- Outpatient evaluations: full neuropsychological batteries for CNS conditions
- Inpatient evaluations: pre-/post-surgical evaluations for epilepsy and oncology
- Respond to consultations ordered by attending physicians to inpatients from medical floors in the hospital
- Follow patients who require continued intervention throughout hospitalization
- Individual and family therapy
- Group therapy
- Developmental, psychological, and psycho-educational testing
- Assess developmental delays, intellectual deficits, neurocognitive sequela, learning problems, emotional and behavioral disturbances
- Epilepsy, Neuro-Oncology, Neuro-Cardiac
- Train medical residents in the areas of early development, assessment, and intervention
- Teach neurology fellows about neurocognitive sequela of seizure disorders and how to interpret neuropsychological assessments.
The Psychology Internship Program Neuropsychology Track, in association with the Departments of Neurology and Neuroscience, provides neuropsychological assessment services for inpatient and outpatient consults. The service offers neuropsychological evaluations focused on children with neurological conditions and/or other medical disorders that affect brain functioning, resulting in behavioral and cognitive alterations. Neuropsychological evaluations provide detailed information regarding cognitive skills including attention, language and communication skills, memory and learning, motor and sensory functions, academic achievement, and "executive" processes. The information obtained from these evaluations provides baseline levels to monitor change over time, serves to determine the presence or absence of brain dysfunction, assists in differential diagnosis and in developing remedial intervention and treatment strategies. The neuropsychology service also collaborates with a wide range of other medical specialties. Services are provided to children with acquired brain disorders including traumatic brain injuries, hypoxic episodes, brain tumors, metabolic encephalopathies, cerebrovascular disease, CNS infections, and other medical conditions that affect the brain. Additionally, the neuropsychology service is part of the hematology-oncology team. Evaluations are frequently requested in order to monitor the impact of treatment on cognitive, intellectual, and academic functioning.
The neuropsychology service has an active role in the epilepsy program at Nicklaus Children's Hospital. This program is considered among the best in pediatric epilepsy in the nation, specializes in the treatment of complex epileptic disorders and has a world-renowned epilepsy surgery program. Neuropsychological assessments are an integral part of the work-up of surgery candidates and test results are discussed weekly in the multi-disciplinary surgical conferences in conjunction with neurology, neurosurgery, radiology, and neuropathology. As part of this program, the neuropsychology service is also involved in clinical research with this patient population and recently began clinical and research activities with functional magnetic resonance imaging in order to "map" the location of cognitive skills pre- and post-surgically.
Interns are involved in all aspects of this service, and clinical training is also provided to post-doctoral fellows and practicum students. They are also provided the opportunity to supervise doctoral practicum students on evaluations to determine epilepsy surgery candidacy. Supervision is provided with regard to test selection, administration and scoring. The intern also reviews, along with his/her supervisor, reports written by the practicum student and discusses relevant issues. Intensive supervision, geared to the individual intern's level of experience, emphasizes both normative and qualitative interpretation of standard neuropsychological tests, with particular focus on integrating results of the neuropsychological examination with pertinent psychodiagnostic findings. Participation in neuroscience meetings, including a weekly inter-disciplinary epilepsy surgery conference is required.
Assessment training also includes the developmental and psychoeducational assessment of children exposed to multiple medical and socioeconomic risk factors. Children diagnosed with or at risk for developmental delay, ADHD, learning disability, and emotional problems are assessed. Children are referred from other departments in the hospital as well as from schools, community agencies, and private referral sources. Evaluations are also conducted to address learning/academic difficulties and emotional adjustment problems and to monitor overall development and specific intellectual functioning due to chronic and acute medical conditions. Cases are varied in terms of ethnic background, socioeconomic status and age (i.e., infancy through adolescence).
The Nicklaus Children's Hospital Neuropsychology Internship is compliant with Houston Conference Guidelines for training in Clinical Neuropsychology and is particularly well- suited for students with career specialty interest in neuropsychology
This service focuses on children and adolescents who are presenting with or are a risk for emotional and behavioral problems. Children from preschool age through adolescence and their families are seen in consultation. Families vary in terms of ethnic background and socioeconomic status. Emphasis is on the assessment and treatment of common behavior problems including attention deficit hyperactivity disorders, mood and anxiety disorders, oppositional defiant and conduct disorders, feeding and elimination disorders, and developmental spectrum disorders. Children and adolescents with difficulties and disorders related to acute and chronic surgical and/or medical conditions are also seen. Collaboration with other disciplines (e.g., medicine, social work, physical therapy, nutrition) and the referral source is a key component of the treatment process. Cognitive-behavioral, developmental and family systems perspectives are emphasized in understanding patients' needs and developing intervention strategies.
- Individual Therapy - Interns will have a minimum of 5 outpatient therapy cases per week. Presenting problems includes anxiety, depression, aggressive behavior, autism, ADHD, and psychosocial factors related to medical conditions.
- Groups- Interns participate as leaders for a variety of clinical groups, such as groups for Social Skills, Anxiety, and ADHD.
The Consultation-Liaison Service focuses on children and adolescents who have acute or chronic medical problems and prevention of medical conditions in children and adolescents. Services are provided to patients on the following inpatients/outpatients units: Neurology, Hematology/Oncology, Bone Marrow Transplant, Diabetes/Endocrinology, Gastroenterology, among others. The training experience focuses on the behavioral aspects of chronic illness (e.g., diabetes, sickle cell disease, asthma, Crohn's disease, etc.), adherence with treatment regimens and problems with disease management (e.g., stress management during medical procedures), and supportive interventions for children and adolescents with chronic diseases. Cases range from pain management to complex family dysfunction and provide training experiences in behavioral interventions and prevention of psychological adjustment problems. Training opportunities include individual and family based intervention. Training is provided in consultation, assessment, and treatment before, during and after medical interventions. Interns participate as members of multi-disciplinary teams providing comprehensive health care. Multidisciplinary teams consist of physicians, nurses, social workers, child life specialists, speech/language pathologists, occupational and physical therapists, and patient advocates. Team meetings and case conferences provide a forum for clinical discussions and training across services.
Interns regularly participate in the training of medical students as well as pediatric residents in the area of early development, assessment and intervention (the first Monday of each month). In addition, they are an integral part of the overall educational/professional program hospital wide, presenting in a variety of forums (nursing, medical students, community outreach) and covering a diversity of topics relevant to our pediatric/adolescent population. There are also opportunities for supervision of practicum students.