Developmental Medicine Center Combined Clinical/Research Fellowship
The Division of Developmental Medicine (DDM) at Boston Children’s Hospital is dedicated to improving the lives of children and adolescents with developmental, learning, and behavioral difficulties and their families through integrated and collaborative clinical care, training, clinical and translational research, neuroscience, and community engagement and collaboration. The interdisciplinary staff comprises developmental-behavioral pediatricians, child psychologists, educational specialists, nurse practitioners, neurologists, and child psychiatrists; in addition, there is the opportunity to consult, as needed, with specialists from a variety of programs, including Speech-Language, Sleep Disorders, and Genetics. As a tertiary care site, the Developmental Medicine Center (DMC) accepts referrals for children with developmental and behavioral challenges that are not well met in the general medical and mental health communities.
The DDM Combined Clinical/Research Postdoctoral Fellowship Program goals are:
- To prepare fellows to pursue careers as clinician-researchers in academic health centers by providing them with the requisite skills to become independent researchers and outstanding clinicians, as well as inspiring teachers and contributors to the profession of psychology.
- To provide fellows with the training and mentorship required to launch an independent research career in developmental/neurodevelopmental disabilities.
- To provide fellows with advance practice competency in assessing youth with neurodevelopmental disorders, including attention deficits, autism spectrum disorders, learning disabilities, intellectual disabilities, and regulatory problems, sometimes within the context of complex medical and/or psychosocial histories. Emphasis is placed on integrating the tenets of clinical psychology, developmental psychopathology, cognitive neuroscience, evidence-based interventions, and principles of child and family development.
The Combined Clinical/Research Psychology Fellowship is two years with the possibility of a third year, depending on the scope of the fellow’s independent research project, progress in the program, and availability of funding. The first year of fellowship will focus more heavily on clinical training, with the expectation that the fellow will use the first year to develop an independent research project, including writing a proposal as well as getting necessary infrastructure in place. The clinical-research fellow may apply for independent funding and is expected to participate in their mentor’s lab or research group during the first year to learn necessary skills for their own project. The second and optional third years of fellowship are dedicated primarily to conducting mentored independent research. During the first two years of fellowship, the clinical-research fellow will accrue supervised clinical hours that can be applied toward the pursuit of licensure. Throughout fellowship, the fellow will also be encouraged to build his or her publication and presentation portfolio. In addition to direct mentorship and clinical supervision, the fellow will have statistical support available as well as opportunities to participate in didactic sessions related to research training through Boston Children’s Hospital or Harvard Catalyst and will be a part of a community of research post-docs in the DDM.
The training experience
Research activities
Postdoctoral fellows will work directly with one of the established research labs or groups in the DDM. The specific research opportunities for each application year will vary based on funding. For applicants who will start in the 2022-23 academic year, research opportunities are available through the Laboratories of Cognitive Neuroscience (LCN) within the Nelson Laboratory, Faja Laboratory, and Arnett Laboratory. In addition, the Down Syndrome Program has an opening for a clinical-research fellow.
- Faja Laboratory: Current activities in the Faja Lab include the use of physiology, eye tracking, and behavioral measures to better understand treatment response and individual differences in children with autism spectrum disorders, ADHD, and developmental delays. Dr. Faja’s work is funded by the National Institutes of Health. Fellows will have an opportunity to participate in ongoing projects and develop their own project on related topics. Some specific skills that a fellow may learn through the Faja Lab include research reliable diagnostic evaluations for autism spectrum disorder (ADOS-2, ADI-R), use of electrophysiological measures with clinical populations, and longitudinal/clinical trial research design. The Faja Lab also has numerous opportunities for scientific writing and developing grantsmanship skills.
- Nelson Laboratory: The overarching goal of the Nelson Laboratory is to elucidate the relation between brain and behavioral development. There are numerous research opportunities across areas of study within the Nelson Lab, depending on the applicant’s interests and training thus far. Dr. Nelson’s work is funded through the National Institutes of Health as well as other sources (e.g., the Bill & Melinda Gates Foundation) and includes several longitudinal investigations. The three major areas of study include: the early identification and trajectory of autism; effect of early adversity on brain and behavioral development (conducted in local and international populations); and the development and neural basis of facial recognition, with particular interest on early recognition of facial emotion and its potential link to anxiety over time. In addition to participating in ongoing projects within the Nelson Lab, fellows also will have the opportunity to develop their own project on related topics. Skill areas that a postdoctoral fellow will obtain/continue to enhance include those related to the use of neuroimaging, clinical interviewing, neuropsychological assessment, physiological data processing, longitudinal research design, scientific writing, and grantsmanship.
- Arnett Laboratory: The Arnett Laboratory utilizes EEG, ERP, and neuropsychological testing to further our understanding of individual differences in neurobiological etiology, behavior, development, and treatment response among children with ADHD and related neurodevelopmental disorders. Current projects include a study of young children with familial risk for ADHD and a longitudinal study of school-aged children with ADHD. Future projects will include investigation of effects of pharmacological and alternative treatments on brain signatures among children with ADHD. Dr. Arnett’s work is funded through the National Institutes of Health and the Klingenstein Third Generation Foundation. Fellows are encouraged to analyze and publish analyses on existing data and to apply for early investigator funding to support independent research projects. Specific areas of clinical and research training available to Arnett Lab postdoctoral fellows include EEG acquisition, data processing, and analysis; scientific writing and grantsmanship; clinical interviewing; and neuropsychological assessment.
- Wilkinson Laboratory: The Wilkinson Lab is interested in understanding the neural mechanisms impairing language acquisition and cognitive development with a specific focus on children with intellectual disability. Our ongoing studies use EEG to investigate biomarkers of language development in young children with Fragile X Syndrome, Down syndrome, and autism spectrum disorders. In addition, our lab is interested in understanding biological and environmental factors that impact early brain development. We collaborate closely with Dr. Charles Nelson on studies that leverage longitudinal data collected from infancy to preschool years. Our current Baby Steps study focuses on early detection of autism and language delays in a diverse population patients seen in our primary care clinic. Dr. Wilkinson’s work is funded through the NIH, the Charles Hood Research Foundation, and the Boston Children’s Translational Neuroscience Center. Specific research and clinical opportunities include experience working with longitudinal data analysis (EEG, behavioral, and/or survey data), neuropsychological assessment, scientific writing, grantsmanship, and mentorship of students and research assistants.
- Down Syndrome Program: The Boston Children’s Hospital Down Syndrome Program’s (DSP) research team is integrated with clinical care. The DSP has a longitudinal clinical database in which clinical data are captured for all patients seen in the program, and this database contains extensive phenotyping of children and adolescents with Down syndrome. The database provides the ability to characterize patterns of development, assess the impact of co-occurring medical conditions on neurodevelopment, and the occurrence of neurodevelopmental disorders such as autism or ADHD in Down syndrome. DSP research is also aimed at exploring novel educational, behavioral, and medical interventions that may improve overall functioning. Multiple opportunities are available to clinical research fellows, including clinical experience in the DSP, clinical trials experience, data analysis, grantsmanship, and scientific writing.
General: Clinical/research fellows will have the opportunity to interact with PIs and post-docs across research groups, which include:
- the Laboratories of Cognitive Neuroscience (LCN), comprising three independent labs (including the Faja, Nelson, and Arnett laboratories) dedicated to furthering our understanding of brain and cognitive development in typically developing infants and children, as well as children who have experienced adversity, and those diagnosed with or at risk for various neurodevelopmental disorders
- the Adolescent Substance Use & Addiction Program, which aims to identify ways to prevent or decrease substance abuse and associated problems in youth
- the Down Syndrome Research Program, which focuses on cognition, learning, and memory, as well as neurodevelopmental and behavioral impairments that commonly co-occur in individuals with Down syndrome
- the DMC Clinical Research Program, which conducts collaborative translational research to advance our understanding of the etiology, early identification, and treatment of developmental disorders. Please visit this page for updated information regarding ongoing research studies in the division.
Clinical activities
Postdoctoral fellows are involved in direct clinical service in the DMC, including performing diagnostic assessments on interdisciplinary teams; consulting in hospital-based and community settings; providing feedback to parents and schools; and providing short-term treatment for anxiety, mood, disruptive behaviors, social skills deficits, elimination disorders, and feeding problems. The number and variety of programs contained within the DMC generally makes it possible to adapt the fellow’s clinical experience to his or her learning needs and professional goals. Rotations are six months in length. The goals of rotations are to expand the knowledge base of learning, developmental, medical, and behavioral disorders and co-morbid psychiatric conditions; provide timely and tailored evaluations; and develop consultation and communication skills in a fast-paced medical environment. There also are opportunities for fellows to work closely with psychology staff to develop supervisory and administrative skills. The DMC clinical programs available for fellowship rotations include:
- Infant Team and Toddler Team: Infant Team and Toddler Team serve children under the age of 2 years, and between 2 and 3.5 years, respectively. Youth seen on these teams typically present with concerns for developmental delay and/or autism spectrum disorder. Team members often include developmental-behavioral pediatricians and psychologists.
- Preschool Team: Preschool Team typically serves children between 3.5 and 6 years of age who present with concerns related to development, learning, and/or behavior. These children may have significant language, cognitive, social, and motor difficulties of many different etiologies. Team members often include developmental-behavioral pediatricians, psychologists, and education specialists.
- School Team: School Team serves youth from approximately 6 to 13 years of age with various presentations. Concerns may include those related to social, emotional, academic, and behavioral functioning. Team members often include developmental-behavioral pediatricians, psychologists, neuropsychologists, and education specialists.
- Young Adult Team (YAT): Youth approximately 12 to 17 years of age are typically seen through YAT and may present with concerns related to behavioral, academic, and/or emotional functioning. Team members often include developmental-behavioral pediatricians and psychologists.
- Advocating Success for Kids (ASK) Program: This program serves youth of all ages within two urban-based primary care centers who are referred by primary care providers. Youth are often referred because of concerns about developmental, learning, social-emotional, and/or behavioral problems. Additionally, children often present with complex psychosocial situations, possible prenatal substance exposure, and/or trauma history. The goal of this program is to screen children for such concerns and to advocate for appropriate services and interventions. An interdisciplinary team approach is utilized, with developmental-behavioral pediatricians, psychologists, social workers, and educational specialists.
- Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Program: The LEND team conducts comprehensive evaluation of youth of all ages. Youth seen through the LEND team often present with developmental concerns within the context of complex medical presentations. In addition to a developmental-behavioral pediatrician and neuropsychologist, the LEND team often has observers from various disciplines, including community advocates.
- Adoption Team: Adoption Team provides assessment and consultation for youth of all ages who have been adopted domestically or internationally. Common concerns presenting on this team may include long-term abuse, neglect, or a history of institutionalization. Team members often include developmental-behavioral pediatricians, psychologists, and educational specialists.
- Down Syndrome (DS) Program: The DS Program conducts interdisciplinary clinical evaluations of youth with Down syndrome from birth through 18 years of age. Program members work closely with children, parents, medical specialists, community physicians, and educators. The DS Program consists of a developmental-behavioral pediatrician, psychologist, neurologist, speech pathologist, physical therapist, nutritionist, dentist, and audiologist, as well as a program coordinator and resource specialist. Services provided by the psychologist on this team include consultation, assessment, parent training, and psychotherapy.
- Consultation and therapy: This service provides individual, group, and family therapy, such as Toilet Training School for parents and children with encopresis and enuresis; parent training for children with ADHD; behavioral and family-based treatment for feeding disorders; school consultation; and cognitive behavioral treatment for anxiety and mood in children and adolescents.
Supervision, seminars, and educational activities
The DDM dedicates one half-day per week for education and professional development of staff and fellows, including a monthly interdisciplinary meeting and forum for special presentations; morbidity and mortality conference; case conference; and journal club. There also are weekly seminars for psychology fellows that focus on neurodevelopmental, medical, and psychiatric disorders; feeding, sleep, and toileting disorders; psychological assessment of complex cases; evidence-based interventions; educational methodology for teaching; advocacy; and professional development. There are several opportunities each year to visit community agencies, specialized schools, or other clinical programs at Boston Children’s. There also are opportunities for fellows to become active participants in the division’s robust Quality and Performance Program (QPP), which oversees all quality improvement activities. Finally, within the Division of Developmental Medicine and in the broader Boston Children’s Hospital/Harvard Medical School community, there are a plethora of educational opportunities, including seminars, lectures, and trainings, that the fellows are required or encouraged to attend. Specific to research, The Boston Children’s Institutional Centers for Clinical and Translational Research offers brief courses throughout the year on topics such as statistics and grant writing. Harvard Catalyst offers more extensive courses on topics related to clinical and translational research, responsible conduct of research, and grant writing.
Supervision is provided by the staff in the DMC Psychology Program and involves in-vivo observations as well as one-to-one meetings. There is a supervisor assigned for each clinical rotation, and fellows have the opportunity to work with several different supervisors over the course of their training. Group supervision experiences are provided to address clinical analysis skills, professional development, and preparation for licensure and board certification. At the beginning of the training year and, on a regular basis thereafter, fellows’ training needs are reviewed and discussed with the training directors. Participation in other clinics in the hospital to obtain specialized training can be arranged on an individual basis. Progress, competencies, and training goals are evaluated on a regular basis. Additionally, Drs. Faja and Arnett are licensed psychologists and provide supervision for fellows in the Clinical-Research Track who conduct clinical research assessments within the LCN.
Positions
The DDM is offering five combined clinical/research postdoctoral fellowship positions beginning in the 2023-24 training year. This is a full time, two-year training experience, with the possibility of a third year, during which the fellow’s time will be divided between clinical service delivery, didactics, and mentored independent research. The option for a third year of fellowship (second research year) is dependent on the scope of the fellow’s chosen research project, successful progress in the program, and considerations of funding. Psychology fellows hold clinical appointments in the Boston Children’s Hospital Department of Psychiatry and Behavioral Sciences and academic appointments in the Harvard Medical School Department of Psychiatry.
Qualifications
Applicants must have received significant research training, be planning a clinical research career with an emphasis on developmental/neurodevelopmental disorders, and have an existing track record of scholarly publication and research presentations. Applicants should have a strong background in research with clinical populations and/or methods in relevant areas of focus, including knowledge of commonly used assessment measures or evidence-based interventions, as applicable. Clinically, applicants should have substantial clinical experience with children, including use and interpretation of psychological and neuropsychological tests; coursework in child development and developmental psychopathology; experience with evidence-based treatment and developmental disabilities; and training and competence in addressing issues of diversity and individual differences. Individuals applying will ideally have training in developmental cognitive neuroscience, although this is not required.
Questions about the DMC fellowship are best addressed via email to Kate Linnea, PhD, at kate.linnea@childrens.harvard.edu.