Outpatient Specialty Clinics:

Residents gain experience in outpatient neuropsychological assessment by participating in all five outpatient specialty clinics. Through their involvement in the outpatient specialty clinics, residents 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 members 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.

Congenital/Genetic Disorders

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 Neurology and Neurogenetics Clinic.

Epilepsy/Brain Injury

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 the pediatric epilepsy team at The Johns Hopkins Hospital (JHH) and the rehabilitation team at Kennedy Krieger to ensure comprehensive treatment planning and recommendations.

Executive Function Clinic

Residents conduct evaluations of children and adolescents with known or suspected neurodevelopmental, psychiatric and/or medical disorders that can be associated with executive dysfunction. Many of the individuals seen in this clinic have or are suspected of having attention deficit hyperactivity disorder (ADHD) and learning disorders. Participation in this clinic provides fellows with opportunities to learn about the development of executive function skills through early childhood and adolescence, common conditions associated with executive dysfunction across settings, special education law, and other school-specific information (e.g., multi-tiered systems of intervention).

Infants, Toddlers and pre-School Years Clinic
Residents conduct evaluations of children from infancy through age 6. Patients in this clinic present with a range of conditions from complex medical histories, including those with histories of perinatal brain injury, cerebral palsy, and congenital and genetic abnormalities, to more general developmental and behavioral concerns. Providers in this clinic work closely with a number of clinics and centers throughout Kennedy Krieger and JHH in order to provide comprehensive and interdisciplinary care for our youngest patients.

Oncology

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 JHH's 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 interdisciplinary pediatric neuro-oncology conference, residents gain knowledge of and experience with a variety of cancer presentations and treatment types.

 

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 inpatient 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 members, 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.

Outpatient Neurorehabilitation

This outpatient neurorehabilitation experience provides the opportunity for the resident to be part of two interdisciplinary treatment teams within our RCC. Residents obtain experience in outpatient neurorehabilitation as part of two rotations. During one rotation, residents spend four days a week in a comprehensive day hospital setting (Specialized Transition Program). This rotation also includes one day every other week in an outpatient specialty clinic. During a second rotation, residents spend one day a week in an interdisciplinary clinic (Concussion Clinic). This rotation also includes one day a week in an outpatient specialty 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.

Concussion Clinic:

The 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's treatment team that includes neuropsychologists, physicians (neurologists or physical medicine and rehabilitation physicians), nurse practitioners 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 members. Residents in this clinic will follow their patients from initial injury to recovery through serial assessments and consultations.

Additional Interdisciplinary Settings:

Kennedy Krieger School Programs

Residents provide 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 spectrum disorder (ASD), learning disabilities, emotional and behavioral problems, speech-language impairments, intellectual disabilities, and other health conditions, 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.

Center for Autism and Related Disorders (CARD)

Residents work within an interdisciplinary team of professionals in speech-language pathology, occupational therapy, social work and medicine to provide diagnostic clarification for children with 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.
 

Sample Schedule of Major Rotations for Incoming Fellows:

    Year One  
Fellow Sept. - Dec. Jan. - Apr. May - Aug.
1 Outpatient Specialty Clinics School Programs/Outpatient Inpatient Neurorehab
2 Concussion/Outpatient CARD School Programs/Outpatient
3 School Programs/Outpatient Outpatient Specialty Clinics CARD

 

    Year Two  
Fellow Sept. - Dec. Jan. - Apr. May - Aug.
1 CARD Concussion/Outpatient STP/Outpatient
2 Inpatient Neurorehab STP/Outpatient Outpatient Specialty Clinics
3 STP/Outpatient Inpatient Neurorehab Concussion/Outpatient