UAB Clinical Child and Pediatric Psychology

The Child specialty track of the UAB Clinical Psychology Internship provides exposure to diverse and complex clinical populations in a wide variety of settings, including Sparks Interdisciplinary Clinics, The Children’s Hospital of Alabama, UAB Center for Psychiatric Medicine, Children’s Rehabilitative Services, a school-based Summer Treatment Program, and the Family Clinic serving children/adolescents with HIV. The diversity of settings and role functions afford numerous opportunities to interface with physicians, other health care professionals, schools, state agencies, advocates, and mental health professionals. All services emphasize the need to impact systems of care and individual lives though clinical service delivery to individuals and families, community education, and advocacy.

Each intern develops a unique training plan in conjunction with his or her yearlong supervisor that can emphasize those clinical areas that will be pursued with particular depth and focus. The primary training method is experiential (i.e., direct service delivery) and supervision plays a central role in the learning process. Supervision is augmented by a wide variety of didactic seminars, observation of staff conducting clinical services, guided reading, and consultative support. All interns are mentored and develop a close working relationship with their faculty preceptor. Interns also participate in weekly individual and when available group supervision sessions. A vertical team approach is employed in some settings and interns may be provided opportunities to supervise undergraduate and graduate level psychology students.

The Clinical Child and Pediatric Psychology Internship Track is a component of the UAB Clinical Psychology Internship. Internship application materials and additional information regarding the UAB Internship Program can be found at the following website: http://www.uab.edu/psychiatry/intro.htm.

The following is a sample of recurring didactic seminars and lectures available to the intern each year *Attendance is mandatory to the first two lecture series.

Neurodevelopmental Disabilities Core Lecture Series*
Psychology Training Consortium Seminar Series*
Adolescent Medicine Seminars and Online Curriculum
Pediatric Psychology/Neuropsychology seminar
UAB Neuropsychology Case Conference
UAB Epilepsy Case Conference
UAB Pediatric Grand Rounds
UAB Child and Adolescent Psychiatry Grand Rounds
CIRC Neurosciences seminar
Human Development Research Seminars

Faculty

Bailey, Kirstin (PhD, Washington State University, 2000); Clinical Psychologist; children at risk for disabilities; pervasive developmental disorders; child, adolescent, and family-based therapy.

Biasini, Fred J. (PhD, University of Alabama, 1984); Assistant Professor Psychology; Infants, toddlers, and young children at risk for disabilities.

Chase, Terry V. (M.A., University of Alabama, 1966); Instructor in Clinical Psychology; Adolescent psychiatry.

Friedman, Vivian K. (PhD, Case Western Reserve, 1975); Associate Professor; Child psychology, projective testing, psychometric testing, psychoanalytic orientation.

Hodgens, Bart (PhD, Auburn University, 1984); Clinical Assistant Professor Psychology, Clinical Instructor Pediatrics, Developmental psychopathology, behavioral assessment and intervention, learning disabilities.

Madan-Swain, Avi (PhD, Georgia State University, 1998; PhD, Purdue University, 1984); Clinical Associate Professor Pediatrics, Pediatric Psychology, Pediatric Rehabilitation and Neuropsychology.

Marullo, Dan (PhD, University of Alabama at Birmingham, 1993); Clinical Assistant Professor Pediatrics; Pediatric Psychologist, neuropsychological and psychological assessment, Pediatric Neurosurgery, consultation to the Pediatric Rehabilitation Team and Pediatric HIV Clinic.

Robinson, Shirley L. (PhD, University of Georgia, 1990); Clinical Assistant Professor, Pediatrics, Psychology, & Psychiatry; Adolescent Medicine, Pediatric Psychology, Maternal and Child Health, PTSD & Internalizing Disorders, Juvenile Justice.

Isbill, Susan D. (PhD, Brigham Young University, 1989); Assistant Professor Psychiatry; early childhood evaluation and treatment, projective testing, individual psychotherapy.

Major Rotations:
Sequence and specific content to be determined at beginning of training year

Child Development Clinic
Multiple Disabilities Clinic
Infant/Toddler Clinic
Autism Clinic
Newborn Follow-up Clinic
Psychology Clinic

Behavioral Assessment Clinic
Psychoeducational Clinic
ADHD Summer Treatment Program
Psychology Clinic

Rotation III:

Pediatric Neuropsychology/ Neurology
Pediatric Hematology Oncology
Pediatric Gastroenterology
Pediatric Rehabilitation
Burn Unit
Family Clinic

*Minor Rotations:
Child and Adolescent Inpatient is a required Minor. Adolescent Medicine is elective.

*A Minor can typically be arranged with any listed clinical experience pending supervisor approval.

Interns participate in the three Major rotations (described in detail below) and three Minor rotations. A Major rotation typically reflects a time commitment of three days and a Minor rotation reflects a two-day commitment. The specific content and sequence of rotations are determined following a meeting with the year-long supervisor and the rotation supervisors. Child interns are required to take Child and Adolescent Psychiatry as a Minor and are encouraged to take at least one Adult Minor experience. Refer to the general UAB Internship page for Adult rotation descriptions (http://www.uab.edu/psychiatry/intro.htm). The Pediatric Psychology/Neuropsychology rotation includes three faculty members (Ackerson, Madan-Swain, and Marullo) and a wider range of inpatient and outpatient experiences, thus requiring additional planning and choices. It is possible to work with any of the three faculty, depending on specific interests and expertise. For interns interested in Rehabilitation we recommend Drs. Ackerson and Marullo, in Pediatric Psychology Drs. Madan-Swain & Marullo, Consultation/Liaison Drs. Madan-Swain and Marullo, and Pediatric Neuropsychology Dr. Ackerson. Due to the heavy workload, some prior training in pediatric psychology or neuropsychology is necessary in order to work with the combination of Drs. Ackerson and Madan-Swain. Those interns interested in the subspecialty of Pediatric Neuropsychology will be able to get specialized training in this area.

Description of Clinical Experiences

Child Development Clinic (CDC) /Multiple Disabilities Clinic (MDC) /Infant and Toddler Clinic (ITC) Fred Biasini, Ph.D., and Kirstin Bailey, Ph.D.

The Child Development, Multiple Disabilities, and Infant and Toddler Clinics are comprised of an interdisciplinary team that includes the disciplines of Psychology, Social Work, Occupational Therapy, Physical Therapy, Speech Language Pathology, Audiology, Vision, Pediatrics, and Nutrition.

Children evaluated through the Child Development Clinic typically range in age from three to ten years old. The Multiple Disabilities Clinic provides assessments to individuals with multiple impairments who typically range in age from approximately four years to eighteen years old. Children evaluated through the Infant and Toddler Clinic range in age from birth to three years old. Referrals come from pediatricians, neurologists, geneticists, mental health professionals, service providers, teachers, and caregivers. The children evaluated through the clinics come from all over the state of Alabama and from surrounding states.

Psychological assessments provided through the clinics include measures of developmental or intellectual functioning (the Wechsler Intelligence Scale for Children, 3^rd Edition, Differential Ability Scales, Bayley Scales of Infant Development, 2^nd Edition, and Leiter International Performance Scale, Revised), adaptive functioning (Vineland Adaptive Behavior Scales, AGS Self-Help/Social Profile Questionnaire), behavior (Child Behavior Checklist, caregiver interview, in-clinic observation), and psychosocial functioning (parent and child interviews). Interns will work directly with their supervisor in administering, scoring, and interpreting assessment measures and supervision will be provided on an on-going basis (before, during, and after each assessment). Interns will participate in team staff meetings and develop recommendations for home and school functioning as a collaborative effort with their supervisor and with clinicians from other disciplines. Trainees will also be responsible for producing reports that include background information, assessment results, clinical interview, and recommendations about treatment planning and future directions. They are encouraged to participate in parent feedback sessions to explain assessment results, provide information about the diagnosis, and offer recommendations. Children evaluated through these clinics can be picked up for short or long-term individual or family-based therapy. Rotation I.

The Newborn Follow-Up Clinic is a multi-disciplinary team clinic that follows children born very low birth weight (less than 2.2 pounds) from birth to five years of age. The intern responsibilities are assessment based during this clinic and include administration of the Bayley Scales of Infant Development, 2^nd Edition, Differential Ability Scales, and the Wechsler Intelligence Scale for Children, 3^rd Edition. Trainees will administer assessment measures, complete a brief (one page) summary, and provide feedback and recommendations to caregivers. Rotation I.

The Sparks Clinics’ Autism Clinic is a diagnostic clinic serving individuals ranging from two to eighteen years of age. This clinic is one of the few of its kind in the state of Alabama; thus children with a suspected Autism Spectrum Disorders are referred from across the state and the surrounding states by pediatricians, neurologists, psychologists, educators, and families. The Autism Clinic team includes psychologists, educators, a nurse, and a developmental pediatrician. The diagnostic assessment includes the Autism Diagnostic Observation Schedule (ADOS), the Autism Diagnostic Interview (ADI), the Childhood Autism Rating Scale (CARS), and the Autism Screening Questionnaire. In addition, most children will participate in a cognitive assessment (using the WISC-III, Differential Ability Scales, Bayley Scales of Infant Development, Leiter International Performance Scales, PPVT-3, or Test of Visual-Motor Integration) and parents respond to the Vineland Adaptive Behavior Scales. In addition, all children receive a medical examination and a neurological screening. Interns electing to participate in the Autism Clinic will develop a familiarity with and competency in the administration of the assessment tools used in the diagnosis of autism. In addition, they will develop knowledge of the diagnostic criteria for each of the Autism Spectrum Disorders and an understanding of the variety of forms these disorders may take.

In addition, several children who have been diagnosed with autism are currently receiving intervention services through Sparks Clinics. These intervention services primarily utilize an Applied Behavior Analytic approach (specifically discrete trial training), but incorporate TEACCH methods, augmentative communication strategies, and play-based relationship building techniques. Interested interns are invited to participate in these intervention opportunities as a co-therapist with their supervisor or individually, depending on their level of comfort and experience. Rotation I.

This Clinic serves children and adolescents aged 5 to 18 usually referred by their primary physician for evaluation of behavioral and academic problems. Before patients are seen, comprehensive behavioral assessment data, medical and school records are obtained and reviewed. The Behavioral Assessment Clinic is staffed by Psychology and Pediatrics, with consultation from Nutrition, Social Work, and other disciplines as needed. Children receive medical and neurodevelopmental exams. The psychological evaluation consists of a semi-structured parent interview, cognitive and academic screening, behavior observation and ratings, and clinical assessment of impulsivity, inattention, and over activity. Parents and children are interviewed, and social emotional functioning is assessed. Group social skills and parent training interventions, as well as individual therapy patients, are developed through this clinic. Follow-up visits for children being medically treated for ADHD are held in the afternoon until the treatments are well established. Implementation and compliance with other recommended interventions is assessed at this time. Rotation II.

Beginning in Summer 2004, the UAB Summer Treatment Program for ADHD will be offered. The program is based on the model program developed by William Pelham, Ph.D. of SUNY Buffalo. It is a nationally recognized intervention program with a proven track record of success in a large NIMH-funded controlled trial and with over 2,500 children treated to date. In the initial year of the UAB Summer Treatment Program, 36 children will be recruited. The program is conducted at a nearby local school. The 8-week program incorporates numerous empirically validated treatments, including: academic remediation, sports skills training, peer relationship-building, parent training sessions, medication assessments, and a variety of behavior modification techniques (e.g., point system, time-out, daily report cards). Additional services are provided during the following school year to insure transfer of treatment gains to the home and school setting. These services include school consultation for development of education and behavior plans and periodic parent meetings for “booster” training sessions and problem-solving. Interns can function as Lead Counselors, supervising a team of four undergraduate counselors in implementing the program. Interns completing a Major rotation with Dr. Hodgens in the summer will primarily participate in this program. Interns on other rotations will participate in the follow-up aspects of the program. This experience is also available as a Minor rotation for adult or child interns. Rotation II.

This Clinic provides interdisciplinary evaluation of school-age children who are experiencing academic problems and are suspected of having a specific learning disability (e.g., reading, written expression) or a processing deficit (e.g., phonological processing, non-verbal learning disorder). Evaluation of cognitive functioning, academic skills, and other specific skills are conducted in a format compatible with school-based evaluations. The PEC is an interdisciplinary Clinic whose team consists of Psychology, Speech/Language Pathology, Occupational Therapy, Audiology, and Special Education. There is a strong focus on educating parents regarding their child’s strengths and weaknesses, legal/procedural aspects of special education and Section 504, how to advocate for their children with the school system, and what to look for in an effective Individualized Education Plan (IEP). Reports from this Clinic include comprehensive recommendations to schools. School visits for IEP development and follow-up services are also provided. Rotation II.

This clinic serves youth, families, and agencies seeking outpatient consultation, screening, evaluation, and/or treatment for youth aged 10 to 18. This elective minor rotation offers individualized leadership training activities, including both interdisciplinary (core disciplines include medicine, psychology, nursing, nutrition, and social work), and discipline-specific psychology activities. Leadership training focus areas include adolescent healthcare transition and positive youth development, PTSD and internalizing disorders, and related maternal and child health and policy issues (e.g., physical activity and obesity, ADHD, sexuality and reproductive health, chronic illness, disabilities, substance abuse, environmental concerns, and co-occurring diagnoses, etc.). Clinical and program consultation referrals through UAB/CHO General Adolescent Clinic, Teen-Tot Clinic, Eating Disorders Clinic, UAB Early Head Start Program, and others, including community-based partners serving system-involved youth and families (juvenile justice, education, social services, public health, etc.). Comprehensive outpatient psychological/diagnostic evaluations of youth include cognitive, achievement, adaptive, and emotional/behavioral concerns, with special interest in trauma and internalizing disorders affecting functioning (e.g., Trauma Symptom Checklist for Children, Child Behavior Checklist, Youth Self-Report, Behavioral Assessment System for Children, Beck Depression Inventory). Caretaker screening as appropriate (e.g., Symptom Checklist 90-R, Quality of Life Inventory). Therapy supervision (cognitive behavioral/eclectic), research, policy, interactive seminars, and online curriculum activities are also available. This experience is currently offered as a Minor only to both Adult and Child specialty interns. Elective Minor.

The Psychology Clinic provides outpatient psychological interventions to children, adolescents, and their families. Treatment approaches are primarily behavioral and cognitive-behavioral but may also include interpersonal and systems approaches. Referrals come from many sources but primarily from the Medical Center. Live supervision and review of audio/videotaped sessions is encouraged. Most supervision is individual and conducted weekly. Child specialty interns are expected to maintain an active therapy caseload of approximately five patients throughout the training year. This may include adult patients supervised by other Internship faculty. Yearlong.

Pediatric Rehabilitation Medicine: Dan Marullo, Ph.D. and Joseph Ackerson, Ph.D.

During the acute rehabilitation treatment phase interns work with youth who have sustained a traumatic brain injury (TBI) or spinal cord injury (SCI) and their families. Clinical interviews are completed with the family and bedside neurobehavioral examinations with TBI patients prior to discharge. Interns participate in weekly Interdisciplinary team staffings and assist with school and community reentry issues. Interns also attend Monthly Rehab Follow-up clinic. Rotation III.

This is a unique opportunity to work closely with a medical/surgical team in a consultative role with children and adolescents during a potentially long-term hospitalization. Clinical activities include assessment of the family and patient for underlying family dynamics that may affect recovery and rehabilitation. Interns have the opportunity for ongoing evaluation of pain and emotional recovery, as well as short-term psychotherapy during the child’s hospitalization. The intern is expected to attend Burn Team meetings and will assist in developing short and long- term rehabilitation goals. This rotation offers an excellent opportunity for learning to work as a member of a dynamic multidisciplinary team. Rotation III.

Consults are received on an as needed basis from the Pediatric Neurology service for inpatient consultation on differential diagnostic issues (e.g., seizure disorder vs. conversion disorder, delirium vs. psychosis) as well as short-term individual and family intervention. Rotation III.

Interns may choose to participate on either the general oncology/neuro-oncology or stem cell transplant team. In both settings interns complete clinical interviews and protocol driven neuropsychological evaluations. Brief written psychological/neuropsychological reports are generated for each newly diagnosed patient. Interns learn to design and implement treatment programs for: individual and familial coping/adjustment secondary to illness; depression and anxiety; pain management (e.g., procedural distress), medication noncompliance, school and community reentry, anticipatory grief, and bereavement issues. Interns also co-lead a parent support group as well as a Teen group. Rotation III.

Interns complete both pre-and 1-year post transplant psychological and neuropsychological evaluations for all patients. Both the child and family are followed inpatient during the course of their hospitalization and after discharge. When necessary the intern designs and implements short-term behavioral interventions to address issues related to pain management, mood management, and adjustment and coping secondary to the medical diagnosis. Rotation III.

Occasional opportunities are available to participate in a behaviorally based interdisciplinary program for encopretic youth in the Gastroenterology Division. Rotation III.

Child and Adolescent Inpatient Psychiatry Units: Terry Chase, MA, Vivian Friedman, PhD, and
Susan Isbill, PhD

Patients include children and adolescents, ages 2-19 and their families who are seen in inpatient psychiatric units (UAB Inpatient Adolescent Psychiatric Unit and UAB Inpatient Children's Unit). These psychiatric units are multidisciplinary, acute care settings where children and adolescents are seen for a full range of DSM IV issues. Interns participate in team meetings, case conferences, clinical interview, psychological testing, group therapy, family meetings/therapy sessions and individual therapy sessions. This experience is offered as a Minor only to Child specialty interns. The exact allocation of time spent in activities is negotiated with the supervisor and trainee and is largely determined by intern need/interest. Most interns complete one evaluation per week. Assessment may include screenings as well as comprehensive evaluations. Interns have an opportunity for experience/training in a variety of assessment procedures for children and adolescents including; diagnostic interviewing, mental status examination, cognitive and psycho-educational testing, projective techniques, objective behavior and personality inventories. Interns have the opportunity for experience/training in treatment procedures for children and adolescents including; group therapy, cognitive/behavioral interventions, parenting interventions, psychodynamic therapy and play therapy. Supervision is provided daily. Minor rotation (required).

Family Clinic (Pediatric HIV Clinic): Dan Marullo, Ph.D. Interns have the opportunity to function as a member of a multidisciplinary team in the long-term treatment of children and adolescents with HIV infection. Interns will be exposed to numerous issues including the ethics of disclosure of HIV status, the effects of anger, guilt and grief in families on utilization of medical services, and evaluation of long-term neurocongitive effects of chronic HIV infection. Opportunities for brief time-limited psychotherapy and parent training are available. Rotation III.

Children and adolescents aged 2-18 with diverse medical, psychiatric and neurodevelopmental disorders. Primarily outpatient clinical training experiences in Pediatric Neuropsychology approaches to evaluating and treating acute and chronic illness with the following referral base (in order of frequency): Pediatric Neurology (epilepsy, genetic, metabolic, developmental and acquired disorders), Rehabilitation (traumatic brain injury and spinal cord injury), Neurosurgery (pre- and post-surgical evaluations), General Pediatric, Neuro-oncology (brain tumor, cancer), Hematology/Oncology (leukemia, sickle cell, cancer), Infectious disease (esp. CNS infections), and Child and Adolescent Psychiatry. Pediatric traumatic brain injury and epilepsy are the most frequently seen populations.

Minimum requirement is one full day of testing per week plus associated paperwork (scoring, documenting observations, and report writing) for about 70-80% time. The remaining day may be spent in report writing, providing verbal feedback, attending out-patient medical clinics (Neurofibromatosis, Rehabilitation, Neurology, etc.), participation in hospital based consultation/liaison activities, outpatient psychotherapy, and research. The Neuropsychology Clinic also has an Educational Specialist and the intern can gain exposure to school consultation, development and implementation of cognitive/academic remediation programs with neurological populations. Release for research time will need to be negotiated with your primary supervisor.

Since the primary focus is outpatient Neuropsychological testing the Intern will initially be responsible for administering, scoring and interpreting all tests. Having demonstrated proficiency in test administration and scoring, the intern will then begin to learn how to utilize technicians, select appropriate instruments, conduct clinical interviewing, and provide verbal and written feedback. Rotation III.

This clinic meets every other month and can be combined with Rehabilitation or Neuropsychology Clinic. Patients ages 2-18 are seen along with Neurology and Neurosurgery in an outpatient medical setting at Children's Hospital. Opportunities to interface with Nursing and Social Work are frequent. Emphasis is on brief interview based or neurobehavioral examination with immediate feedback to family and physicians. Rotation III.

Interns participate in this weekly clinic. They are responsible for completing clinical interviews with the family and protocol driven neuropsychological testing with the child. When needed short-term problem-focused behavior and/or cognitive behavioral interventions are implemented. Rotation III.

This is an interdisciplinary clinic for pediatric survivors of childhood cancer and their family. The intern completes clinical interviews with the survivor and the family, participates in the education of the family regarding medical and psychological later effects related to the cancer treatment. Rotation III.

This outpatient clinic provides long-term services to children and adolescents that have sustained a traumatic brain injury and/or spinal cord injury. The intern will function as a member of a multidisciplinary team and will develop recommendations based upon brief neurocognitive and psychological screening for more in depth assessment, school re-entry/remediation, and other services. Rotation III.

In addition to core interdisciplinary Adolescent Medicine evaluations, brief psychology screening, consultation, and evaluation opportunities are offered through medical outpatient clinics such as General Adolescent Clinic, Teen-Tot Clinic, Family Clinic, Eating Disorders Clinic, and others. See also I. Outpatient Interdisciplinary Clinics above. Elective Minor.

Contact Information

Sheryl R. Jackson, Ph.D.
Assistant Professor, Dept. of Psychiatry
University of Alabama at Birmingham School of Medicine
(205) 934-4301
Fax: (205) 975-7248
srjackson@uabmc.edu

Jennifer Mahaffey
Psychology Training Consortium Secretary
UAB Neuropsychiatry Clinic
1700 7th Ave South, 4th floor
Birmingham, AL 35294-0018
Ph: 205-934-4301
Fax: 205-975-7248
jmahaffey@uabmc.edu

Kirstin Bailey, Ph.D.
Clinical Psychologist
Civitan International Research Center
Ph: 205-934-5471
Fax: 205-975-2380
kbailey@civmail.circ.uab.edu

The UAB Clinical Psychology Internship is a broad-based training program administratively housed in the UAB Department of Psychiatry and Behavioral Neurobiology - Psychology Section. The program is co-sponsored by the Psychology Service of the Department of Veterans Affairs Medical Center, Bryce Hospital, The Civitan International Research Center, and the Department of Psychiatry and Behavioral Neurobiology at the School of Medicine.

Additional information regarding the accreditation status of the UAB Clinical Psychology Internship site as well as other sites is available from the American Psychological Association - Office of Program Consultation and Accreditation: 750 First Street, NE, Washington D.C. 20002-4242; (202) 336-5500 or (202) 336-5979 (www.apa.org).

The UAB Psychology Training Consortium belongs to the Association of Psychology Postdoctoral and Internship Centers (APPIC; www.appic.org). The program endorses and adheres to all policy set forth by the APPIC.

Clinical Child and Pediatric Psychology Internship Track Sponsored by The Civitan International Research Center

Faculty

Rotation III:

Description of Clinical Experiences

Contact Information

Clinical Child and Pediatric Psychology Internship Track
Sponsored by The Civitan International Research Center