpatient and inpatient multidisciplinary clinics and teams.
Rotations and descriptions are as follows:
Mild TBI / Concussion Clinic: The resident will participate in a comprehensive multidisciplinary concussion clinic providing neuropsychological consultation to children and teenagers with mild TBI, ranging from sport-related concussion to complicated mild TBI. The program sees over 1,000 new patients each year. The resident will learn and utilize an abbreviated assessment model to evaluate postconcussive difficulties and guide treatment planning, as well as work with physicians and community providers regarding return to play decisions and school management. The resident will become expert in pediatric mild TBI and sport-related concussion by learning the natural clinical course of mild TBI, its risks, the various factors that can complicate recovery, the role of performance/symptom validity testing in mild TBI evaluations, and empirically sensible management strategies. Concussion-relevant didactics and experiences include: monthly complex concussion case study meetings and bi-monthly concussion seminars, as well as co-presentation opportunities to schools and community providers.
Neurology Rotation: During the 6-month rotation in Neurology, the resident will complete 2 evaluations per week with children and adolescents with a variety of neurologic and genetic disorders, including epilepsy, Neurofibromatosis Type 1, tuberous sclerosis, stroke, leukemia, multiple sclerosis and brain tumors. The resident will also have the opportunity to attend multi-disciplinary clinics with a faculty member. Possible clinics include NF Clinic, Tuberous Sclerosis Clinic, Stroke Clinic, Epilepsy Clinics, and clinics through hematology/oncology. Attendance at neuroradiology and epilepsy conferences, as well as Neurology Grand Rounds, and Pediatric Neurology Journal club is encouraged.
Developmental Specialty Clinics: The resident will participate in two specialty clinics that focus on younger patient populations (i.e., under 5 years) to allow for the acquisition or refinement of knowledge and skills particularly relevant to preschool and infant/toddler assessment. The International Adoption Clinic (IAC) is a multidisciplinary clinic focused on the medical, developmental, and emotional/behavioral assessment of children recently adopted internationally. Children range in age from birth to 18 years of age but are primarily preschool-aged or younger. The resident will perform formal cognitive assessment, informal assessment of language development, and consultation around emotional and behavioral challenges often faced by these children. The Non-Accidental Brain Injury Care Clinic (NABICC) is a large, multidisciplinary, outpatient clinic focused on the care of young children after non-accidental brain trauma. Children are followed in the clinic on a regular basis for two years after sustaining injury. The resident will perform cognitive assessment and provide consultation around psychosocial concerns.
Inpatient Neurotrauma/Rehabilitation Unit: The resident will participate in the hospital’s multidisciplinary inpatient neurotrauma/rehabilitation unit for children recovering from a variety of acquired injuries and illnesses including moderate/severe TBI, spinal cord injury, anoxic/hypoxic brain injuries, encephalitis, cardiac conditions, stroke, tumor resections, epilepsy surgery, and other neurological and neuromuscular disorders. Resident responsibilities on the inpatient unit would include acute and serial assessment of cognitive status, abbreviated neuropsychological evaluations, psychoeducation to patients and families, and treatment planning, as well as follow-up consultation with service providers, families, and school teams. The resident also would be regularly involved in the multidisciplinary team meetings, cognitive-focused groups, and family treatment meetings.