Name of Program:

Stanford University

Program Director:

Heidi M. Feldman, MD, PhD

Contact Person:

Amanda Garcia
750 Welch Road, Suite 315
Palo Alto CA  94304
Phone: 650-723-5711
FAX: 650-725-8351

Faculty:

Lucy S Crain, MD, MPH
Anne DeBattista, MSN, CRNP
Heidi M. Feldman, MD, PhD
Ronald Garcia, PhD
Neville Golden, MD
Lynne C Huffman, MD
Shashank V Joshi, MD
Irene M Loe, MD
Karen Wayman, EdD

Number of Fellows:

3

MCHB Funding Years:

2

RRC Accreditation Year:

2007

Program Goals:

The program is designed to allow fellows to develop leadership skills in developmental-behavioral pediatrics and maternal and child health while meeting all of the six ACGME competencies. Specific objectives are as follows:

1. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Objectives are as follows:
1. Accurately assess children with the developmental and behavioral disorders outlined in the RRC program requirements and included in the bulleted list below
2. Manage children with developmental and behavioral problems using counseling, therapy, psychopharmacology, education, and other modalities as appropriate
3. Provide family-centered, culturally competent, compassionate care
4. Make appropriate referrals to other health professionals and community resources to assist in the assessment and management of developmental and behavioral disorders.

Conditions included are as follows:

• Developmental and behavioral aspects of chronic conditions, e.g., perinatal conditions, chromosomal/genetic disorders, metabolic, neurologic, sensory, endocrine, cardiac disorders, etc.
• Cognitive/adaptive disabilities
• Language and learning disorders
• Motor disabilities and multiple handicaps, e.g., cerebral palsy, myelodysplasia, dystrophies
• Autistic spectrum disorders, e.g., autism, Asperger
• Attention Deficit Hyperactivity Disorder
• Externalizing conditions, e.g., aggressive behavior, conduct disorder, oppositional defiant disorder
• Internalizing behaviors and conditions, e.g., anxiety, mood, and obsessive disorders, suicidal behavior
• Substance use/abuse, e.g., tobacco, alcohol, illicit drugs
• Child abuse and neglect, e.g., physical, sexual, factitious
• Somatoform disorders and pain
• Sleep problems
• Feeding/eating problems, e.g., obesity, failure to thrive, anorexia, bulimia
• Elimination disorders, e.g., encopresis, enuresis
• Sexuality, e.g., sexual orientation, gender identity, deviance
• Atypical behaviors, e.g., tic disorders, self-injurious behavior, repetitive behaviors

1. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care, teaching and research. In specific, medical knowledge includes the ability to describe the biological basis of developmental disabilities; environmental factors impacting disabilities; the interaction of biological and environmental forces; clinical presentations and treatment options. Objectives are as follows:
1. Describe the biological mechanisms in development and behavior, e.g., development and functional organization of the central nervous system, genetics, and biological risk factors.
2. Examine family and societal factors that contribute to children's development and family functioning
3. Discuss adaptations to general health problems and their treatments, e.g., acute illnesses, chronic illnesses, physical disabilities, hospitalization
4. Evaluate complementary and alternative therapies for developmental-behavioral problems
2. Practice-Based Learning and Improvement that involves investigationand evaluation of their own patient care, appraisal and assimilation ofscientific evidence, and improvements in patient care.
1. Analyze research studies in terms of methodology, data analysis, impact and implications
2. Use biostatics methods in conducting research studies
3. Complete and disseminate a scholarly project in the area of developmental-behavioral pediatrics are considered components of this competency.
4. Contribute to a quality improvement project
3. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals.
1. Differentiate presentations of clinical disorders and the adaptation of families in terms of cultural traditions and individual differences
2. Demonstrate the ability to share decision-making with families
3. Use respectful communication with all members of the interdisciplinary team
4. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
1. Contribute respectfully to an interdisciplinary team.
2. Explain ethical principles that relate to developmental-behavioral pediatrics practice
3. Teach medical students, residents, and community partners about developmental-behavioral pediatrics.
4. Demonstrate leadership in the area of developmental-behavioral pediatrics using the leadership paradigm of MCHB
5. Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
1. Describe knowledge about community-based services for children with disabilities and their families
2. Make referrals to agencies and professionals.
3. Discuss the laws, regulations, and rights for individuals with disabilities

Special Features:

Developmental-Behavioral Pediatrics is nested within the Division of Neonatal and Developmental Medicine at Stanford University School of Medicine. This new program received funding from the Maternal Child Health Bureau (MCHB) in 2008 as we accepted our first fellow. Dr. Heidi M Feldman serves as Program Director. She is an accomplished researcher who focuses on the development of language in children developing typically and children with developmental disorders. She is also an award-winning teacher, highly sought after for continuing medical education programs. Clinical training within Developmental-Medicine at Stanford is supervised by Dr. Lucy S Crain who spent 30 years in General Pediatrics and Developmental-Behavioral Pediatrics at UCSF before joining the faculty at Stanford University; Dr. Irene M. Loe, a rising star in developmental-behavioral pediatrics; and Anne DeBattista, a nurse practitioner with clinical and leadership roles in the field for over two decades. Rotations in Child Psychiatry are headed up by Dr. Shashank Joshi and rotations in Adolescent Medicine by Dr. Neville Golden. Based in a research-intensive university, the three-year fellowship program for pediatricians complements outstanding clinical training and community partnerships with a focus on the fellow's development of a research focus and research skills. Adequate time is available in all three years of training to allow this focus. Lynne C Huffman MD serves as an initial research mentor until the fellow can transition to a mentor within his or her specific field of interest.

The program places high value on the fellows' development of family centered practice and cultural competence. To this end, Karen Wayman EdD, Executive Director Family-Centered Care Lucile Packard Children's Hospital Stanford University, and Ronald Garcia PhD, Senior Lecture in Family Medicine, Director of Center of Excellence, are faculty within the program.