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Clinical Experience

Developmental and Behavioral Pediatrics Fellowship

Continuity Clinic Experiences

Developmental Continuity Clinic

The developmental continuity clinic meets one half-day per week throughout the first year of training. Under the direct supervision of a developmental-behavioral or neurodevelopmental pediatrician, the fellow is taught to evaluate, assess, and manage a wide variety of developmental disabilities for children ranging in age from infancy through adolescence.

Behavioral Continuity Clinic

The behavioral continuity clinic meets one half-day per week throughout the first 17 months of fellowship training. Under the direct supervision of a clinical child psychologist, the fellow is taught to use empirically-based treatment approaches for commonly behavioral concerns including noncompliance, toileting, sleeping, anxiety-related disorders, and behaviors common among children with autism spectrum disorder.

Developmental-Behavioral Continuity Clinic

Beginning mid-way through the second year of fellowship training, the developmental continuity clinic and behavioral continuity clinic combine to form the developmental-behavioral continuity clinic. This experience, supervised by a developmental-behavioral or neurodevelopmental pediatrician, meets two half-days weekly for the last half of the second year and increases to three half-days throughout the third year of fellowship training. The combining of the continuity clinic experiences allows the fellow to follow individual patients longitudinally and develop relationships with families over time and is designed to assist the fellow in becoming an independent practitioner.

Upon completion of the program, the fellow will have developed clinical skills that include not only diagnostic, evaluation, and basic management, but also the use of psychotropic medications and behavioral interventions for children with a wide variety of developmental and genetic etiologies.

Rotations during the first year of fellowship

Overview of Developmental and Behavioral Health

The goal of this one-month rotation is simply to acquaint the in-coming fellow with the Division of Developmental and Behavioral Health. The fellow rotates with multiple members of the division to become familiar with faculty and the wide array of patients served within the division.

Learning and Cognition in Psychology

During this one-month rotation, the fellow will learn to interpret the results of cognitive and achievement testing completed by psychologists or professionals within school districts and provide patients/families with appropriate guidance regarding educational and/or adaptive supports appropriate for the child. The fellow will also develop an understanding of the impact of these results on conditions treated by developmental-behavioral pediatricians.

Genetics

During this two-month rotation, the fellow will work closely with faculty in Genetics to gain expertise in dysmorphology and metabolic and chromosomal disorders. The fellow will also gain experience in the biologic underpinnings of a wide range of neurological, developmental and behavioral issues.

ADHD Clinic

The first year of fellowship training includes a 10-month rotation in ADHD Clinic. This experience, supervised by a developmental-behavioral pediatrician and a clinical child psychologist, meets two half-days per week and focuses on medication and behavioral intervention of attention-deficit/hyperactivity disorder (ADHD) for children ranging from preschool through adolescence.

The fellow will also gain experience with developmental of behavioral plans, classroom intervention plans, and formal plans in accordance with Section 504 of the Rehabilitation Act.

The time in ADHD Clinic culminates with participation in the ADHD Summer Treatment Program (STP), an evidence-based, intensive, summer day treatment program for school-aged children with ADHD.

Psychiatry

This three-month rotation meets once weekly under the supervision of a child and adolescent psychiatrist. The purpose of this rotation is to allow the fellow to gain experience in interviewing, assessment, and treatment (including psychopharmacology) of children and adolescents with internalizing/externalizing disorders, mood disorders, and other psychiatric disorders.

Pediatric Rehabilitative Medicine

This two-month rotation is designed to provide the fellow with an integrated experience working with children with a wide variety of motor impairments. Conditions treated in this clinic include nerve and muscle disorders, cerebral palsy, spinal defects, brachial plexus injury, limb deficiency, and traumatic brain injury. During this rotation, the fellow will work in a multi-disciplinary setting with physicians, occupational and physical therapists, and a neuropsychologist.

Neurology

During this one-month rotation, the fellow will develop an understanding of the neurologic basis of developmental and behavioral issues and a working knowledge of appropriate referral to our neurology colleagues.

Occupational Therapy/Physical Therapy/Speech & Language/Audiology

In addition to working directly with professionals from OT, PT, and speech/language during interprofessional team experiences, the fellow will complete a one-month rotation with these professionals during the first year of training This rotation will allow the fellow to become more adept at recognizing typical and atypical development and the treatment approaches utilized to optimize development for children with delays and/or disabilities. The fellow will also observe and interpret the results of hearing evaluations completed for children of various ages and levels of disability.

Feeding

During the Feeding rotation, the first-year fellow will learn skills necessary for working with physicians and other allied health care professionals (interprofessional team) in evaluation and treatment of psychological concerns surrounding feeding difficulties and disorders.

Community Services

The fellow will tour and observe agencies within the Kansas City Metropolitan area that provide various services/supports to children in our community. These facilities include agencies which work with children with a specific disability or concern, as well as those that work predominately with typically developing children. This allows the fellow to become familiar with resources in the community.

Rotations during the second year of fellowship

Developmental Assessment of the Young Child/Developmental Diagnostic Team and Dyad

During the second training year, the fellow will spend one half-day weekly participating in interprofessional developmental assessment teams in evaluation and provision of treatment recommendations for children with developmental concerns suspect for autism spectrum disorder. Participation in these interprofessional evaluations allows the fellow to learn assessment and management skills from multiple specialists including developmental-behavioral pediatricians, psychologists, occupational therapists, and speech-language pathologists.

Behavioral Change in the Older Child and Teen

The focus of this four-month rotation is to assist the fellow in development of skills in behavioral intervention and motivational interviewing of older school-aged children and adolescents within a clinic setting. This rotation meets twice weekly during the second training year and is supervised by a clinical child psychologist.

Inpatient Consultation

For ten months during the second year, one half-day is dedicated to inpatient consultation with either psychology or psychiatry. By participating in inpatient consultations, the fellow gains exposure to assessment of children with complex issues such as substance abuse and gender identity concerns. The fellow will also participate in consultation to provide guidance regarding need for transfer to an inpatient pediatric psychiatric facility for inpatients who are medically unstable after attempting suicide.

Elimination Disorders

This two-month rotation meets one half-day per week. The primary focus of the rotation is evaluation and empirically supported behavioral intervention for enuresis and encopresis among children and adolescents.

Parent-Child Interaction Therapy (PCIT)

The primary faculty for this two-month rotation are licensed clinical social workers who provide child and family therapy at Children’s Mercy. During the rotation, the fellow will learn the principles of PCIT and the coaching techniques utilized by this therapeutic approach.

Down Syndrome Clinic

This is a two-month rotation that meets for one half-day during the second year of training. During this experience, the fellow will participate a multidisciplinary team to provide medical care to children with Down Syndrome.

Elective Experiences

There are several opportunities for elective experiences during the second and third years of fellowship training. Elective experiences may be scheduled as one-month rotations, six-month continuity experiences, or a combination of these. Previously selected elective experiences include:

  • Abuse and neglect
  • Advocacy
  • Eating disorders
  • Failure to thrive
  • Family therapy
  • Genetics with primary focus on dysmorphology
  • Genetics with primary focus on metabolic disorders
  • Individualized therapeutics
  • Integrative pain management
  • International Medicine Elective (taken as one full-month)
  • Neonatal follow-up
  • Ophthalmology
  • Psychopharmacology
  • Sleep disorders
  • Substance abuse
  • Tourette
  • Weight management