Intellectual and Neurodevelopmental Disabilities Post-Doctoral Fellowship

The IND Postdoctoral Fellowship trains in accordance with the scientist-practitioner model. The fellowship is viewed as a process of leadership specialization, whereby fellows are provided with the opportunity to demonstrate increasingly independent practice over the course of the program. Provision of necessary knowledge and skill base is undertaken in the context of modeling, mentoring, teaching and supervision. Training occurs across the following areas of core competence, which are essential to all activities of professional psychologists and are directly related to the quality of psychological services:

• Assessment
• Intervention
• Consultation and Interdisciplinary Relationships
• Scientific Foundations and Research
• Leadership and Advocacy
• Professional Development

The fellowship director will work with each incoming fellow to develop an individualized training program based on the fellow’s training goals and needs, previous experience and level of independence, and the requirements of each training clinic. Therefore individual schedules and rotations will vary.

Assessment

Interdisciplinary Diagnostic Assessments (IDAs)

At the CDC, fellows work as part of an Interdisciplinary Diagnostic Assessment (IDA) team. Team members include a medical provider (e.g., developmental-behavioral pediatricians, pediatric neurologists, psychiatrists or advanced practice nurses), speech therapist, psychometrician, genetic counselor and nurse/medical assistants.

During IDAs, children suspected of autism or developmental delay are evaluated by the full team. Fellows then complete a full psychological assessment to further evaluate the child’s functioning and generate recommendations for services.

Psychological Evaluations

Fellows complete independent psychological evaluations of children with other intellectual and developmental disabilities at the CDC. There are also opportunities to experience other evaluation formats such as targeted assessments for very young children with ASD or transition evaluations for older children with disabilities.

Other Assessment Activities

Assessment activities also occur within several hospital-based, medical sub-specialty clinics as well as an ICF/IID (intermediate care facility for individuals with intellectual disabilities). Typical responsibilities in these clinics include brief psychological testing and/or behavioral consultation. Current clinics with IND Fellowship involvement are:

• Heinzerling Foundation (ICF/IDD facility) – Fellows complete cognitive and adaptive evaluations for residents in a residential facility for children and adults with severe and profound intellectual disability.
• Neurodevelopmental Clinic (Department of Neurology) – Fellows work with an interdisciplinary team (neurologist, psychologist, SLP, occupational therapist and physical therapist) to evaluate children with concerns for developmental delays or ASD, other neurological conditions, and genetic disorders.
• Non-Accidental Traumatic Brain Injury Clinic (NATBI; Department of Developmental/Behavioral Pediatrics) – Fellows work with a child abuse pediatrician, a developmental-behavioral pediatrician, a physical medicine pediatrician and a psychologist to monitor young children who were victims of abusive head trauma.
• Fellows Clinic (Department of Developmental/Behavioral Pediatrics) – CDC fellows work with a developmental-behavioral pediatrics fellow to evaluate young children under age 6 with global concerns in development.
• International Adoption Clinic – Fellows conduct interviews and developmental testing for children who have been internationally adopted as part of a multidisciplinary team and provide consultation to parents regarding behavioral difficulties or social/emotional adjustment to adoption.
• Inpatient Consultation and Liaison Service – Fellows will work with Psychology faculty to provide brief assessment and consultation throughout the broader hospital as needed and on our psychiatric inpatient unit, which recently opened a unit specializing in children with a comorbid developmental disability. 

Treatment

Training opportunities focused on behavioral therapy for children with neurodevelopmental disabilities are an integral part of training. Applied Behavior Analytic (ABA) approaches are most commonly used, along with modified cognitive behavioral approaches for anxiety and depression. Treatment cases may also include parent training, particularly the RUBI model and Parent Child Interaction Therapy (PCIT). Treatment experiences will cover a wide range of presenting problems, including diagnoses such as Intellectual Disability, Autism Spectrum Disorder, Fetal Alcohol Spectrum Disorders, Down Syndrome, Anxiety Disorders, Depression, and Attention-Deficit/Hyperactivity Disorder. Commonly seen treatment referrals are those typical to children with intellectual and neurodevelopmental disabilities, including feeding problems, noncompliance, tantrums and aggression, self-injury, sleep problems, toileting delays, and other gastrointestinal issues. There may be complicating family/psychosocial issues to address. Treatment cases may also involve habilitative interventions for adaptive behavior, language development, school and academic interventions, and early intensive behavioral intervention for autism or other developmental disorders.

Fellows typically provide outpatient treatment services throughout the year, typically with a caseload of 3-4 patients at a time. Additionally, some Fellows will participate in the program’s outpatient feeding treatment services, which includes an intensive model (child and family attend three feeding appointments per week for three to four weeks).

Treatment services are also interdisciplinary, emphasizing collaboration with physicians on medical management, clinical social workers on family therapy, and possibly Board Certified Behavior Analysts on behavioral interventions.

Advocacy

IND Fellows take part in advocacy activities during the fellowship. Past opportunities have included

• Participating as speakers for the CDC’s various Project ECHO programs
• School observation visits
• Assistance with IEP planning
• Interaction with legislators
• Developing presentations for community organizations or schools.

Professional Development Project and Research

Fellows will complete a research or program development project over the course of their fellowship.

Goal of this project: To give Fellows valuable experience in taking a leadership role in developing and carrying out a project to improve practice or increase knowledge in the area of neurodevelopmental disabilities.

• Project will increase the Fellow’s competitiveness for future employment in their chosen job setting.
• Project will be developed and carried out under the guidance of the postdoctoral co-directors, taking into account Fellow’s interests and career goals.
• At the culmination of this project, Fellows will prepare a presentation to share with CDC faculty that can serve as a job talk for future employment opportunities.

To facilitate these projects, Fellows participate in a biweekly research group to discuss study design and review relevant scholarly literature. There are additional opportunities to participate in research projects being run by other psychology faculty based on the Fellow’s interests. Fellows also can attend Autism Treatment Network (ATN) Webinars.

Didactics and Continued Learning

Various educational opportunities occur throughout the week at the CDC, these include:

• Each week, fellows attend Group Supervision with faculty and other trainees, including discussion of treatment and assessment cases, presentation of empirically-based treatment programs, and an opportunity to discuss the application of treatments to specific cases.
• Clinical Case Problem Conference (also known as “Stump the Chump”) is a monthly case conference that requires trainees to present one assessment case to other trainees and CDC faculty. This is an opportunity to receive feedback about assessment procedures, interpretation of results, and ideas for recommendations.
• Cutting Edge Seminar. Occurs periodically and involves Guest speakers from the community, various medical departments at Nationwide Children’s Hospital, or professionals at The Ohio State University share their research on topics relevant to IND concerns.
• Diagnostic Intake (DI) Rounds also occurs monthly and is led by CDC’s social work/family therapy team to problem-solve concerns that arise during CDC intake appointments.