Psychology Education and Training Program

Core Training Area I: Assessment

Center for Management of ADHD

An interdisciplinary team accepts referrals for children 3 to 18 years of age. Children presenting with attentional dysfunctions, excessive motor activity, impulsivity and other comorbidities receive priority. The interdisciplinary team consists of a pediatric psychologist, developmental pediatrician, and child and adolescent psychiatrist. Modes of supervision include individual and small group supervision and direct observation of clinical practice.

Differential diagnosis is predicated upon review of previous medical records, structured interview with caregiver(s), direct observation of child behavior, curriculum-based assessment and interpretation of child, caregiver and teacher-derived measures.

Training objectives

• To understand ADHD and associated learning and behavioral disorders
• To learn a set of procedures for assessing ADHD, academic skill deficits and internalizing as well as externalizing behavioral disorders
• To collaborate in developing applied research projects related to ADHD and school problems
• To develop skills in diagnostic and behavioral assessment, school consultation, and interdisciplinary team process.

Autism Spectrum Disorders (ASDs) School Age

This rotation provides the opportunity to evaluate school-age children for possible autism spectrum disorders (ASDs). Children are participants in a research projects, and receive a diagnostic and psychological evaluation as part of their participation. Most of the children are not intellectually impaired, and in many cases this is the child’s first comprehensive diagnostic evaluation. Approximately 20 percent of children referred for studies do not end up meeting research criteria for an ASD. The majority of participants (with or without ASD) have a comorbid diagnosis (most frequently an anxiety disorder, ADHD, or Intellectual Disability). Thus, the intern will receive experience with complex differential diagnosis. In addition, interns may have the occasion to evaluate a typically developing control, which provides a good opportunity to compare performance in children from clinical and nonclinical populations.

Training objectives

• Administer IQ, adaptive, behavioral questionnaires, and sometimes language or achievement testing included in the research protocol.
• Observe and ultimately administer or co-administer the ADOS and/or ADI-R depending on prior training and experience.
• Develop recommendations for additional assessment and intervention.
• Provide written and oral feedback to families.

Paperwork expectations

The intern will take increasing responsibility for writing the comprehensive report, completed within one week of the evaluation. The Center for Autism Research (CAR) actively seeks opportunities to practice writing concise reports that are amenable to a sustainable clinical practice. The intern will also ensure data collected is reliable and valid for use in study analyses.

Autism Spectrum Disorders Young Child Rotation

This rotation provides the opportunity to evaluate young children (6 months – 6 years) for possible autism spectrum disorders (ASDs). Children are participants in a research projects, and receive developmental and/or diagnostic evaluations as part of their participation. In most cases this is the child’s first comprehensive diagnostic evaluation. Approximately 20 percent of children referred for studies do not end up meeting research criteria for an ASD. In addition, interns may have the occasion to evaluate a typically developing control, which provides a good opportunity to compare performance in children from clinical and nonclinical populations.

Training objectives

• Administer IQ, adaptive, behavioral questionnaires included in the research protocol.
• Observe and ultimately administer or co-administer the ADOS and/or ADI-R depending on prior training and experience.
• Develop recommendations for additional assessment and intervention.
• Provide written and oral feedback to families.

Paperwork expectation

The intern will take increasing responsibility for writing the comprehensive report, completed within one week of the evaluation. CAR actively seeks opportunities to practice writing concise reports that are amenable to a sustainable clinical practice. The intern will also ensure data collected is reliable and valid for use in study analyses.

Neonatal Follow-up Program

The training goal of this program is to provide direct practice opportunities with an interdisciplinary team in the assessment of medically high-risk infants and preschoolers. Team members include a pediatrician, nurse practitioner, social worker, physical therapist and program coordinator, in addition to a psychologist. Most children have repeated assessments from infancy to school age.

Training objectives

• To achieve a better understanding of the relationships between prenatal, perinatal and postnatal complications and later neurodevelopmental outcome
• To learn the administration of standardized instruments, parent interview and behavioral and play observations
• To develop the ability to interpret findings in the context of medical history
• To work with families to understand their needs
• To make recommendations for intervention
• To effectively communicate developmental findings

Children are typically referred at the time of discharge from the Newborn/Infant Center (N/IC) or at later ages from other neonatal intensive care units. Some children have disabilities including mental retardation, cerebral palsy, sensory deficits, learning disabilities, pervasive developmental disorder and other developmental difficulties. Our population also includes children who, despite high-risk histories, have normal developmental outcome.

Neuropsychology Service

This training module offers direct experience with the clinical provision of neuropsychological services to children and adolescents in a medical setting. Through core and elective rotations, the opportunity exists to obtain training consistent with Houston guidelines. During the course of this training you will gradually assume increasing responsibility for clinical services, with the support of individual weekly supervision. Your didactic opportunities will include a weekly multidisciplinary Clinical Neuroscience Seminar, weekly Clinical Case Conference, and opportunity to attend other relevant didactics including Neurology Grand Rounds, Neuroradiology Grand Rounds, and Brain Cuttings.

Training objectives

• To obtain a better understanding of brain-behavior relationships within a developmental context
• To apply assessment and intervention principles based on the study of human behavior as they relate to the normal and abnormal functioning of the central nervous system
• For those specializing in other areas of professional psychology, to become an informed consumer of neuropsychological services
• For those planning to pursue post-doctoral training and eventual practice as a neurophysiologist, to extend specialty preparation in the science and professional practice of neuropsychological

You will have opportunities to become familiar with:

• Common referral issues in a hospital-based practice and how they are reflected in typical referral questions
• Clinical populations regularly seen for neuropsychological services, including children referred with: congenital central nervous system anomalies or conditions /treatments associated with an adverse effect on central nervous system functioning (e.g., epilepsy, including candidates for epilepsy surgery; genetic/metabolic disorders; neuro-oncology and oncology; neurofibromatosis, traumatic brain injury, spina bifida, stroke)
• A developmentally appropriate range of assessment instruments and techniques, interpretation of findings, case conceptualization from a neuropsychological perspective, and the communication of findings and recommendations to patients, families, other healthcare providers, treatment teams, and educational professionals report writing, documentation, and professional issues in the clinical practice of neuropsychology

Oncology

The Division of Oncology is a large children’s cancer treatment center, which sees over 300 new patients annually. The Perelman Pediatric Oncology Unit consists of 40 beds, including a wing dedicated to bone marrow/stem cell transplants. Approximately 40 attending physicians are housed in the Division of Oncology and the psychosocial services team consists of six licensed psychologists, several psychology post-doctoral fellows, six social workers and three child-life specialists. Interns participating in the Oncology Assessment rotation will complete cognitive assessments of patients across a broad age range (infant through early adulthood). These patients may be currently on treatment or cancer survivors. Assessments will include intake meetings with families; test selection, administration, interpretation and writing up of results; and feedback with parents and medical team.

Training objectives

• Develop consultation skills as the psychosocial member of an interdisciplinary team providing care to oncology patients and their families.
• Learn to conduct and interpret developmentally appropriate psychological assessments related to neurotoxic effects of chemotherapy and radiation, with regard to short- and long-term impact on learning and school achievement.

Interns are expected to attend patient care meetings and didactics within the Division of Oncology, including Psychosocial Rounds, Journal Club and Tumor Board. Specific training objectives of the rotation will be tailored to each intern’s training needs, goals and objectives.

Psychological/Psycho-Educational Assessment

Designed as rotation to build skill and experience with psychological and psycho-educational assessment.

• Opportunity for psychological/psycho-educational assessment of patients with complex medical needs. Interns will build competence in assessment, with a focus on the assessment of intelligence, academic achievement, adaptive functioning and emotions/behavior.
• Interns will gain experience with the clinical skills of case conceptualization, evaluation/testing, scoring, interpretation, diagnosis, report preparation and provision of feedback to patients, families and healthcare providers.
• Opportunities for taking increasing responsibility for report writing and conducting interpretive feedback sessions and clinical interviews as part of neuropsychological assessment.
• Intern will gain exposure to the practice of pediatric neuropsychology.