Site: Rhode Island Hospital (up to 1 day per week during second year)
Supervisor(s): Christine L. Trask, Ph.D., ABPP
Description of Sites
Memorial Hospital of Rhode Island (MHRI)is a not-for-profit health, teaching and research center. Our teaching hospital and integrated delivery system for primary health care, serving the Blackstone Valley of Rhode Island and Southeastern Massachusetts, are affiliated with the Brown Medical School.Our main campus is in Pawtucket, RI, and our affiliates provide primary and ambulatory care services at sites in Quality Hill, , Barrington and Central Falls. Memorial is also a member of the Care New England (CNE) health system and is home to a state-of-the-art cancer treatment facility in Pawtucket. Within the Department of Pediatrics at MHRI, the New England Pediatric Institute of Neurodevelopment (NEPIN- formerly the Neurodevelopmental Center) is nationally-recognized in providing multi-disciplinary evaluation and treatment services for infants, children, and adolescents.
NEPIN is the main outpatient center for the Pediatrics Department of MHRI which is comprised of neuropsychologists and clinical psychologists, developmental behavioral pediatricians, pediatric nurse practitioners, a parent consultant, as well as two primary care pediatricians. Through an affiliation with the Providence Center outpatient therapy is also provided at this location. Approximately 500 new patients are evaluated and several thousand patients are seen in follow-up each year. The primary population served by NEPIN is children and adolescents with neurodevelopmental and neurobehavioral disorders (e.g., Attention Deficit/Hyperactivity Disorder, Dyslexia/Learning Disabilities, Language Disorders, Autism Spectrum Disorders, Developmental delays, Intellectual Disabilities, Tourette Syndrome, etc.) and acquired neurological conditions of childhood (e.g., concussion/mild Traumatic Brain Injury). Referrals to the clinic are made by primary care physicians, families, schools, and other agencies. NEPIN also has a number of specialty clinics, including those for Autism, Lead Exposure, and Concussion. A number of different evaluations are available at NEPIN, including independent neuropsychological, concussion, and dyslexia evaluations and multi-disciplinary team neurodevelopmental evaluations. Multimodal assessment, in which test results are integrated with information from a child’s family, teachers, and physicians, is emphasized. Families are provided with both oral and written feedback regarding evaluation results and detailed recommendations. On occasion, information and consultation is provided during school IEP meetings. Many children for whom pharmacotherapy is recommended return to NEPIN for regular follow-up care with the medical staff.
Rhode Island Hospital is a private, not-for-profit, acute care hospital and academic medical center founded in 1863. Hasbro Children's Hospital (HCH) is the pediatric division of Rhode Island Hospital. Built in 1994, the seven-story building provides the comprehensive health services for approximately 7,000 inpatient and 60,000 outpatients. It has earned worldwide recognition for its family-centered environment and expert staff. HCH has the area's only pediatric intensive care unit and pediatric oncology and cardiac programs, has separate emergency and surgical units designated for pediatric patients, and operates specialty clinics treating children ranging in age from newborn to 18 years. Integrated pediatric neurological services are provided in the multi-disciplinary Children’s NeuroDevelopment Center.
The RIH Neuropsychology Program – pediatric focus – includes an active neuropsychological consultation service and a busy outpatient program. Consultations come from pediatric oncology, with specific questions related to late cognitive effects from treatment. In addition, we participate in a multi-disciplinary pediatric brain tumor board, during which neuro-imaging results and treatment issues are discussed in a group format. In addition, consultations are provided to children in the Partial Hospital Program (PHP), a unique day treatment program for children with both medical and emotional issues. The outpatient program receives referrals from pediatric neurologists, pediatricians, schools, and mental health providers, with questions of differential diagnosis and treatment planning for a wide range of patients, including those with epilepsy, metabolic disorders, and other developmental, psychiatric, or medical issues. A major focus of the evaluation process is the follow-up, feedback appointment, at which time parents are provided with both written and oral summaries of the examination, along with detailed recommendations.
To provide the fellow with broad post-doctoral training in the area of pediatric neuropsychology, with an emphasis on neurodevelopmental disorders, acquired neurological conditions of childhood, and neuropsychological consequences of chronic medical illness.
To provide the fellow with a strong working knowledge of assessment, treatment and research conducted with children and adolescents with neurodevelopmental disorders and acquired neurological conditions.
To enable the fellow to gain proficiency in: neuropsychological evaluation and multidisciplinary team neurodevelopmental evaluations of children and adolescents; treatment plan development with these populations; and, oral and written communication of evaluation findings.
To actively participate in research, including grant writing, data collection, management and analysis, and development and implementation of a research proposal, with the goal of presenting research results at a national meeting and writing peer-reviewed manuscripts.
The fellowship is designed to span two years, contingent upon satisfactory progress during the first year. The anticipated start date is July 1, 2016, although an alternative start date no later than September 1, 2016 may be negotiated on an individual basis. In December 2016, the supervisors will determine if the fellow will be offered the second year of training and the fellow will then decide to accept or decline the offer.
Clinical Activity Plan (70% time)
In order to ensure that the fellow receives a high level of clinical training in the area of pediatric neuropsychology, the following activities will be required during the fellowship:
Clinical assessment: The fellow will perform neuropsychological evaluations and/or participate in neurodevelopmental team evaluations conducted with children and adolescents. During the first year, all evaluations will be conducted at NEPIN. Fellows will complete approximately 80 standard neuropsychological/ neurodevelopmental evaluations at NEPIN (approximately 2 per week) both years. In addition, during the first year fellows will have two 6-month supplemental rotations at NEPIN. One supplemental rotation will consist of developmental evaluations, generally of children 4-6 years old. The second is an alternative learning experience to be decided jointly between the primary supervisor and individual fellow (for example, the concussion clinic). During the second year, the fellow will participate in a supplementary rotation at RIH on a weekly basis, where they will conduct approximately one evaluation every other week. Across sites, the fellow will be individually supervised on each case by a staff psychologist or neuropsychologist. The fellow will participate in all aspects of assigned cases, including clinical interviews, face-to-face assessment, scoring/interpretation of results, report writing, and family diagnostic feedback sessions.
Clinical Intervention: A major focus of the evaluation process is the follow-up, feedback appointment, at which time the clinician or team provides feedback to families, and the patient as appropriate, regarding the results of the evaluation, including diagnoses and treatment recommendations. The fellow will also have opportunities to gain competencies through work with staff pediatricians and nurse practitioners at NEPIN in seeing patients evaluated in clinic and in medication follow-up appointments. The fellow may also have the opportunity to assist in school reintegration services through the Concussion Program. Occasionally, opportunities are available to participate in school IEP meetings. If the fellow has interest in conducting individual, family and/or group therapy with patients from the Center, these opportunities will be arranged, with supervision provided by a staff psychologist or neuropsychologist.
Professional Development: The fellow will be able to apply for licensure and work towards successfully negotiating all aspects of the licensure process, and will be license-eligible following the first year of the fellowship. This process requires attendance at the monthly Clinical Ethics Seminar during the first year of fellowship. If available, the fellow will gain supervision experience through working with a practicum student.
Research Activity Plan (20% time)
The fellow will be exposed to various aspects of clinical research work. This is achieved via participation in some of the following activities:
Review of pediatric neuropsychological literature: The fellow will be provided with a series of readings in the area of pediatric neuropsychology, with an emphasis on neurodevelopmental disorders.
Opportunities are available for collaboration on multidisciplinary research projects conducted by Drs. McLean, Amaya-Hodges and Wilson in the areas of Concussion, Autism Spectrum Disorder, Learning Disorders, Lead, and ADHD. If pursing this option, the fellow will be encouraged to develop research projects of interest to him or her that can be conducted with our available clinical populations.
There are also opportunities to be involved in ongoing research projects with several established research partners. If pursing this option, the fellow will be encouraged to join established projects. He or she may also have the opportunity to develop research projects of interest to him or her that can be completed based on the data collected for these projects. Research partners include:
Brown University’s Advanced Baby Imaging Lab: Brown University’s Advanced Baby Lab, an interdisciplinary research facility, uses MRI, neuropsychological assessments, and medical & behavioral assessments to track longitudinal structural and functional neurodevelopment in children ages 3 months through 11 years. The Lab specializes in myelin and white matter maturation patterns and has run studies with a large array of foci. The Lab’s database currently houses data on almost 500 children, many with longitudinal data-points. The Lab provides many excellent opportunities for independent research. The Lab has a track record of NIH and independent funding including recent grants in collaboration with NEPIN. These include a) a R21 for the study of the effects of Lead (Pb) on Early Brain Development and b) one of the cohorts of the Environmental Influences on Child Health Outcomes (ECHO) Program, where NEPIN and the Lab will study the impact of various prenatal, postnatal, dietary, environmental, genetic and behavioral factors on brain development.
The Rhode Island Consortium for Autism Research and Treatment (RI-CART): The mission of the Rhode Island Consortium for Autism Research & Treatment is to improve the lives of Rhode Islanders with autism spectrum disorder and related neurodevelopmental disorders by promoting collaborative, cutting-edge research, improving health care and support services, and providing data-driven education and advocacy. Examples of past research projects by NEPIN faculty and fellows in collaboration with RI-CART include phenotypic aspects of Autism Spectrum Disorder (e.g., executive functioning skills and their relation to adaptive function and restricted and repetitive behaviors), medical co-morbidities, and the genetic mechanisms underlying ASD.
Grant writing: The fellow will be offered support, which may include participation in grant writing seminar or being actively involved in grant writing, should he or she wish to develop a grant idea during the fellowship years.
Manuscript preparation and submission: The fellow will be encouraged to collaborate on manuscript preparation and poster submissions at national and international conferences. Individually tailored goals will be established in this area.
The fellow will be encouraged to participate in research meetings that take place at their research site and/or within NEPIN.
Didactics (10% time)
The fellow will be required to participate in mandatory post-doctoral seminars through the Brown Post Doctoral Training Program, including Core Seminars (monthly, 1st year), DPHB Academic Grand Rounds (monthly, both years), Neuroanatomy Seminar (weekly, generally 2nd year) and Clinical Ethics (monthly, 1st year). Required track seminars include Neuropsychology Seminar (weekly, 1st year), and Rounds (both years), NEPIN didactics (case conferences, journal club, and/or topic presentations), pediatric brain tumor board at RIH (twice a month, 2nd year), and mock fact-finding sessions at RIH (approximately twice a year, 2nd year). Optional didactics available to the fellow include Academic Friday–Grantsmanship Seminars, Special Topics in Statistics.
Drs. McLean, Amaya-Hodges, or Wilson (MHRI) and Dr. Trask (RIH) will supervise each clinical evaluation assigned to the fellow. The fellow will meet with the case supervisor to review the case and to discuss the evaluation plan. The supervisor will be on site during the evaluation and is available for consultation as the evaluation is being performed. The fellow will meet individually with the supervisor after the completion of the case to review the evaluation process, test results, and recommendations. On average, the fellow will receive one to two hours of supervision for each case by the assigned supervisor. In addition, the fellow will attend weekly supervision with the MHRI supervisors to discuss additional clinical and research issues, research projects, and topics of professional development. The fellow may also have opportunities to provide direct supervision to graduate student trainees when available – particularly during the second year of training – and to discuss supervision styles, strategies and different facets of the supervisor/supervisee relationship.
At the midpoint and conclusion of each year of the fellowship, the fellow and the supervisors will provide formal evaluations, and evaluations of the program relative to the goals and learning objectives of the fellowship.
Resource Requirements The fellow’s primary office will be at NEPIN (MHRI), where he or she will be provided with the following resources:
Private office space and library privileges
Front office staff support
A personal computer workstation
When at RIH, the fellow will be provided with access to space appropriate for clinical care, including access to a desktop computer, telephone, and internet.
Reporting and Approval
This fellowship will be part of the Neuropsychology track. The position has been discussed and approved by the Neuropsychology track faculty in their monthly meeting of 10/27/16.
Neuropsychology Track Post-Doctoral Training Coordinator
Associate Director of Investigator-Funded/APA Approved Fellowships