A typical week in the life of the Neuropsychology intern includes two formal assessment days. On each day, the intern works with a faculty supervisor seeing patients through that particular faculty member’s clinic. These clinics differ in their emphasis on the specific clinical populations (e.g., movement disorders, dementia, epilepsy, TBI, pediatric neuropsychology, etc.). Thus, in each quarter, the intern is supervised by at least two different neuropsychology faculty. The remaining days involve clinical supervision, seeing therapy clients, and participating in educational and clinical conferences. The latter include neurology ground rounds, Epilepsy Management Conference, Deep Brain Stimulation pre-surgery rounds, and various clinical and research conferences.
GENERAL ADULT
Monday Adult Neuropsychology
Supervisor: Dawn Bowers, Ph.D., ABPP
This is a multidisciplinary clinic held at the Center for Movement Disorders and Restoration. During this clinic, patients with a variety of neurocognitive disturbances are seen including dementia subtypes (PDD, LBD, CBD, AD), subcortical diseases (Parkinson disease, Essential Tremor, dystonia), psychogenic and neuropsychiatric disorders (OCD, Tourettes), and various sequelae of medical disorders (rare genetic diseases,, MS, etc.). Many Parkinson patients seen on Mondays are candidates for deep brain stimulation surgery. Trainees have the opportunity to attend monthly multidisciplinary conferences where DBS candidates are discussed by neuropsychology, neurology, neurosurgery, psychiatry, OT, PT, and Speech. Weekly group supervision occurs on Fridays. During these meetings, interns present their cases, including history, results, and interpretation, to the team. Hypotheses about the mechanisms of deficit, and further treatment/evaluation recommendations are formulated. User friendly reports are emphasized, meaning reports that are jargon free and comprehensible to the referring physician or patient.
Tuesday Adult Neuropsychology
Supervisor: Duane Dede, Ph.D.
During this rotation, interns will see primarily outpatient evaluations on a variety of diagnoses. Most referrals will focus on adult learning disabilities, traumatic brain injury, competency evaluations for impaired professionals. We will also occasionally see cases of epilepsy, dementia and general mental health. Occasionally, cases of disability or brain injury will present as forensic evaluations. Trainees learn to administer a structured interview, conduct feedback sessions while administering and interpreting a comprehensive battery of tests. Individual and group supervision are provided.
Wednesday Adult Neuropsychology
Supervisor: Russell Bauer, Ph.D., ABPP
During this rotation, interns will conduct neuropsychological evaluations on patients with a variety of cognitive disorders. Most common disorders during this rotation are subtypes of dementia (e.g., Alzheimer, Lewy Body, vascular), neurocognitive sequelae of medical disorders (e.g., stroke, neoplasm), epilepsy, and neuropsychiatric disorders. Interns gain some exposure to disability evaluations and forensic cases. The intern will learn a hypothesis-oriented approach using a flexible battery, and will become familiar with major modalities of diagnosis used by interdisciplinary health care teams. Interns will typically assess one patient per week and are invited to attend a Dementia Consensus Conference at 1:30-3 each Tuesday where patient findings are presented (as are neurologic, medical/laboratory, and neuroimaging findings) and a consensus diagnosis is reached. During supervision, we meet as a team and trainees present their cases, including history, results, and interpretation, to the team, where hypotheses about the mechanisms of deficit, and further treatment/evaluation recommendations are formulated. Background readings are provided where appropriate.
Thursday Adult Neuropsychology
Supervisor: Catherine Price, Ph.D.
During this rotation, interns will conduct inpatient and outpatient evaluations of adults with a variety of neurocognitive disturbances. Typical referrals include pre and post-operative assessments of older adults who undergo surgical interventions (Cardiac, Orthopedic Surgery), present with symptoms of dementia, autonomic/movement disorders (PD/MSA), psychogenic presentations, epilepsy, and others. Supervision is individual, group, and involves video review. Supervision also includes review of selected readings and introduction to basic radiology readings (particularly for dementia and white matter disease). Interns are encouraged to attend and present their cases at an interdisciplinary dementia case conference and medical review boards (e.g., cardiology).
GENERAL PEDIATRIC
Thursday Pediatric Neuropsychology
Supervisor: Shelley Heaton, Ph.D.
During this rotation, interns will conduct inpatient and outpatient evaluations of children and adolescents with a variety of neurological, psychoeducational, and behavioral disturbances. The age range of patients seen on this rotation spans from 2 to 19 years old, allowing trainees to gain exposure to a wide range of pediatric neuropsychology assessment methods and a broad range of developmental issues. Referrals are received from a variety of sources and represent a wide variety of patient groups, including neurology (epilepsy; pre/post brain surgery evals; rare neurological or genetic disorders), hematology/oncology (brain tumors/cancer; pre/post surgery and chemo/radiation evals), School Problems Clinic (academic difficulties of unknown etiology; opportunities for multidisciplinary work), pediatric ICU and/or pediatric neurosurgery (traumatic brain injury; acute inpt evals), Brooks Rehabilitation Hospital (traumatic brain injury; post-rehab outpt evals), and local pediatricians (developmental delays, cognitive deficits w/mood or behavioral disturbance). Trainees are expected to take primary responsibility for the assessment and report-writing on 1 case per week, participate in weekly group supervisions (Friday afternoons from 1-2), and complete supplementary readings of relevance to the disorder at hand.