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 service. These services differ in their emphasis on the specific clinical populations (e.g., movement disorders, dementia, epilepsy, TBI, pediatric neuropsychology, neurorehabilitation, 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.
Adult
Rehabilitation
Supervisor: Dahomey Abanishe, Ph.D.
This is an inpatient rotation embedded in the UF Rehabilitation Hospital at 2708 SW Archer Road. Referred patients are often discharged from the hospital due to stroke, traumatic brain injury, spinal cord injury, amputation, burns, transplant, or major joint replacement. We work directly with a multi-disciplinary of specialists, including physical/internal medicine and allied health specialties (occupational, physical, and speech therapy). We aim to support patients’ quality of life while managing major traumas, injuries, or diseases. Interns conduct inpatient neurobehavioral examinations with a focus on qualifying the patient’s current mood, adjustment, coping strategies, mental status, neurobehavioral bases of behaviors, and readiness for discharge. These interviews aim to provide the treatment team accurate information about patients’ capacity for decision-making and self-care, insight into their condition, monitor for signs of delirium, and potential cognitive/emotional barriers to care and discharge. Feedback is then provided to patients, patients’ families, and the treatment team. Interns will also shadow each member of a patient’s allied health team to learn each member’s contribution to patient recovery and will administer bedside evaluations of patients’ current neurocognitive health to facilitate discharge planning for patients post-TBI, post-CVA, or with suspected neurodegenerative disease.
Cross-cultural Neuropsychology Service
Supervisor: Franchesca Arias, Ph.D.
The cross-cultural neuropsychological service at UF has been designed to provide comprehensive neuropsychological assessments to linguistically diverse patients presenting with a number of clinical conditions. While the clinic’s primary focus will be the neuropsychological assessment of cognitive functioning in older adults, patients 21 and older who are monolingual (Spanish) and bilingual (English and Spanish), will be welcome. Referrals from Neurology, Oncology, Geriatric Medicine, Primary care, and other specialties will be accepted. Patients will likely present with memory and global cognitive complaints, movement disorders, and changes in cognition after stroke or surgery.
Fixel Memory Disorders Clinic
Supervisor: Breton Asken, Ph.D., ATC
The typical patients seen in this service are older adults with suspected neurodegenerative diseases, including cognitive impairment related to Alzheimer’s disease and less common conditions like behavioral variant frontotemporal dementia, primary progressive aphasias, and atypical parkinsonisms. Test batteries tend to be relatively short and targeted. Interns will advance their understanding of clinico-pathological correlates and how to integrate biomarker data into their diagnostic differential. This service also includes opportunities for same-day “warm handoff” evaluations in conjunction with neurology where interns develop skills for rapid case conceptualization and efficient communication with multidisciplinary team members.
Interdisciplinary Movement Disorders and Adult Neuropsychology
Supervisor: Dawn Bowers, Ph.D., ABPP
This service is embedded within a multidisciplinary context that includes health care providers from neurology, neurosurgery and psychiatry. Interns conduct outpatient evaluations of various neurocognitive disturbances ranging from dementia subtypes, subcortical diseases, and neuropsychiatric disorders (OCD, Tourettes, psychogenic) to neurocognitive sequelae of medical disorders, sometimes quite rare (i.e., NSS). Most adult candidates for deep brain stimulation (DBS) are seen on this service and interns have opportunity to: a) shadow DBS neurosurgeons and rehabilitation experts (PT, OT) who are seeing the same patients we are evaluating; b) attend twice monthly consensus conferences where DBS candidates are discussed by the multidisciplinary team and c) observe DBS surgery. By virtue of being in an embedded clinic, interns rapidly develop interprofessional communication skills. We meet at the start of the clinic to discuss patients being seen that day. As part of same day supervision, 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. Emphasis is placed on user friendly reports and prescriptions for maintaining brain health via a “brain health profile”. This clinic is located off site at the Norman Fixel Institute for Neurological Diseases.
Triage Clinic
Supervisor: Dawn Bowers, Ph.D., ABPP
This is a high paced clinic that involves brief neurocognitive screening exams of patients who are often seen in conjunction with a neurology dementia specialist at the UF Normal Fixel Institute of Neurological Disease. A unique aspect of this clinic is that the intern works closely with the Neuropsychology Post-Doc (and Attending) to interpret findings and provide clinical impressions “on the spot” to other professionals, with feedback to patients and families being provided directly the same day. The service is highly interactive and didactic, with neuroimaging, testing, and other results being integrated into differential diagnoses and treatment plans. Though the common referral concern is “memory”, the actual range of patients is highly diverse including typical and atypical dementias, MCI variants, rare genetic syndromes, ALS, MS, hydrocephalous, etc.
Adult Neuropsychology Services
Supervisor: Erika M. Cascio, Psy.D.
This practicum is focused on adult neuropsychological assessment. Interns will see a variety of cases across a wide range of diagnostic populations. They will administer and score tests, write integrative reports, and conduct diagnostic interviews and participate in feedback.
Supervisor: Joe Gullett, Ph.D.
Patients include adults and older adults ages 55+ who are referred for a neuropsychological evaluation, with an emphasis on neurodegenerative diseases of aging.
Supervisor: Shellie-Anne Levy, Ph.D.
During this rotation, interns conduct outpatient evaluations of primarily older adults with MCI, typical and atypical dementias within a cultural neuropsychology framework. Other patient referrals may include post-surgical, psychiatric, stroke, movement disorders (Parkinson’s etc., post-DBS), TBI, and epilepsy. Interns participate in weekly group supervision on the day of the assessment as well as individual supervision. Graduate students, interns, and postdoctoral fellows rotate through this clinic; therefore, there will be opportunities for tiered supervision. There will often be review of selected readings pertinent to specific disorders. This clinic is held at the Norman Fixel Institute of Neurological Diseases.
Supervisor: Glenn Smith, Ph.D., ABPP-cn
Neuropsychological assessment of cognitive/memory and movement disorders in older adults.
Adult Acquired Neurological Injuries
Supervisor: Kristin Hamlet, Ph.D.
Outpatient neuropsychological assessments of adults with acquired neurological injuries. Assessment focuses on differential diagnosis and characterization of cognitive and functional strengths and weaknesses to inform actionable recommendations for community re-integration and/or achievement of patient-identified goals. These assessments may facilitate patient enrollment in cognitive interventions such as outpatient cognitive rehabilitation.
Acute Adult Neurotrauma
Supervisor: Kristin Hamlet, Ph.D.
Referred patients include those who have acutely acquired brain or spinal cord injuries and their family/loved ones. These inpatient visits serve patients and their loved ones throughout their acute hospital stay through a flexible approach most often involving 1) psychoeducation regarding brain injury or spinal cord injury, 2) psychological screening and brief interventions to support adaptive adjustments to injury, 3) cognitive screening to characterize existing impairments, and 4) psychosocial interviews to identify pre-existing patient-factors that might influence recovery trajectories (e.g., neurodevelopmental disorders, psychological disorders, substance use disorders, etc.)
Adult Brain Tumor/Awake Cortical Mapping
Supervisor: Shelley Heaton, Ph.D.
The cortical mapping rotation is a specialty neuropsychology rotation. Patients served are presenting with brain tumors in “eloquent cortex” (i.e., speech and/or motor centers) and surgical procedures are anticipated to require neuropsychological assistance in mapping these functional brain regions and monitor function in the awake patient through the surgery. All patients are adults, but vary in age from early to late adulthood. This is a fast-paced clinical training experience that involves work across outpatient, inpatient (hospital), and operating room (surgical) settings. Interdisciplinary work is a key aspect of training. This rotation has three clinical training components: 1) pre-operative (outpatient) assessment, 2) intraoperative (surgical) mapping procedures, 3) post-operative bedside (hospital) assessment.
Adult Epilepsy/WADA
Supervisor: Shelley Heaton, Ph.D.
In this specialty practica, interns will have opportunity to observe/participate in WADAs, shadow physicians on the epilepsy monitoring unit, engage in bedside neurocognitive evaluations, observe brain surgery and cortical mapping, and participate in interdisciplinary conferences. Interested interns are expected to evaluate a designated number of patients before and after brain surgery for treatment of intractable epilepsy.
Perioperative Cognitive Anesthesia Network
Supervisor: Catherine Price, Ph.D.
During this specialty practica, interns will learn 1) the type and severity of cognitive impairment prevalent in older adults electing surgical procedures, 2) how baseline cognition interacts with surgical and anesthetic prep and procedural outcome, 3) how to provide rapid diagnostic impressions and feedback within one hour, 4) how to speak to surgeon and anesthesiology colleagues about brain-behavior without using neuropsychology jargon, and 4) how cognition can change after surgery. Most importantly, interns will begin to appreciate how neuropsychologists can contribute to presurgical optimization of older adults and why neuropsychology-anesthesiology-surgical collaboration should be fostered. Interns will also engage in collaborative interactions with anesthesiologists, surgeons, geriatric medicine, primary care, neurology, and nursing staff. They will participate in at least one shadowing experience with an anesthesiology colleague.
Holistic Intervention for Brain Health and Recovery (HI-BHaR Clinic)
Supervisor: Aliyah R. Snyder, Ph.D.
The HI-BHaR Clinic provides behavioral health interventions focused on leveraging biopsychosocial factors to support recovery and brain health for patients with neurological disorders and other medical conditions. The HI-BHaR clinic employs a neuropsychology-informed educational approach to brief, time-limited therapeutic models aimed at improving cognitive, emotional, and health behaviors that impact recovery and rehabilitation for patients 12 years and older. Three treatment pathways are available using empirically based interventions: psychoeducational cognitive behavioral therapy, cognitive remediation, and mindfulness-based biofeedback. Interdisciplinary collaboration and communication are central tenants of the HI-BHaR clinic and therapists are often integrated within occupational therapy, physical therapy, and medical treatment teams. Referrals come from a wide range of medical concerns including but not limited to, concussion/traumatic brain injury, post-viral complications (Long COVID), and cognitive concerns in aging and neurodegenerative disease. The HI-BHaR clinic is also optimized to provide in-person and telehealth services, improving access to services for patients. Interns may schedule patients in-person at the Fixel Institute or via telehealth at the Psychology Main Clinic.
Multidisciplinary BRAIN Injury Clinic
Supervisor: Aliyah R. Snyder, Ph.D.
The purpose of this service is to provide brief and comprehensive neuropsychological assessments for patients with traumatic brain injury, to coordinate care with the medical team, and to equip patients and families with appropriate psychoeducation and resources to support recovery. Typically, there are 2-4 brief neurocognitive evaluations per week along with 2 comprehensive evaluations per month. These cases are typically split between 2 trainees. For brief neurocognitive evaluations, scoring is and feedback are completed same day and findings are communicated to the medical treatment team live to help with case conceptualization and treatment coordination.
Stroke and Other Acquired Conditions
Supervisor: John Williamson, Ph.D.
This is an advanced neuropsychological assessment clinic in which two to three patients patients per week are seen. Referrals include adult medical and include stroke/cerebrovascular disease, neurodegenerative disorders, neuropsychiatric considerations, and other acquired injuries (TBI). The assessment approach is a flexible battery.
Pediatric
Pediatric Neuropsychology
Supervisor: Shelley Heaton, Ph.D.
Interns completing this rotation will acquire competencies in the practice of neuropsychological assessment within the developmental context of pediatric practice. Competencies focused on during this rotation include: knowledge of cognitive and behavioral developmental milestones/expectations from birth to early adulthood, familiarity of common developmental and acquired neurological conditions in childhood, consideration of cultural and linguistic context in assessment, test administration, scoring, interpretation, clinical interviewing, integration of assessment findings, differential diagnosis, report writing, and oral feedback. Primary populations served are school-aged youth (mean age = 12) with complex medical and developmental histories with multi-factorial contributions to presenting problems. Rare neurological and genetic disorders are sometimes served. Example medical populations include: epilepsy, brain injury, hematology/oncology populations (including stroke), premature birth, and genetic disorders. Youth often have at least one co-occurring developmental disorders (LD/ADHD/low IQ). Mood and behavioral disorders are also assessed.
Craniofacial Anomalies Interdisciplinary Clinic
Supervisor: Shelley Heaton, Ph.D.
This practicum involves consultation to families of children with cleft lip or palate and other craniofacial disorders. Interns attend the weekly multidisciplinary team meetings of the craniofacial clinic and conducts screening assessments of 8-12 families weekly. Disciplines participating in the weekly clinic include pediatrics, social work, speech pathology, pediatric dentistry, oral and maxillofacial surgery, plastic surgery, orthodontics, and genetics. All team members meet after families are seen and an interdisciplinary treatment plan is developed for each child. Interns participate in follow-up assessment and therapy for children or families as necessary.
Pediatric Neuropsychology
Supervisor: Erika M. Cascio, Psy.D.
Interns completing this rotation will acquire competencies in the practice of neuropsychological assessment within the developmental context of pediatric practice. Competencies include: knowledge of cognitive and behavioral developmental milestones/expectations from birth to early adulthood, familiarity of common developmental and acquired neurological conditions in childhood, consideration of cultural and linguistic context in assessment, test administration, scoring, interpretation, clinical interviewing, integration of assessment findings, differential diagnosis, report writing, and oral feedback. Primary populations served are school-aged youth (mean age = 12) with complex medical and developmental histories with multi-factorial contributions to presenting problems. Rare neurological and genetic disorders are sometimes served. Example medical populations include: epilepsy, brain injury, hematology/oncology populations (including stroke), premature birth, and genetic disorders. Youth often have at least one co-occurring developmental disorders (LD/ADHD/low IQ). Mood and behavioral disorders are also assessed.
Pediatric Hematology/Oncology
Supervisor: Erika M. Cascio, Psy.D.
This service specializes in neuropsychological assessments for patients ages 6 months to 26 years who have been diagnosed with a brain tumor, hematologic condition, or cancer. Interns will learn about the neurocognitive effects of these conditions and their treatments, as well as the common psychological and psychosocial consequences/contributors to adjustment and treatment outcomes. Opportunities to follow individual cases from pre- to post-treatment are available via intervention/therapy. Interns are part of an interdisciplinary team and participate in various aspects of inpatient consultation/liaison work.
Holistic Intervention for Brain Health and Recovery (HI-BHaR Clinic)
Supervisor: Aliyah R. Snyder, Ph.D.
The HI-BHaR Clinic provides behavioral health interventions focused on leveraging biopsychosocial factors to support recovery and brain health for patients with neurological disorders and other medical conditions. The HI-BHaR clinic employs a neuropsychology-informed educational approach to brief, time-limited therapeutic models aimed at improving cognitive, emotional, and health behaviors that impact recovery and rehabilitation for patients 12 years and older. Three treatment pathways are available using empirically based interventions: psychoeducational cognitive behavioral therapy, cognitive remediation, and mindfulness-based biofeedback. Interdisciplinary collaboration and communication are central tenants of the HI-BHaR clinic and therapists are often integrated within occupational therapy, physical therapy, and medical treatment teams. Referrals come from a wide range of medical concerns including but not limited to, concussion/traumatic brain injury, post-viral complications (Long COVID), and cognitive concerns in aging and neurodegenerative disease. The HI-BHaR clinic is also optimized to provide in-person and telehealth services, improving access to services for patients. Interns may schedule patients in-person at the Fixel Institute or via telehealth at the Psychology Main Clinic.