CIDD Collaborative Connections: Specialized Support for Developmentally Complex Youth Served by UNC Pediatrics (C3Y)
Background
The Behavioral Medicine Clinic (BMC) at the Carolina Institute for Developmental Disabilities (CIDD) has been seeing behaviorally and medically complex children with Intellectual/Developmental Disability (IDD) since 2009. The BMC is directed by Robert Christian, MD and Jean Mankowski, PhD. This program provides initial and ongoing psychiatric behavioral consultation/management to about 75 new cases per year and supports approximately 110 families at any given time.
The CIDD is North Carolina’s only University Center of Excellence for Developmental Disabilities (UCEDD). It has the unique perspective and expertise to perform this work as a part of a nationwide network of centers that seek to address issues and advance research related to the needs of individuals with developmental disabilities. Lastly, CIDD specializes in serving individuals with intellectual and/or developmental disabilities who may have co-existing behavioral, mental health, or medical health needs.
Our Program
Through the experiences across our team members, we continued to come across gaps in our medical, educational and Medicaid systems where youth with complex medical needs and IDD or youth with autism or IDD and co-occurring behavioral health needs had trouble navigating systems and getting their needs met. Additionally, many of the individuals with autism, physical disabilities or traumatic brain injuries were not eligible for the available Medicaid waiver programs.The CIDD Collaborative Connections: Specialized Support for Developmentally Complex Youth Served by UNC Pediatrics (C3Y) program started in 2020 to support youth with intellectual and/or developmental disabilities who also have co-occurring behavioral, mental/behavioral health or medical complexity and their families.
Services under C3Y may involve behavioral medication consultation, connection to ongoing psychiatry or behavioral medication support, behavioral consultation, screenings to determine appropriate testing and family navigation services. Referrals can be made into C3Y by UNC Pediatric Neurology, UNC Developmental Behavioral Pediatrics, UNC Pediatric Complex Care or the CIDD Behavioral Medicine Clinic. Services for each participant and family may include one or all of the services available in our program. We seek to provide participant and family-centered experience. We meet caregivers where they are and try to match the level of support they need. For some families, we simply provide resources and information. For others, we may walk beside them for a longer period of time connecting to multiple services and resources along the way as the family has the time and capacity to pursue them. We understand that each family’s needs and wants may vary based on cultural norms, their experiences with different government systems and their need to triage accessing support while managing the daily needs of their loved ones. Since its inception, the C3Y program has served almost 400 participants.
CIDD Collaborative Connections: Specialized Support for Developmentally Complex Youth Served by UNC Pediatrics (C3Y)
- Behavioral medication consultation for the referring medical provider with CIDD Board Certified Pediatric Psychiatrist
- Identification and connection to ongoing psychiatry services (CIDD faculty, UNC Psychiatry clinics, UNC Developmental Behavioral Pediatrician or community provider)
- Behavioral consultation* to help identify triggers, share general behavior guidance, assess other needs
- Screening to determine needs for additional testing
*Not a mental health diagnostic or psychological assessment.
- Lived experience peer support to caregivers for navigating school, healthcare, government systems (Medicaid, SSI) and assistance connecting to resources.
- Family System Consultation provided by social work team to inform family navigation services
Our Team
Psychiatry
C3Y was created by Dr. Robert Christian, a pediatrician and psychiatrist.
Assistant Professor of Psychiatry and Pediatrics
Associate Director, North Carolina LEND Program
Psychology
Our behavior consultations and test screenings are conducted by our CIDD psychologists.
Clinical Associate Professor of Psychiatry
Licensed Psychologist #3643
Director of Training, NC-LEND
Clinical Assistant Professor/ Licensed Psychologist
Department of Psychiatry
Licensed Psychologist
Social Work
Our social workers are the backbone of C3Y through implementation of Family Support Services: providing supervision, training and support to our family navigators and the larger C3Y team. Additionally, Morgan Parlier also provides social work consultations and sexual health education consultations.
Director of Family Support Services
Clinical Social Work Faculty
Asst Director of Family Support Services
NC-PAL I/DD Coordinator
Family Navigation
Our family navigation is provided by caregivers with lived experience as the primary caregivers and decision makers for children or adults with intellectual and/or developmental disabilities with co-occurring behavioral, mental health or medical complexity like the participants we serve.
Family Support Coordinator
Lead Family Navigator
Family Navigator
Family Navigator
Trillium focused
Family Navigator
Trillium focused
Core C3Y Medical Provider Team
Our core team including everyone above meets weekly to review and advise on best support for participants of the program. We are fortunate the expertise of pediatric complex care, represented by Neal DeJong, MD, MPH, co-PI, neurology and developmental behavior pediatrics for the interdisciplinary approach to care provided by C3Y. Additional physicians consult for our program participants as needed.
Primary Care, Pediatric Diagnostic and Complex Care, General Pediatrics and Adolescent Medicine
Pediatric Neurology
Pediatric Neurology
Child Learning and Development, Autism
Additional C3Y Program Support Members
LEND Clinical Trainees (Social Work, Psychology, Mental Health Counseling)
CIDD Clinical Assistant
IDD Peer Support
C3Y Program Highlights
During first six years of program, we have supported 393 participants and 497 referrals. We expanded family navigation efforts during the 2024-2025 fiscal year with support from Trillium Health Resources.
Advocacy
Our C3Y program also participates in state level information sharing and advocacy to highlight areas of need and better serve the IDD community. Our program was initially created at the request of North Carolina’s Department of Health and Human Services (NC DHHS) to support this underserved population. Through C3Y and CIDD, we have created partnerships NC DHHS, Disability Rights North Carolina (DRNC), NC START’s Central Region, Alliance Health’s Children with Complex Needs, Trillium Health Resources, Autism Society of North Carolina, The Arc of North Carolina, North Carolina Council of Developmental Disabilities and others to help identify barriers to accessing care, education or services for youth with intellectual and/or developmental disabilities and co-occurring behavioral, mental health or medical complexity.
Sponsors
Current C3Y program sponsors include North Carolina Department of Health and Human Services, Trillium Health Resources and The Arc of North Carolina.