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Autism

First and second year Child Psychiatry fellows complete an 8-month rotation in the University of Florida Autism Program. During this time, fellows gain experience in the diagnosis and treatment of children and adolescents with Autism Spectrum Disorder (ASD) and related developmental disorders. They also serve as a member of a multidisciplinary team and learn a systematic approach to the assessment and treatment of developmental disorders.

A. Required 8-month rotation occurring in the first and second year at institution 1 and requires 10% of the residents time.

B. Faculty consists of one full-time Child Psychiatrist and one-full-time advance registered nurse practitioner.

C. Fellows spend 1½ to 2 hrs for new evaluations which consist of patient observation/interview, family interview and interview of related staff, and review of standardized intake materials. All patients are staffed with the faculty. Fellows may attend also multidisciplinary treatment meetings.

D. The clinic population consists 40% females and 60% males, with ranging from 2 to 17 years, with a mean of 10.7 years. All of the children are diagnosed with Pervasive Developmental Disorders, including Autistic Disorder, Asperger’s syndrome, or Pervasive Developmental Disorder, not otherwise specified. Some children have identifiable genetic syndromes. This clinic provides initial assessment as well as a multidisciplinary treatment plans. Comprehensive assessments often include neurological consultation, hearing and speech assessment, laboratory testing, imaging studies, genetic consultation and psychological testing. Interventions include psychotropic medications, functional behavioral analysis as well as parent education and support, referral for services thorough the Center for Autism and Related Disorders (CARD program) and other forms of therapy.

E. Average fellow caseload includes one new outpatient assessment every-other week with additional follow-ups during the clinic time period. The fellow works with the multidisciplinary team consisting of representatives from psychology, CARD, and applied behavior analysts (ABA).

F. Each fellow receives supervision from faculty during initial assessment and follow-up visits. Faculty also supervises the resident in multidisciplinary conferences.

G. Following are the goals and objectives for this rotation:

Goal: To become proficient in applying psychiatric skills in the evaluation, diagnosis, treatment, and management of children and adolescents with a variety of pervasive developmental disorders.

Objectives:

Knowledge: The fellow should demonstrate knowledge of the fundamentals of evaluation, diagnosis, and treatment of children and adolescents with a variety of developmental disorders. Specifically, the fellow should:

  • Be able to identify normal and abnormal development in infants through adults.
  • Have a clear knowledge of the criteria used to establish diagnoses in the pervasive developmental disorder spectrum.
  • Understand the role of laboratory testing as well as imaging in the diagnosis of autism.
  • To understand the role of speech and language, physical therapy and occupation therapy in the treatment of pervasive developmental disorders.
  • Be able to identify symptoms and situation for which psychotropic medications may be a useful treatment modality.

Skills: The fellow should demonstrate the ability to

  • Provide specialty assessment of children and adolescents with complex neuro-developmental difficulties.
  • Perform Childhood Autism Rating Scale and Denver Development Screening Examination.
  • Develop a comprehensive differential diagnosis and multi modal treatment plan for children, adolescents and families, including the use of appropriate laboratory, medical and psychological examinations.
  • Collaborate with professionals of various disciplines in the provision of care for children, adolescents, and families.
  • Work as a member of a multi-disciplinary outpatient team, and to increasingly provide leadership within the team structure.
  • Handle emergent situations such as self-injurious behavior in an appropriate manner.

Attitudes: The fellow will demonstrate

  • A strong sense of responsibility for patients.
  • Commitment to utilize supervision to continuously improve his/her skills in the evaluation and treatment of children and adolescents with developmental disorders.
  • Sensitivity to potential parental disappointment and sense of loss of the ideal child.
  • Awareness of cultural differences in expression of symptoms and meaning of having a developmentally delayed child.
  • Ethical conduct in the treatment of all patients and families.