Pediatric Neuropsychology Residency Program Major Rotations: Primary Clinical Experiences

Outpatient Specialty Clinics:

Residents gain experience in outpatient neuropsychological assessment by participating in all four outpatient specialty clinics. During each outpatient rotation, residents complete two evaluations per week in two different specialty clinics. Through their involvement in the outpatient specialty clinics, residents will gain experience 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 participate in two rotations involving combinations of the outpatient clinics, including those below:

Oncology

Within the oncology clinic, residents conduct neuropsychological assessments 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 and presurgical baseline
assessments and mid- or post-treatment follow-up evaluations. Through assessments, rounds, and attendance at the JHH weekly multidisciplinary pediatric neuro-oncology conference, residents gain knowledge of and experience with a variety of cancer presentations and treatment types. Supervisors:
T. Andrew Zabel and Lisa Jacobson.

Within the oncology clinic, residents conduct neuropsychological assessments of children and adolescents who are currently undergoing cancertreatment 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 and presurgical baselineassessments and mid- or post-treatment follow-up evaluations. Through assessments, rounds, and attendance at the JHH weekly multidisciplinary pediatric neuro-oncology conference, residents gain knowledge of and experience with a variety of cancer presentations and treatment types. Supervisors:T. Andrew Zabel and Lisa Jacobson.

Congenital/Genetic Disorders: Within the congenital/genetic disorders clinic, residents conduct neuropsychological assessments of 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: In this clinic, residents provide outpatient neuropsychological evaluations of children with seizure disorders and those who have had neurological injuries. Evaluation types include presurgical, 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 ensure comprehensive treatment planning and recommendations. Supervisors: Cynthia Salorio and Vanessa Ramos Scarborough.

Executive Function: Within the executive function clinic, residents provide neuropsychological assessments of 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 E. Mark Mahone.

Rehabilitation Continuum of Care:

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

Inpatient Neurorehabilitation

Within this rotation, residents focus 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 one day a week in a multidisciplinary clinic (Neurorehabilitation Concussion Clinic). These settings are described as follows:

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 interventions, 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 provides focused evaluation and management of mild traumatic brain injuries within a fast-paced clinic setting. Residents work as part of a clinic treatment team that includes neuropsychologists, physicians (neurologists or physical medicine and rehabilitation physicians), and nurses. 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. Supervisor: Megan Kramer.

Additional Interdisciplinary Settings:

Kennedy Krieger School Programs

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, including autism, learning disabilities, emotional and behavioral problems, speech-language impairments, intellectual disabilities, and other health problems, such as seizures and traumatic brain injuries. 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 in speech-language pathology, occupational therapy, social work, and medicine to provide diagnostic clarification for children with autism spectrum disorders (ASD) and various other complex medical and behavioral conditions. Residents also participate in independent neuropsychological evaluations and consult with providers, schools, and therapists, both within the Institute and throughout the community. Exposure to treatment (e.g., social skills groups) and the Autism Diagnostic Observation Schedule-2 (ADOS-2) is also incorporated into the rotation. The center 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, sensory-motor functioning, and a variety of other topics. Supervisor: Ericka Wodka.

Sample Schedule of Major Rotations for Incoming fellows:

 

Year 1

Year 2

Fellow

Sept-Dec

Jan-Apr

May-Aug

Sept-Dec

Jan-Apr

May-Aug

1

Outpatient Specialty Clinics I

School Programs

Inpatient Neurorehab

CARD

Outpatient Specialty Clinics II

Outpatient Neurorehab

2

Outpatient Specialty Clinics I

CARD

School Programs

Inpatient Neurorehab

Outpatient Neurorehab

Outpatient Specialty Clinics II

3

School Programs

Outpatient Specialty Clinics I

CARD

Outpatient Neurorehab

Inpatient Neurorehab

Outpatient Specialty Clinics II