Clinical Rotations
Approximately 45-65% of overall time is devoted to clinical work. Fellows typically have two “clinic days” per week. A clinic day can follow various formats, such as a full neuropsychological evaluation, a more brief/focused evaluation, or a day in concussion clinic seeing multiple new and follow-up patients. Fellows receive the assistance of our well-trained psychometrists, who administer and score a portion of the assessment, and also work with extern assistants (see Didactics and Professional Development Experiences). Faculty provide at least two hours of individual supervision per week, plus group supervision, with supervisor involvement in cases tailored to the needs of the individual fellow to support growing independence.
Fellows are based in our Rockville office and typically spend some time at other locations in Washington DC and Maryland. Patients are seen for evaluation at outpatient facilities, but there are occasional opportunities to provide consultation or brief service on inpatient units and in hospital-based clinics. We mainly see school-age children through late adolescents. We offer optional rotations with preschoolers for interested trainees. Referrals include patients with complex neurodevelopmental and medical/ neurological disorders. The Washington DC metro region is home to a heterogeneous population and we are committed to providing sensitive and quality care to people from all backgrounds.
Rotations for the Neuropsychology Postdoctoral Fellowship are organized to provide broad experience with complex neurodevelopmental disorders, a mix of medical conditions and a varying of referral questions in Year 1, and more in-depth experiences with specific medical populations (e.g., epilepsy, hem/onc, and/or some other particular area of interest) in Year 2. Some rotations are core and completed by most or all postdocs, especially in Year 1, and some are electives. We consider individual preferences and goals when assigning the second-year rotations in order to individualize the training experience. Each rotation typically offers both didactic experiences (e.g., attending rounds) and experience with a given patient population.
Explore Clinical Rotations
YEAR 1 CORE ROTATION
General Outpatient Service
Children and adolescents seen in the general outpatient service present with a variety of developmental or acquired neurocognitive difficulties. This service captures any referral not coming through one of the other more specific clinics/programs. Referral questions most often involve learning and attention problems. This rotation may also include opportunities to provide brief consultations.
YEAR 1 OR YEAR 2 CORE ROTATION
Medical Referrals
This rotation affords the fellow the opportunity to see cases with a variety of medical etiologies, such as genetic disorders, sickle cell, stroke, AVM, transplant, cancer, congenital heart disease and neurological disorders
YEAR 1 CORE ROTATION
Executive Function Clinic
Year 1 core rotation. Our faculty are known for expertise in executive function skills. This biweekly clinic provides rapid, focused evaluations of children with attentional and executive function problems. The rotation includes group supervision, and particular training in executive function profiles in ADHD and other neuropsychological disorders and evidence-based recommendations.
YEAR 1 CORE ROTATION
Score Program
This clinic conducts serial, focused neuropsychological evaluations with children and adolescents who have sustained a mild TBI/concussion. Patients are often seen early after an injury and followed through to recovery. This individualized model emphasizes the integration of cognitive, physical and psychological data to inform comprehensive evidence-based treatment plans. Fellows coordinate referrals and multidisciplinary care with our colleagues in Behavioral Pain Medicine and Neurology. Fellows may also provide consultation to physicians, educators, athletic trainers and physical therapists regarding school and return to play/activity issues.
Year 1 core rotation
Center for Autism Spectrum Disorders (CASD) Autism Neuropsychology
Fellows in this rotation evaluate children who are verbal communicators with prior diagnosis or question of autism, including those with medical conditions impacting neurodevelopment. Fellows conduct neuropsychological evaluations and function as part of a multidisciplinary team of professionals. Differential diagnosis skills are emphasized. Fellows receive individual and group supervision and participate in team meetings, case presentations and didactics. Year 2 elective rotations are available through CASD, including opportunities to work with very young children (CASD Preschool clinic or rapid diagnostic evaluation with toddlers, to provide executive function treatment (“Unstuck and On Target” group), or to complete additional neuropsychological evaluations with this population.
YEAR 2 CORE ROTATION
Comprehensive Pediatric Epilepsy Program
Fellows participate in weekly multidisciplinary epilepsy team conference virtually and provide outpatient evaluations of children and adolescents diagnosed with seizure disorders. Fellows also work with surgical patients to complete pre-surgical baseline assessment and post-surgical follow-up, and may observe functional mapping sessions (fMRI, Wada, grid/sEEG).
YEAR 2 CORE ROTATION
Hematology/Oncology Program
Fellows provide consultations and evaluations to patients referred from medical specialties and the Brain Tumor Institute, a world leader in childhood brain tumor care and research. In addition, fellows obtain clinical experience evaluating children with Neurofibromatosis Type 1 (NF1) referred by colleagues in our Gilbert Family Neurofibromatosis Institute, which is one of the largest NF programs in the world There is also an elective option to complete an additional rotation in neuro-oncology, providing additional experience in screening, consultation, and focused assessment of brain tumor survivors.
Year 1 or Year 2 elective rotation
Bilingual (Spanish) Assessment
For trainees who are fluent and demonstrate professional language proficiency in Spanish. Rotation will include supervised experience testing children with varying levels of English language exposure (potentially ranging from recent immigrants who speak little to no English to those raised in a bilingual household in the U.S.) and from a variety of cultural and socioeconomic backgrounds. The fellow will also receive supervision on providing culturally-responsive clinical interviews and feedbacks. Referrals will include both medical and neurodevelopmental populations.
Year 2 elective rotation
Special Medical Populations
Fellows can request a rotation with a specific medical population. This is flexible and driven by the trainee’s interests. Options could potentially include referrals from Congenital Heart Disease, Neuroimmunology, Turner Syndrome or Neurogenetics programs.
YEAR 2 ELECTIVE
Neuropsychological Evaluation and Support for Toddlers (NEST Clinic)
Comprehensive neuropsychological evaluation of very young children with medical and neurodevelopmental challenges.