Developmental Behavioral Pediatrics

Developmental Behavioral Pediatrics Fellowship Training Program

The Developmental Behavioral Fellowship Training Program of The Warren Alpert Medical School of Brown University is based at Hasbro Children’s Hospital, the pediatric division of Rhode Island Hospital (RIH). The primary site for our clinical, educational, scholarly and advocacy work is the Children’s Neurodevelopment Center (CNDC). Our program began in 1966 and was initially accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 2003.  

Our training program has received continuous funding from the U.S. Health Services Resources Administration/Maternal Child Health Bureau (HRSA/MCHB) since 2007. In 2016, we integrated our interdisciplinary, HRSA/MCHB-funded Rhode Island Leadership Training in Neurodevelopmental Disabilities program (RI LEND) into our fellowship. Between 2003 and 2019, 23 fellows completed training in our program and now practice across the country and the world, primarily in academic medical centers. 

Our program’s mission is to train future leaders in developmental behavioral health care by providing comprehensive, interdisciplinary and culturally competent clinical experiences that are patient and family centered, as well as supporting a robust array of hypothesis-driven research opportunities, clinically relevant scholarly endeavors and advocacy projects. 

Goals and Objectives

The goal of this fellowship program is to prepare fellows in developmental behavioral pediatrics (DBP) for patient care, teaching, research and community leadership.

At the completion of three years of fellowship, each fellow will:

  • Demonstrate a broad, in-depth understanding of normal and abnormal child development and children with special health care needs
  • Demonstrate competence in:
    • elucidating developmental history and evidence of disability through interactions with parents and children
    • administration of psychosocial, developmental, behavioral, functional and neuropsychiatric screening and assessment tools used by DBP providers
    • diagnosing and managing a wide range of developmental behavioral issues experienced from birth through adolescence
    • behavioral counseling for a wide range of disorders
    • collaborative care of children with developmental disabilities or special needs
    • understanding of the needs of children at risk (e.g., due to poverty, fragmented families, abuse or neglect)
    • teaching the concepts of DBP in multiple settings
  • Demonstrate knowledge regarding:
    • research methods used in DBP
    • federal, state and local resources to support families and foster child development
  • Demonstrate ability to collaborate with policy and governmental agencies as a consultant and child advocate
  • Complete a scholarly project in DBP

This fellowship provides a broad variety of clinical experiences in diverse settings. Upon mastery, fellows have opportunities to share their knowledge with students, residents and junior fellows. By the end of their training they are independent in patient management, skilled in working in interdisciplinary teams, confident teaching others and competent in implementing program evaluation and independent research.

General Overview

During the first year of training, fellows learn clinical skills first through close observation of faculty providing clinical care. They gradually increase their responsibility for elements of assessment including careful record review and history taking, astute child-focused behavioral observation, direct developmental behavioral testing, development of an individualized plan of further interdisciplinary evaluation, and provision of their impressions and recommendations in a manner that is strength-based and sensitive to the family’s perspective. They are mentored in writing thorough yet concise notes that are provided to families. In addition, fellows take two courses in biostatistics and applied data analysis in the Brown School of Public Health where they learn to manage data in national datasets and complete a project of analysis that typically leads to multiple national presentations and a published paper. Fellows attend the annual HRSA/MCHB Fellows’ Meeting, where they are mentored by faculty from other DBP training programs and present their research in progress.  

During their second year of training, fellows typically participate in RI LEND with interdisciplinary trainees and faculty mentors. They attend the annual SDBP meeting in the fall, presenting their research when it is ready, and they can also choose to attend the AUCD Disability Policy Summit in Washington, DC, as part of their RI LEND year. During this year, fellows have additional time for rotations with colleagues in the CNDC in genetics and child neurology, as well as outside of the CNDC in the Hasbro Partial Hospital and Pediatric Rehabilitation Center; Women and Infant’s Neonatal Follow-up Program, Fussy Baby Clinic and Psychopharmacology Program; and at Bradley Hospital’s Center for Autism and Developmental Disabilities and Early Childhood Partial Hospital Program. During this time, they continue to see new and follow-up patients in their DBP continuity practice in the CNDC and continue completing their scholarly projects.  Fellows also have an option to compete for a Hassenfeld Scholarship that would fund them to complete two additional courses and earn a Certificate in Clinical and Translational Research from the Brown School of Public Health. 

During their third fellowship year, fellows continue to refine their clinical skills and efficiency, taking on more responsibility for patient care in their continuity DBP practice. They complete their scholarly project and many choose to work on a second scholarly project over the course of this year. They are mentored in presenting their research findings at national meetings. Fellows also take on additional administrative roles in organizing curricula for both fellowship and residency training. In addition to their four weeks of vacation, they are also provided a week for job interviews.

Sites

Hasbro Children’s Hospital (HCH) is a division of Rhode Island Hospital. This seven-story teaching hospital includes an 87-bed pediatric inpatient unit and RI’s only pediatric intensive care unit (PICU). HCH offers a wide range of pediatric services and programs in all medical and surgical subspecialties. The major teaching hospital for the department of pediatrics, HCH is a state-of-the-art children’s hospital that was not only designed by physicians and clinical staff, but by patients and their families. The hospital continues to depend on the Parent Advisory Board for guidance in addressing family needs. Annually, the hospital cares for, on average, 6,500 inpatients and 70,000 outpatients. HCH is the major site for pediatric education for The Warren Alpert Medical School of Brown University. Brown University is one of the oldest academic institutions in the U.S., but its first class of medical doctors (MDs) graduated in 1975. The Warren Alpert Medical School has been listed in the top quartile for research funding for academic medical centers by U.S. News and World Report for more than 20 years. The department of pediatrics at Brown has 90 full-time faculty, 20 pediatric surgical subspecialists, 79 residents and 40 fellows, and is responsible for the pediatric clinical teaching of Brown medical students. 

The Children’s Neurodevelopment Center at HCH provides evaluation and care for children with neurodevelopmental and behavioral disorders and is the primary site supporting developmental behavioral pediatric fellowship education. The CNDC is located in south Providence, a diverse low-income community, and serves a socio-economically, racially and ethnically diverse population. It is the major site for ambulatory care for the divisions of developmental behavioral pediatrics and child neurology and genetics, and is the home of interdisciplinary programs in craniofacial anomalies, Down syndrome, muscular dystrophy, spina bifida and neuromuscular disabilities.  

Bradley Hospital was the nation’s first neuropsychiatric children’s hospital and is the only comprehensive facility for the care of infants, preschoolers, children, and adolescents with emotional disorders and developmental disabilities and their families in Rhode Island and adjacent areas of Connecticut and Massachusetts. More than 60 percent of admissions annually are publicly supported. Clinicians and trainees work closely with RI’s Department for Children, Youth and Families (DCYF) and RI’s eight mental health centers in the care and after-care of children and youth. A full range of services including acute hospitalization, day treatment and residential care, outpatient treatment and home-based care are available. These services include a specialized unit, the Center for Autism and Developmental Disabilities (CADD). DBP fellows can choose to spend time in any of these programs.

Neonatology is based at Women and Infants Hospital (WIH) on the RIH campus. The hospital has an annual delivery rate of around 8,000 and serves as the tertiary perinatal center and the only Level IV neonatal intensive care unit (NICU) of southeast New England. WIH has a long-standing commitment to leadership in development of national networks tracking neonatal outcomes. These include research on outcomes for prenatal drug exposure, congenital hearing impairment and low birthweight. The New England Pediatric Institute of Neurodevelopment (NEPIN) of WIH provides interdisciplinary assessment and treatment for children with autism, attention-deficit/hyperactivity disorder (ADHD) and other neurodevelopmental disabilities. It has NIH funding for longitudinal developmental follow-up and neuroimaging of children with autism spectrum disorder (ASD), lead exposure and typical development. DBP fellows consult in the WIH NICU, participate in NICU follow-up, rotate at NEPIN and may choose to work on research with their faculty.

Fellows’ Clinics and Conferences

Throughout the three years of training, fellows maintain a continuity practice of DBP patients with a range of concerns including ASD, ADHD, learning challenges, genetic syndromes, sensory deficits and delays in their development under the close supervision of experienced faculty. All fellows are mentored in administration of developmental tests including the Autism Diagnostic Observation Survey (ADOS) by skilled faculty and have an opportunity to gain research certification in using this tool. 

When: Wednesdays at 12 p.m. 
Where: CNDC 
Topics: Neurodevelopment, Genetics, Metabolism Conference

When: Fridays (September through June) at 8:30 to 9:30 a.m. 
Where: RIH 
Topics: Pediatric Grand Rounds

When: Fridays (September through June) at 9:30 to 10:30 a.m. 
Where: CNDC
Topics: RI LEND for postgraduate year (PGY) 5 only

When: Fridays at 1 to 2:30 p.m. 
Topics: Developmental behavioral pediatrics fellows conferences including literature seminar, research symposia, case discussions and didactic presentations.

Training will also include PHP 2507, Biostatistics,  and PHP 2508, Biostatistics and Applied Data Analysis, courses at Brown School of Public Health. This is during PGY 4 only. Fellows will also attend the Annual Society for Developmental Behavioral Pediatrics Meeting and the Annual HRSA/MCHB Developmental Behavioral Fellow’s Meeting.

Benefits

Rhode Island Hospital offers a competitive salary and benefits package to all its house staff. Stipends are reviewed annually and recommendations are made by the Graduate Medical Education Committee.

Stipend as of July 2020:    

  • PGY 4 (Year 1) - $69,410
  • PGY 5 (Year 2) - $74,420
  • PGY 6 (Year 3) - $75,280

Vacation: 4 weeks paid each year

Benefit package:

  • Professional liability insurance: malpractice coverage for three years provided
  • Medical and dental benefits
  • Long term disability insurance (LTD)
  • Paid family leave (TCI)
  • Fitness and wellness program (Coastline Employee Assistance Program)
  • Employee health services
  • Temporary disability insurance (TDI)
  • On-call accommodations
  • On-campus day care center: Bright Horizon Children’s Center
  • Paid and unpaid leave of absence
  • Free employee parking
  • Courtesy shuttle service to the parking lots and other facilities

Please note that Rhode Island Hospital, as a Lifespan partner hospital, does not hire users of tobacco products, illegal drugs, or nonmedical marijuana, and conducts pre-employment drug and nicotine testing for candidates who have received a conditional offer of employment.

Application to the Fellowship Program

For the academic year 2019, we are recruiting two fellowship positions. Applications should be sent through Electronic Residency Application Services beginning July 1. Interviews will be conducted from September to November. We participate in the National Residency Matching Program.  

On occasion we also accept fellows off-cycle. For additional information, please contact Geralyn Hafey, program coordinator, at [email protected] or call 401-444-5440.

Fellowship Program in Development Behavioral Pediatrics

Please watch our video to learn more about the Developmental Behavioral Pediatrics fellowship program at Brown University and Hasbro Children’s Hospital.