Pediatric Neuropsychology Residency Program Major Rotations: Primary Clinical Experiences

Outpatient Specialty Clinics:

Residents gain experience in outpatient neuropsychological assessment by participating inall four outpatient specialty clinics.  During each outpatient rotation, residents evaluate complete two evaluations per week in two different specialty clinics. Through their involvement in the outpatient specialty clinics, residents will obtain experiences serving individuals ranging in age from infancy to young adulthood, with a wide range of acquired neurological conditions and neurodevelopmental disorders. As part of this experience, residents offer consultation to medical providers, school staff, and families, and are exposed to relevant special education law and its application within the field of pediatric neuropsychology.  The specific outpatient specialty clinics are described below.

Outpatient Specialty Clinics I & II:

Residents particiapte in two rotations involving combinations of the outpatient clinics listed those below:

Oncology. The oncology clinic focuses on provid­ing neuropsychological assessment of children and adolescents who are currently undergoing cancer treatment or have survived cancer. Primary patient populations include individuals treated for leukemia and brain tumors, who are typically referred by the Johns Hopkins Hospital (JHH) Pediatric Oncol­ogy Services and Survivorship Program. Evaluation types include preradiation/presurgical baseline assessments as well as mid- or post-treatment follow-up evaluations. Through assessments, rounds, and attendance at the JHH weekly multidisciplinary pediatric neuro-oncology conference, residents gain knowledge and experience with a variety of cancer presentations and treatment types. Supervisors: T. Andrew Zabel and Lisa Jacobson.

Congenital/Genetic Disorders. The congenital/genetic disorders clinic provides neuropsychological assessment to children and adolescents with a variety of developmental disorders. Patient populations include individuals with more commonly occurring neurologic conditions, such as hydrocephalus, Sturge-Weber syndrome, 22q deletion syndrome, cerebral palsy, and spina bifida, as well as patients with rare genetic conditions and metabolic disor­ders. Providers in this clinic consult with several specialized clinics at Kennedy Krieger, including the Neurogenetics program. Supervisors: T. Andrew Zabel, Rebecca Vaurio, and Jennifer Reesman.

Epilepsy/Brain Injury. This clinic provides outpatient neuropsychological evaluations to children with seizure disorders and those who have had neurological injuries. Evaluation types include pre-surgical, postsurgical, and general epilepsy evaluations, as well as follow-up evaluations for individuals who are past the acute phase of recovery from neurological injury. Providers in this clinic work closely with JHH’s pediatric epilepsy team and Kennedy Krieger’s rehabilitation team to assure comprehensive treat­ment planning and recommendations. Supervisors: Cynthia Salorio and Vanessa Ramos.

Executive Function. The executive function clinic provides neuropsychological assessments to children and adolescents with a variety of developmental or medical disorders that produce impairments in executive function. Typical patient populations include school-age children with attention-deficit hyperactivity disorder (ADHD), Tourette’s syndrome, prematurity, prenatal substance exposures, and anxiety or other affective disorders, with many children also presenting with co-occurring learning problems (e.g., dyslexia). Procedures focus on empirically supported assessment methods and web-based pre-visit data collection from parents and school staff. Supervi­sors: Lisa Jacobson and Mark Mahone.

Rehabilitation Continuum of Care:

The Rehabilitation Continuum of Care (RCC) provides comprehensive interdisciplinary rehabilitation services to children and adolescents with brain injuries, spinal cord injuries, cerebral palsy (primarily post orthopedic surgery) and other neurodevelopmental disabilities. Residents gain experiences in both inpatient and outpatient settings within the RCC.

Inpatient Neurorehabilitation

This rotation focuses on evaluating and treating children with traumatic or acquired brain injuries who are admitted to the brain injury unit for neurorehabilitation. Residents are part of an interdisciplinary treatment team, and their responsibilities include conducting neuropsychological evaluations, offering education and recommendations to family and staff, providing cognitive rehabilitation and supportive psychological services, and assisting with treatment and discharge planning. Residents also evaluate children with a range of other disorders who are admitted to the inpatient unit for a variety of medical concerns, including spinal cord injuries and chronic pain disorders. Supervisors: Beth Slomine, Megan Kramer, and Cynthia Salorio.

Outpatient Neurorehabilitation

This rotation provides the opportunity for the resident to be part of two interdisciplinary treatment teams within our RCC. Residents spend four days a week in a comprehensive day hospital setting (Specialized Transition Program) and spend one day a week in a multidisciplinary clinic (NeuroRehabilitation Concussion Clinic). These settings are described below:

Specialized Transition Program (STP).   STP is Ken­nedy Krieger Institute’s comprehensive rehabilitation day hospital. The program strives to transition children and adolescents undergoing intensive neurorehabilitation back into their homes, communities, and schools. Working as part of an interdisciplinary treatment team, primarily with children and adolescents recovering from acquired brain injuries, residents’ responsibilities include conducting comprehensive neuropsychological evaluations, providing consultation to families and the team, and assist­ing with treatment and discharge planning. Based on interest, the resident may also provide individual and group-based neuropsychological intervention, including cognitive rehabilitation. Opportunities will also be available to work with children diagnosed with a wide range of complex neurodevelopmental disabilities. Supervisor: Gianna Locascio

NeuroRehabilitation Concussion Clinic. The NeuroRehabilitation Concussion clinic is an interdisciplinary clinic that provide focused evaluations and management of mild traumatic brain injuries within a fast-paced, clinic setting. This clinic team includes neuropsychology and medicine (neurology or by physical medicine and rehabilitation). Residents play an active role in decisions regarding returning to sports and other activities following injury and collaborate with schools and athletic training staff. Residents in this clinic will follow their patients from initial injury to recovery through serial assessments and consultations. Super­visors: Jennifer Reesman and Megan Kramer.

Additional Interdisciplinary Settings:

Kennedy Krieger School 

The school rotation emphasizes assessment and consultation in a nonpublic special education day school. Residents work in a nationally recognized school with students who have a variety of diagnoses and federal classifications, such as autism, learning disabilities, emotional and behavioral problems, speech-language impairments, intellectual disabilities, and other health problems, such as seizures and traumatic brain injuries (TBI). Learning opportunities include special education law and consultation/collaboration with educators and other related service providers in an interdisciplinary setting. Supervisor: John Beetar.

Center for Autism and Related Disorders (CARD)  

Residents work within a multidisciplinary team of professionals, including neuropsychology, speech-language pathology, and neurology, to provide diagnostic clarification for children with autism spectrum disorders (ASD), along with various other complex medical and behavioral conditions. Residents also participate in independent neuropsychology evaluations and consult with providers, schools, and therapists, both within the Institute and throughout the community. CARD is a federally funded National Center of Excellence, with research programs actively investigating early detection and intervention for ASD, standards of practice for autism centers, genetic factors associated with autism, sensory processing, and a variety of other topics. Supervisors: Ericka Wodka and Rebecca Vaurio.

Sample Schedule of Major Rotations for Incoming fellows: