Autism Clinic

Richard D'Alli

Richard E. D’Alli, MD, MEd, ScM

Gregory Valcante, Ph.D.

Gregory Valcante, PhD

Faculty:

Richard D’Alli, MD, MEd, ScM

Gregory Valcante, PhD

First and second year Child Psychiatry residents complete a rotation in the University of Florida Autism Program, one-half day per week (on Friday mornings).  During this time, residents gain experience in the diagnosis and treatment of children and adolescents with autism 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. An Autism Center of Excellence at the University of Florida is under development, and as this progresses, we expect interprofessional teamwork between child psychiatry, pediatrics, psychology and occupational therapy to increase.

A. Required one year rotation occurring in the first year at institution 1 and requires 10% of the resident’s time. During the second year, the fellows’ role with the Comprehensive Autism Program expands, but will consist of 10% time.

B. Faculty consists of one full-time Child Psychiatrist , and the consultation services of the Center for Autism Related Disability professionals.

C. Residents spend 2 hours 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. Residents attend also multidisciplinary treatment meetings.

D. The clinic population consists of 30% females and 70% males, with ranging from 2 to 17 years, with a mean of 10.7 years. All of the children are diagnosed with Neurodevelopmental Disorders, including Autistic Spectrum Disorder, Social Communication Disorder, or Unspecified Neurodevelopmental Disorder.  Some children have identifiable genetic syndromes (notation that DSM V criteria will change demographics).  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 CARD program and other forms of therapy.

E. Average resident caseload includes one new outpatient assessment a week with additional follow-ups during the clinic time period. The resident works with the multidisciplinary team consisting of representatives from psychology, The Center for Autism and Related Disability and behavior analysts.

F. Each resident 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 resident should demonstrate knowledge of the fundamentals of evaluation, diagnosis, and treatment of children and adolescents with a variety of developmental disorders. Specifically, the resident 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 resident should demonstrate the ability to:

  • Provide specialty assessment of children and adolescents with complex neurodevelopmental 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 resident 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.
  • Commitment to learning how to provide the highest standard of patient care, including the use of the literature to guide treatment and quality parameters to evaluate treatment.