Universal Psychology Postdoctoral Directory

Elements of quality clinically focused postdoctoral training

Program Overview

Neuropsychology services at Boston Children's Hospital have been provided for more than forty years, developing from collaborations among the Departments of Psychiatry, Neurology, and Neurosurgery. These services were developed to meet the growing demand for more sophisticated assessments of children with known or suspected central nervous system injury or dysfunction. The Center for Neuropsychology currently brings together neuropsychology faculty from the Departments of Psychiatry and Behavioral Sciences, Neurology, and Otolaryngology. The activities of the Center encompass clinical services, research, education/training, and advocacy in pediatric neuropsychology at Boston Children’s Hospital. The work of the Center is grounded in an innovative model of understanding brain-behavior relationships in the developing child. The theoretical framework is developmental – emphasizing the role of experience in building and sculpting the brain, the importance of context and relationships in providing critical experiences, the dynamic (interacting, re-organizing) nature of the brain’s transactions with context, and the need to understand the processes involved in developmental trajectories and neurobehavioral outcomes.

Clinical and research efforts involve relationships with the Dana-Farber Cancer Institute, the Department of Cardiology, the Spina Bifida Center, the Epilepsy Center, Neuroimmunology and Demyelinating and Related Disorders, Cerebrovascular Disorders and Stroke, Deaf and Hard of Hearing Program, Infectious Disease, Gastroenterology, Craniofacial Center, and the Brain Injury Center.

The Boston Children's Hospital's Neuroscience Program provides comprehensive, condition-specific care from a team of clinicians led by internationally known pediatric neurologists, neurosurgeons, psychiatrists and neuropsychologists. Children and teens with complex conditions involving the brain— such as epilepsy, brain tumors, brain injury, and vascular malformations—need a specialized team behind every treatment decision. Our integrated treatment centers combine the collective expertise of pediatric neurologists, neurosurgeons, psychiatrists, neuropsychologists, neurophysiologists, neurosciences nurses, and education and support specialists, with the expertise of subspecialists throughout Children's to deliver the best outcomes and quality of life.

In the Center for Neuropsychology, clinical assessment is approached from a neurodevelopmental systems perspective which addresses:

• the child as a whole

• the child in context (social, cultural, familial, academic, societal)

• the neural substrates of behavior

• psychological processes

• developmental change in brain and behavior.

The assessment strategy emphasizes the close relationship of evaluation and management, broad- based data gathering, integration of variables of diversity and culture, the importance of ecologically- valid interventions, and parent/child/teacher education. Consultation with a wide variety of professionals in medical, educational, and mental health settings and short-term interventions with children and parents around issues of adjustment and behavioral management related to problems arising from neuropsychological deficits are provided as needed.

Neuropsychological Assessment of Children

Children are referred by sources within and outside the Hospital, including neurologists, neurosurgeons, oncologists, psychiatrists, psychologists, and other physicians and nursing personnel from a wide variety of clinics. Children of all ages are seen, as well as some adults with developmental disorders or medical disorders dating from childhood. Assessment is sought around a number of issues:

• evaluation of neuropsychological strengths and weaknesses, including cognitive and socio- emotional status, control processes, motor/sensory, and academic skills;

• documentation of neurocognitive abilities;

• differential diagnosis of neurobehavioral disorders;

• differential diagnosis of neuropsychological versus psychological disorders;

• intervention and educational planning;

• psychosocial adjustment and development;

• monitoring of behavioral change over development or as a function of medical/surgical treatment.

Postdoctoral Residency in Pediatric Neuropsychology

The Center for Neuropsychology offers a two-year, full-time fellowship that provides training in clinical neuropsychological assessment of children and clinical research in epilepsy, leukemia, traumatic brain injury, congenital heart disease, learning disabilities/disorders, spina bifida, genetic disorders, and neuro-oncology. The program is designed to conform to Houston Conference guidelines for training in neuropsychology and prepares candidates for board certification in clinical neuropsychology through ABPP/ABCN. The goal of our program is to prepare for independent specialty practice in pediatric neuropsychology.

Overall Program Goals

• To train for competent, ethical, culturally responsive, independent practice in the specialty of clinical neuropsychology focusing on the neuropsychology of the developing child.

• To teach a neurodevelopmental systems approach to neuropsychological assessment in the context of an advanced understanding of brain-behavior relationships that addresses:

                   -the child as a whole

                   -the child in context (social, familial, academic, cultural, societal)

                   -the neural substrates of behavior

                   -psychological processes

                   -developmental change in brain and behavior.

• In the tradition of the scientist-practitioner model, to develop habits of scholarly inquiry, critical thinking, and life-long learning in the behavioral sciences as these apply to clinical practice, research investigation, and ongoing professional development.

• To prepare residents for board certification in clinical neuropsychology by the American Board of Professional Psychology.

• To train future leaders and educators in the field of pediatric neuropsychology.

Clinical Activities

Postdoctoral fellows are involved in direct clinical service in the Center for Neuropsychology for approximately 50% of their time. Fellows are involved in the general outpatient service throughout the two years of training in addition to specific clinical rotations (described below). Fellows perform neuropsychological assessments:

• By means of extended evaluations varying from three to six hours of testing over one to three sessions. For many patients, evaluations are delivered in a hybrid model that includes telehealth as well as in-person visits. Supervision in the planning of the evaluation, in test administration, in observation techniques, and in analysis and report preparation is provided by staff neuropsychologists. Fellows participate in outpatient assessments throughout the two training years with a range of children and young adults with medical, neurological, and developmental disorders.

• According to specific clinical protocols developed to address the special needs of particular neurological or medical populations (with senior staff supervision).

• In consultation to specific medical/neurological specialty clinics (with staff supervision).

Opportunities are also available for fellows to develop culturally competent practice skills providing neuropsychology services in community and international service-learning projects. In addition, fellows who are fluent in Spanish can receive specialized training and supervision in neuropsychology with our two Latinx neuropsychologists.

General Outpatient Service

The Center for Neuropsychology at Boston Children's Hospital provides evaluation of children/ adolescents with medical or neurological illnesses affecting the brain and development. Postdoctoral residents perform general outpatient evaluations for a range of neurological/medical conditions, including spina bifida, childhood leukemia, and other non-CNS neoplasms, genetic disorders, craniofacial disorders, sickle cell disease, cardiovascular disorders, metabolic disorders, organ transplants, and neurosurgical interventions, among others. Fellows work with different supervisors throughout the two years of training in the outpatient service.

Clinical Rotations

Clinical service time is split between specialized programs and general outpatient services. Rotations change every 6 months, and fellows have the opportunity to work with different faculty members over the course of their training.

• Epilepsy Program: Fellows assigned to the Epilepsy Program are responsible for evaluating children undergoing multi-disciplinary work-ups for epilepsy surgery. The rotation involves consultation, assessment, and participation in multi-disciplinary team meetings. Fellows present their findings at the weekly Epilepsy Neurosurgery Rounds. Fellows are also involved in post- surgical evaluations, providing feedback to the medical team, parents, and schools. Goals of this rotation include expanding the knowledge base in the area of pediatric epilepsy, providing timely and tailored evaluations and consultations to the medical team, and developing consultation and communication skills in a fast-paced medical environment. Opportunities for participating in cortical mapping are available as well.

• Neuro-oncology: Fellows assigned to Neuro-oncology perform neuropsychological evaluations with children followed in the Dana Farber Cancer Institute Brain Tumor Program. Responsibilities include participation in weekly multi-disciplinary clinics and consultation with treatment teams. Fellows will work closely with clinicians from the School Liaison Program at the Dana Farber Cancer Institute in the management of patients. Opportunities for developing school consultation skills through school observations and educational team meetings are available. Goals for the rotation include expanding knowledge of brain-behavior relationships, medical issues, and intervention management relevant in children with brain tumors; refining neuropsychological assessment and formulation skills; and developing multi-disciplinary consultation skills.

• Learning Disabilities Program: Fellows function as members of a multi-disciplinary team providing comprehensive assessments of children with learning disorders. Fellows work with a team of neurologists, psychologists, psychiatrists, speech/language pathologists, reading specialists, and math specialists. The rotation includes evaluation, consultation, supervision, and participation in team deliberations. Goals for the rotation include gaining familiarity with a range of learning disorders, developing tailored evaluation techniques, and refining consultation skills within an inter-disciplinary team setting.

• Neuropsychology Psychology Intern Clinic: In this rotation, second-year fellows develop supervision and teaching skills in neuropsychology by supervising psychology interns in their neuropsychological assessment rotation. Fellows work closely with neuropsychology faculty to develop supervision, leadership, and clinic management skills.

• Brain Injury Center: The Brain Injury Center cares for children from birth through young adulthood who have had a head or spinal cord injury. The goal of the program is to provide the best care practices for the entire spectrum from prevention through long-term follow-up. As a part of the center, fellows perform inpatient consultations and screenings for children admitted to the hospital for head injuries. Fellows also participate in a multi-disciplinary clinic providing consultation for children and young adults who suffered head injuries. They work with the attending neuropsychologist and specialists from psychiatry, neurology, trauma, neurosurgery, physical therapy, and occupational therapy to develop treatment plans. Fellows will also be involved in a concussion clinic focused on ongoing management and follow-up of mild head injuries. The Center is also involved in ongoing follow-up, educational, prevention, and program evaluation activities.

Elective Experiences

Fellows can select additional clinical experiences in stroke, infant/toddler assessment, deaf and hard of hearing, and spina bifida.

Research Activities

Fellows will meet with faculty early in the program to develop personal goals for research during their two-year stay. This may include working on their existing research projects, such as bringing dissertation research to publication, or undertaking new projects using existing data sets in areas of investigation in our program. These include long-term neurobehavioral outcomes of children treated for cancer (brain tumors, leukemia), the neurodevelopmental bases of learning disabilities, neuropsychological outcomes in spina bifida, and neurobehavioral consequences of epilepsy, craniofacial disorders, neurofibromatosis, congenital heart disease, cerebrovascular disorders, and head injury. They will also be assigned to currently active research projects where they can participate in data collection and data management and participate in research design and methodology deliberations. Fellows will attend monthly didactic sessions, focusing on skills that will prepare them for independence as investigators, such as reviewing and writing journal articles, as well as preparing IRB protocols and grants.

Didactic Seminars/ Supervision

Fellows attend seminars focusing on clinical, academic/research, and professional issues. The Neuropsychology Seminar is coordinated by the faculty of the Center for Neuropsychology. Clinical topics covered include: theoretical bases of assessment; diagnostic methodology; selection, administration and interpretation of tests/tasks/techniques; communication of findings, written (chart notes, consults, formal reports) and oral (feedback sessions); strategies for intervention and management; consultation in the medical setting and with outside professionals. Brain-behavior relationships in children, learning disabilities and learning disorders, developmental neuropathology, clinical research design, and professional issues will also be discussed in detail throughout the year. Fellows also attend a weekly small group seminar that includes a functional neuroanatomy/behavioral neurology tutorial, research skills training, fact-finding, and advanced clinical analysis over the course of the two-year residency. Fellows also attend the Longwood Area Neuropsychology Seminar. Fellows may attend Boston Children's Hospital Neurology, Neurosurgery, and Psychiatry Rounds and are expected to participate in the many conferences and seminars offered in the hospital, Harvard Medical School, and local institutions.

Supervision is provided by the faculty in the Center for Neuropsychology and involves in vivo observation as well as one-to-one meetings. Fellows receive a minimum of three hours of supervision per week and have the opportunity to work with several different supervisors over the course of their training. Group supervision experiences are also provided to address clinical analysis skills, professional development, and preparation for board certification. At the beginning of the training year, and on a regular basis thereafter, the fellow’s training needs are reviewed and discussed. Arrangements are made to provide appropriate didactic experiences to meet educational needs. Participation in other clinics in the hospital to obtain specialized training in specific areas can be arranged on an individual basis with the postdoctoral fellow. Progress, competencies, and training goals are evaluated on a regular basis.

Positions

The Center for Neuropsychology, Boston Children's Hospital is offering two postdoctoral fellowship positions in Neuropsychology for the 2025-2027 training period. This is a TWO-YEAR, FULL-TIME training experience in which the fellow’s time will be divided between clinical service delivery in the Center, didactics, and research activities. Travel support is available for conference participation for fellows presenting research. The Boston Children's Hospital Postdoctoral Residency in Neuropsychology Program is a member of the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN), the standards, procedures, and mission of which it endorses.

Qualifications

Applicants must present evidence of: substantial clinical experience with children, including use and interpretation of basic psychological tests; of coursework in physiological psychology, neuroanatomy, and neuropsychology; of training and competence in addressing issues of diversity and individual differences; and of a commitment to clinical research. Please include a list of relevant courses (title, instructor, location, year) and representative publications or published abstracts with the application.

Interviews

All interviews will be conducted via video conference in January 2025. There will be two interview days (Friday, January 17, 2025 and Wednesday, January 22, 2025) and applicants will have the opportunity to meet with our current fellows on the interview day. Applicants may request an optional site visit. Starting in 2024, Match submission and notification dates will be fixed on the 2nd and 3rd Wednesdays of February, regardless of the timing of the INS Annual Meeting.

• 2nd Wednesday in February (February 12, 2025): Final date for submission of applicant and program Rank Order Lists.
• 3rd Wednesday in February (February 19, 2025): Results of the Match are released to applicants and program directors.

For further information contact Clemente Vega, PsyD, ABPP, Training Director, Center for Neuropsychology; clemente.vega@childrens.harvard.edu or (617) 355-4462.