Carolina Institute for Developmental Disabilities (CIDD) Track Description 2022-2023

Track Overview: The CIDD Track offers interns a comprehensive training experience in assessment, evidence-based intervention, and clinical consultation in the areas of intellectual and developmental disability (IDD), autism spectrum disorder, learning disability, epilepsy, chronic medical conditions, sensory impairments, genetic syndromes, and other related neurodevelopmental disabilities across the lifespan. The CIDD intern works within interdisciplinary teams as well as with families, schools, group home personnel, care providers, and other professionals. Specific activities may include, but are not limited to, evaluation and diagnosis across the lifespan, behavioral and mental health consultation, intervention groups, consultation for children and adults with IDD living in the community or in local/regional group homes, and therapy with individuals with IDD. Pediatric neuropsychology evaluation experience is also available.

The Carolina Institute for Developmental Disabilities (CIDD) is North Carolina’s University Center for Excellence in Developmental Disabilities (UCEDD) and is home to a Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program and an Intellectual and Developmental Disability Research Center (IDDRC). As such, the CIDD has a rich offering of clinical, training, and research opportunities. The CIDD intern will participate in the interdisciplinary 2023-2024 LEND cohort. For all CIDD trainees, there is an emphasis on opportunities to observe and learn evaluation and treatment techniques from the other disciplines, including special education, speech and language pathology, social work, genetics, neurology, occupational and physical therapy, psychiatry, and pediatrics.

Interns will receive training and supervision with a focus on cultural sensitivity and awareness. The CIDD has an active Diversity, Equity, and Inclusion Committee that oversees periodic cultural responsiveness training for faculty, staff, and trainees.

Clinical Rotations and Patients:

Adult Autism Clinic (Melissa Beck, Ph.D.)

CIDD’s Adult Autism Clinic (AAC) offers diagnostic evaluations for adults. Often this clinic focuses on evaluating autism spectrum disorder in individuals who have struggled to succeed in school, vocationally, and socially. Many of these persons have been misidentified as having psychiatric diagnoses and/or have unidentified co-occurring autism spectrum disorder. An important element of evaluations for older adolescents or young adults is to assist in helping them transition from school and home-based services to adult educational, residential, and vocational services. This clinic is held twice per month.

Behavioral Medicine Clinic (Jean Mankowski, Ph.D.)

CIDD’s Behavior Medicine Clinic (BMC) is an interdisciplinary evaluation and treatment service for children, adolescents, and adults with underlying neurodevelopmental disabilities co-occurring with complex behavioral and/or psychiatric challenges. The evaluation and treatment team includes a psychologist and a physician trained in both pediatrics and psychiatry. Common referral concerns include assistance with self-injurious behaviors, disabling ritualistic behaviors, difficulties surrounding obsessive/narrow areas of interest, anxiety, depression, PICA, and explosive/aggressive behaviors. Evaluation services are problem focused. Diagnostic clarification of the underlying developmental disability is not the area of focus in this clinic. Intervention services can include but would not be limited to development of a detailed behavioral management plan, psychopharmacologic consultation, and collaborative institution of all recommendations with the family and community providers as appropriate. Consultation with the patient/family will vary from one visit to a longer period of co-management with the family and/or community provider as appropriate. This clinic is held on a weekly basis.

The Early Childhood Clinic (Becca Grzadzinski, Ph.D.; Melissa Beck, Ph.D.)

CIDD’s Early Childhood Clinic (ECC) offers diagnostic evaluations for children up to 6 years of age. The primary purpose of this clinic is to determine whether the child meets criteria for autism spectrum disorder or other developmental disorder. The team consists of a licensed psychologist and a licensed speech language pathologist. One of the attending SLPs is fluent in Spanish. Professionals from other disciplines are included as needed based on the referral questions. Evaluations for ASD typically use the ADOS-2, Vineland-3, diagnostic interviewing, developmental testing, and administration of other questionnaires as appropriate. Parents/caregivers are provided an interpretive conference regarding the results the evaluation, strategies to address their referral concerns, and opportunity to return for follow-up consultation and parent training/therapy. A report of the findings and recommendations is tailored to the needs of the family. This clinic is held weekly.

Hearing and Development Clinic (Jean Mankowski, Ph.D.)

The HDC offers diagnostic evaluations of individuals of all ages who are Deaf/Hard of Hearing in combination with developmental concerns. The primary purpose of the clinic is to better understand a child’s global developmental profile and provide relevant recommendations for treatment. Typical referral concerns include speech, language, or learning difficulties, developmental or intellectual delays, autism spectrum disorders, and/or concerns regarding socialization, communication, or sensory dysfunction. The team consists of an audiologist, speech-language pathologists, a psychologist, a learning specialist, and occupational therapy as needed based on referral concerns. At the conclusion of the interdisciplinary assessments an interpretive conference is provided for parents/caretakers to explain the results of the evaluation and strategies to address referral concerns. A report is provided along with assistance in identifying local resources. This clinic is held twice per month.

Pediatric Neuropsychology Clinic (Heather Hazlett, Ph.D.)

CIDD’s Pediatric Neuropsychology Clinic focuses on neuropsychological assessment of children and adolescents with neurological illness, medical illnesses and disorders, genetic disorders, psychiatric illness and behavior problems, brain injury, developmental disabilities, and complex learning issues. Individuals are referred to the clinic from a variety of sources, including neurology, nephrology, oncology, pediatric rehab, and local school systems. Neuropsychological assessment describes brain-behavior relationships by assessing multiple cognitive domains and relating a patient’s performance within these domains to neuroanatomical and neurophysiological principles. A typical clinic day begins with a parent/child interview to clarify questions and concerns, followed by three to five hours of assessment. Interpretive sessions may take place on another day in order to have time to score all assessments, develop the diagnostic formulation, and select appropriate treatments and recommendations. Interns participate in all aspects of the clinic, and gradually move into more independence in interviewing, battery development, and formulation. Interns participating in this clinic will be exposed to a wide range of clinical presentations, semi-structured clinical interviewing, neuropsychological testing procedures, interpretation of data, clinical interpretive with clients and family members, report writing, and community consultation and information sharing as requested by the families. This clinic is held twice per month.

The School-Age Autism Clinic (Melissa Beck, Ph.D.)

The CIDD’s School-Age Autism Clinic (SAAC) offers diagnostic evaluations for children and adolescents. The primary purpose of this clinic is to determine whether the child meets criteria for autism spectrum disorder, and differential diagnosis of other possible neurodevelopmental and/or psychiatric conditions. The team also provides consultation to families regarding tailored recommendations for interventions and supports. Evaluations typically consist of reviewing records, diagnostic interviewing, observational assessment (including the ADOS-2 when appropriate), measures of cognitive and adaptive functioning, and administration of questionnaires as needed. This clinic is held twice per month.

The School Age Team (Jean Mankowski, Ph.D.)

CIDD’s School Age Team (SAT) is the most comprehensive interdisciplinary clinic provided by the CIDD. Children and adolescents aged 3-21 who are struggling with a variety of different types of learning, developmental, social and/or behavioral/emotional concerns are referred to the SAT for evaluation. Currently, children and their caregivers spend a full day with CIDD faculty (representing up to 11 different disciplines). Consultation, interviewing, and standardized assessments are conducted, as appropriate. All clinicians participate in a team meeting following the evaluations to discuss findings and develop a plan for the child and family. Results are provided on the same day to the family. This clinic is held twice per month.

The Telehealth Evaluation and Consultation Clinic (Laura Hiruma, Ph.D.)

The Telehealth Evaluation and Consultation (TEC) clinic through the CIDD offers virtual telehealth services to families throughout the state. These include first-line screening and consultation visits, or more in-depth remote evaluation for families who might not otherwise be able to participate in an in-person visit. Clinic visits may involve clinical comprehensive assessments, clinical interviewing, remote assessments (including standardized tools for remote diagnostic assessment), and administration of questionnaires as needed, as well as tailored developmental and behavioral consultation. Individuals of all ages are seen through this clinic, which is offered twice per month.

Group-Based Social Skills Training (Gabriel Dichter, Ph.D.)

The Social Skills Group Clinic is a recurring 8-week group-based social skills training program. The group runs once during the Fall and once during the Spring. The group focuses on social cognition (understanding the intentions of others) and social skills (improving social behaviors) and relies on structured didactics, videos, and role-plays. The group is open to those with a formal diagnosis that impacts their social abilities (such as autism spectrum disorder or ADHD) as well as to those simply wishing to improve their social skills. The group is geared towards older teenagers and young adults, and most participants are in high school.

Genetic Syndrome Clinics (Offered less frequently)

Angelman & Duplication 15 Syndrome Clinics (Anne Wheeler, Ph.D.)

This clinic occurs once a month multidisciplinary clinic serving individuals with AS or Dup15 and their families across NC and surrounding states. Angelman Syndrome is a genetic disorder originating from the maternal leg of chromosome 15 which results in severe/profound intellectual disabilities, minimal speech, seizures, and an unusual happy demeanor. Duplication 15 Syndrome is a genetic disorder characterized by motor delays, epilepsy, and a high likelihood of intellectual disability and autism spectrum disorder. The clinic team is comprised of psychology, neurology, psychiatry, speech/language, nutrition, PT, OT, medicine, and genetic counseling. A medical consultation model is used in providing support to families who come to the clinic. Typically, 2-3 individuals and their caregivers are seen each month.

Neurogenetics Clinic (Heather Hazlett, Ph.D.)

CIDD’s Neurogenetics Disorders clinic is an interdisciplinary evaluation service for children, adolescents, and adults with genetic syndromes or documented chromosomal abnormalities associated with developmental disability (e.g., Fragile X Syndrome, Williams Syndrome, Down Syndrome, 22q11 Deletion Syndrome, and others). The clinic team is comprised of psychology, neurology, and speech/language disciplines. The clinical team provides assessment of cognitive strengths and weaknesses, neurologic concerns, sensory processing differences, and speech/ language concerns that may be part of a genetic disorder. After the clinic visit, a report will be provided with recommendations for local resources. Ongoing monitoring and consultation will be available for clinic patients if needed. This clinic is held once per month.

Prader-Willi Syndrome Follow up Clinic (Melissa Beck, Ph.D.)

CIDD’s Prader Willi Syndrome clinic is once every other month. This multidisciplinary clinic serves individuals with PWS and their families across NC and surrounding states.

PWS is a genetic disorder originating on the paternal leg of chromosome 15, which results in borderline to moderate intellectual disability, mild to extreme hypotonia, often severe hyperphagia (urge to eat), OCD and autistic-like behaviors, and mild self-injurious behaviors (mostly skin-picking). Many individuals with PWS have obesity-related health concerns as well. The clinic team is comprised of psychology, psychiatry, speech/language, nutrition, social work, medicine and genetic counseling. A medical consultation model is used in providing support to families who come to the clinic. Multiple families are seen by rotating providers each clinic.

Recommended Minor Rotations:

Didactics:

The CIDD intern participates in the didactics offered in our LEND program, which includes a broad interdisciplinary training curriculum on neurodevelopmental disorders with an emphasis on ASD, especially with respect to increasing early diagnosis and intervention. Interns participate in a weekly course September through April wherein cases are imparted through both small group asynchronous discussion and live meetings. The course provides a life span perspective related to interdisciplinary topics within the neurodevelopmental disabilities field. As such, they examine key issues, such as public health, life course perspective, cultural and linguistic competence, ethical decision making, person-/ family-centered approach, a systems lens, and community outreach. Additionally, the interns will attend hour long lectures twice monthly during the academic year that are didactic in nature and cover a wide variety of topics related to neurodevelopmental disabilities. If interested the intern can participate in a summer sign language workshop in a relaxed and interactive setting.

Professional Development:

The CIDD intern participates in a series of workshops designed to prepare future leaders with the ability to change the direction of policies, practices, and services in ASD/DD and to positively alter the life course trajectory for individuals and families. The workshops follow a developmental progression in focusing on leadership skills relative to self, then others, then the wider community. The model is unique in its application to public health issues while the curriculum is designed to provide a foundation for interdisciplinary and public health leadership. These 8 leadership workshops cover topics such as multiculturalism, bias, ethics, communication, conflict resolution, critical thinking, self-assessment, systems navigation, advocacy, family-professional relationships, policy evaluation, and dissemination skills in the context of leadership.

Research Opportunities:

Many of the CIDD faculty are involved in research projects, and CIDD has a rich community of researchers focused on neurodevelopmental disorders. Interns are welcome to interact with faculty around their research, often visiting labs, attending lab meetings or journal clubs, or attending grand rounds, talks by visiting scholars, or research seminars as their schedule allows. Psychology interns at CIDD can use their research time to explore options for postdoctoral fellowships, either formal programs such as the NIH funded T32 fellowship in neurodevelopmental disorders at CIDD, or informal opportunities for fellowships working on research projects. Interns can also choose protected time to work on their dissertation.

Supervision Training and Opportunities:

Interns will have opportunities to supervise graduate-level clinical psychology practicum students and to provide education and training to trainees within other medical or allied health disciplines.

Track Coordinator:

Jean Mankowski, Ph.D.

Clinical Supervisors:

Gabriel Dichter, Ph.D.

Heather Hazlett, Ph.D.

Laura Hiruma, Ph.D.

Jean Mankowski, Ph.D.

Becky Pretzel, Ph.D.

Melissa Beck, Ph.D.