Developmental Medicine Center Clinically Focused Fellowship
The Developmental Medicine Center (DMC) at Boston Children’s Hospital is dedicated to improving the lives of children and adolescents with neurodevelopmental, learning, and behavioral difficulties, and their families, through integrated and collaborative clinical care, training, translational research, neuroscience, and community engagement. The interdisciplinary staff comprises developmental-behavioral pediatricians, child psychologists, educational specialists, nurse practitioners, neurologists, and child psychiatrists; in addition, there is the opportunity to consult, as needed, with specialists from a variety of programs including Speech-Language, Sleep Disorders, and Genetics. As a tertiary care site, the DMC accepts referrals for children with neurodevelopmental and behavioral challenges that are not well met in the general medical and mental health communities. Established in the 1980s, the goals of the DMC Psychology Fellowship Program are:
- To prepare fellows to pursue careers in academic health centers or other health care settings by providing them with the requisite skills to become outstanding clinicians, inspiring teachers, and contributors to the profession of psychology through active involvement in professional organizations and advocacy.
- To provide fellows with advance practice competency in assessing youth with neurodevelopmental disorders, including attention deficits, autism spectrum disorders, learning disabilities, intellectual disabilities, and regulatory problems, sometimes within the context of complex medical and/or psychosocial histories. Emphasis is placed on integrating the tenets of clinical psychology, developmental psychopathology, cognitive neuroscience, evidence-based interventions, and principles of child and family development.
- To facilitate advanced scholarly skills by being active consumers and producers of clinical research and making informed decisions regarding assessment and intervention.
The training experience
Postdoctoral fellows are involved in direct clinical service in the DMC for 60 percent of their time, including:
- performing diagnostic assessments on interdisciplinary teams
- consulting in hospital-based and community settings
- providing feedback to parents and schools
- providing short-term treatment for anxiety, mood, disruptive behaviors, social skills deficits, elimination disorders, and feeding problems
The number and variety of programs contained within the DMC generally make it possible to adapt the fellow’s clinical experience to his or her learning needs and professional goals. Rotations are six months in length. The goals of rotations are to expand the fellow’s knowledge base of learning, developmental, medical, and behavioral disorders and co-morbid psychiatric conditions; provide timely and tailored evaluations; and develop consultation and communication skills in a fast-paced medical environment. There also are opportunities for fellows to work closely with psychology staff to develop supervisory and administrative skills. The DMC clinical programs available for fellowship rotations include:
- Infant Team and Toddler Team: Infant Team and Toddler Team serve children under the age of 2 years, and between 2 and 3.5 years, respectively. Youth seen on these teams typically present with concerns for developmental delay and/or autism spectrum disorder. Team members often include developmental-behavioral pediatricians and psychologists.
- Preschool Team: Preschool Team typically serves children between 3.5 and 6 years of age who present with concerns related to development, learning, and/or behavior. These children may have significant language, cognitive, social, and motor difficulties of many different etiologies. Team members often include developmental-behavioral pediatricians, psychologists, and education specialists.
- School Team: School Team serves youth from approximately 6 to 13 years of age with various presentations. Concerns may include those related to social, emotional, academic, and behavioral functioning. Team members often include developmental-behavioral pediatricians, psychologists, neuropsychologists, and education specialists.
- Young Adult Team (YAT): Youth approximately 12 to 17 years of age are typically seen through YAT and may present with concerns related to social, behavioral, academic, and/or emotional functioning. Team members often include developmental-behavioral pediatricians and psychologists.
- Advocating Success for Kids (ASK) Program: This program serves youth of all ages within two urban-based primary care centers who are referred by primary care providers. Youth are often referred because of concerns about developmental, learning, social-emotional, and/or behavioral problems. Additionally, children often present with complex psychosocial situations, possible prenatal substance exposure, and/or trauma history. The goal of this program is to screen children for such concerns and to advocate for appropriate services and interventions. An interdisciplinary team approach is utilized, with developmental-behavioral pediatricians, psychologists, social workers, and educational specialists.
- Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Program: The LEND team conducts comprehensive evaluation of youth of all ages. Youth seen through the LEND team often present with developmental concerns within the context of complex medical presentations. In addition to a developmental-behavioral pediatrician and neuropsychologist, the LEND team often has observers from various disciplines, including community advocates.
- Adoption Team: Adoption Team provides assessment and consultation for youth of all ages who have been adopted domestically or internationally. Common concerns presenting on this team may include long-term abuse, neglect, or a history of institutionalization. Team members often include developmental-behavioral pediatricians, psychologists, and educational specialists.
- Down Syndrome (DS) Program: The DS Program conducts interdisciplinary clinical evaluations of youth with Down syndrome from birth through 18 years of age. Program members work closely with children, parents, medical specialists, community physicians, and educators. The DS Program consists of a developmental-behavioral pediatrician, psychologist, neurologist, speech pathologist, physical therapist, nutritionist, dentist, and audiologist, as well as a program coordinator and resource specialist. Services provided by the psychologist on this team include consultation, assessment, parent training, and psychotherapy.
- Deaf and Hard of Hearing Program: Fellows have the opportunity to participate in clinical activities in the Deaf and Hard of Hearing Program (DHHP), which is an interdisciplinary team of neuropsychology/psychology, speech-language pathology (SLP), and audiology. The DHHP is part of the Cochlear Implant (CI) program and works closely with surgeons in Otolaryngology. The DHHP also runs an autism clinic with the Developmental Medicine Center (DMC). Experiences in DHHP include comprehensive outpatient evaluations of children with reduced hearing, participation in pre- and post-surgical evaluations for bilateral and unilateral CI, interdisciplinary evaluations with SLP and DMC in identifying diagnoses of autism spectrum disorder in children with reduced hearing, and opportunities for attendance at CI rounds and DHHP Lunch and Learn seminars.
- Consultation and therapy: This service provides individual, group, and family therapy, such as Toilet Training School for parents and children with encopresis and enuresis; parent training for children with ADHD; behavioral and family-based treatment for feeding disorders; school consultation; and cognitive behavioral treatment for anxiety and mood in children and adolescents.
The research rotation allows fellows the opportunity to participate in ongoing research projects in the Division of Developmental Medicine (DDM) and/or quality improvement efforts. Fellows are matched with research advisors from the DDM faculty. Along with developmental-behavioral pediatrics fellows, psychology fellows participate in research seminars comprising didactic sessions, journal club, and skills training in research design, methods, and analysis. Additional activities include attending lectures in the Laboratories of Cognitive Neuroscience (LCN) directed by Charles Nelson, PhD. Based on availability of research grants, a psychology fellow may elect to spend a second year in ongoing clinical research projects and/or define a discrete project that can be completed within a fellowship year.
Research projects in the DMC encompass topics and methods in basic science, translational, clinical, and health services research. There are methodologists and statisticians available to assist in planning studies and analyses, and when financially feasible, research assistants may be assigned to help with aspects of research. Research computers and standard statistical software are available for use by fellows in all programs. Please visit this page for information regarding research studies in the division.
Seminars, supervision, and educational activities
The DMC dedicates one half-day per week for education and professional development of staff and fellows, including a monthly interdisciplinary meeting and forum for special presentations; morbidity and mortality conference; case conference; and journal club. There also are weekly seminars for psychology fellows that focus on neurodevelopmental, medical, and psychiatric disorders; feeding, sleep, and toileting disorders; psychological assessment of complex cases; evidence-based interventions; educational methodology for teaching; advocacy; and professional development. There are several opportunities each year to visit community agencies, specialized schools, or other clinical programs at Boston Children’s.
Supervision is provided by the staff in the DMC Psychology Program and involves in-vivo observations as well as individual meetings. Each fellow receives a minimum of three hours of supervision per week. There is a supervisor assigned for each clinical rotation, and fellows have the opportunity to work with several different supervisors over the course of their training. Group supervision experiences are provided to address clinical assessment skills, professional development, and preparation for licensure and board certification. Participation in other clinics in the hospital to obtain specialized training can be arranged on an individual basis. Progress, competencies, and training goals are evaluated on a regular basis.
There are opportunities for fellows to become active participants in the DDM’s robust Quality and Performance Program (QPP), which oversees all quality improvement (QI) activities. Fellows can attend team leadership meetings and quality improvement seminars, develop quality metrics for clinical outcomes and processes, review data for ongoing projects, and propose, implement, and present their own mentored QI project. Emphasis is placed on developing solid working knowledge of quality improvement principles and strategies for rigorous and effective implementation.
Finally, within the DDM and in the broader Boston Children’s Hospital/Harvard Medical School community, there is a wide array of educational opportunities, including seminars, lectures, and trainings that fellows are required or encouraged to attend.
The DMC is offering two to four postdoctoral fellowship positions for the 2022-23 training year. This is a full time, one-year training experience during which the fellow’s time will be divided between clinical service delivery, didactics, and scholarly activities. The option for a second-year advanced fellowship may be available with consideration of funding and matching fellow/program interests.
Applicants should have substantial clinical experience with children, including use and interpretation of psychological and neuropsychological tests, coursework in child development and developmental psychopathology, and experience with evidence-based treatment and developmental disabilities; training and competence in addressing issues of diversity and individual differences; and a commitment to clinical research.
Questions about the DMC fellowship are best addressed via email to Kate Linnea, PhD, at email@example.com.