Inspired By Patients, Child Development Unit Staff Excels at Providing Care
from The Children's Hospital (TCH) News, July 2006
Dr. Ann Reynolds of Children’s
Child Development Unit works
with patient Christopher Ayres,
10, during a recent visit. The unit
is the only one of its kind in the
state and the only unit in which
a child with developmental
problems can work with a
multidisciplinary group of
specialists and medical experts in
a single clinic visit.
The caregivers in The Children’s Hospital’s Child Development Unit are “constantly inspired” by the patients and families they see, said director Pamela McKenzie, MD.
Inspiration and teamwork are at the heart of the Child Development Unit that, although one of the smaller departments in the hospital, is a model for staff dedication and patient care.
The Child Development Unit is a unique and important facet of Children’s team and community, as it is the only such unit in the state. In addition, it is the only clinic in which a child with develop-mental problems can work with a multidisciplinary group of specialists and medical experts in a single clinic visit.
Staff in the clinic see approximately 500 children annually, often from out of state and the country. The staff of nine, made up of pediatricians, psychologists and nurse practitioners, work as a cohesive unit to address the developmental, behavioral and medical problems facing children.
Many of the children referred to this unit by their pediatricians or family-medicine physicians have autism. Others are seen for similar developmental and behavioral disorders such as mental retardation, fetal alcohol syndrome, birth defects, genetic disorders, sensory hypersensitivity and general developmental delays. These patients undergo outpatient multidisciplinary diagnostic evaluations that may include cognitive, occupational therapy and speech-language therapy assessments.
The children who are referred to this clinic often experience a great complexity of both developmental and medical problems.
“Our patients are very complex and need more extensive and further care than a typical outpatient clinic visit,” Dr. McKenzie said.
The clinic is unique as it adapts to the complexity of childrens’ problems by extending visit time to approximately two to four hours. The in-depth evaluations allow the staff to address and evaluate each child’s diagnoses, weaknesses and strengths, thus enabling them to make appropriate recommendations for care.
Examples of this include the multidisciplinary Infant and Toddler Clinics. Staff dedicate four hours two times a week to see children under the age of 3 with complicated medical, behavioral and social problems. Staff in these clinics are specialists in young infants and children, and are able to evaluate the impact of a variety of problems on the functioning of the child and the family. Staff in this clinic strive to provide an early, accurate diagnosis and treatment plan so effective therapy and additional intervention can be implemented.
The Child Development Unit also actively participates in research of the disorders they treat. Ann Reynolds, MD, currently has two protocols funded by Children’s Clinical Translational Research Center (CTRC) and the Centers for Disease Control (CDC) to evaluate intestinal permeability and to describe gastrointestinal and sleep disorders in children with autism. Rebecca Wilson, MD, and Jennifer Epstein, MD, are studying the outcomes and needs of adult males with Fragile X syndrome.
Through this clinic’s work with patients in early stages of their disorders, doctors are able to gather an abundance of information surrounding developmental problems, specifically autism, giving hope that through this research, they will achieve a better understanding of a variety of diagnoses.
“We are hopeful that one day, our research will help us find the causes, interventions and outcomes of many developmental disorders,” Dr. McKenzie said.
The staff in the Child Development Unit is as dedicated and committed to children and families as they are to each other, always utilizing their teamwork skills to meet the needs of their patients and families. Teamwork is not only at the heart of their unit but also at the core of their methods of patient care.
Due to the complexity and difficulty these patients face in not only in clinic visits but in their daily lives, Child Development Unit staff are especially sensitive to the child and family and as result work hard to make sure families are as comfortable and informed about the outcomes of their child’s disorder as possible.
The greatest challenge staff in the clinic face, Dr. McKenzie said, is relaying news of difficult outcomes to families. But once families know their child’s diagnosis, she said, staff then focus on informing the family about their options and the resources and positive outcomes available now that they know their child’s specific diagnosis and treatment plan.
While the Child Development Unit staff excel at caring for children and families, they are extremely hopeful that the move to the new hospital in the fall of 2007 will further equip them to give families the best possible clinical experience.
For example, hospital planners are currently discussing the option of having video access in exam rooms, which would allow physicians and multidisciplinary team members to observe assessments and child behavior without creating an intimidating environment for the child. In addition, the video access would allow residents and other trainees to view assessments and learn communication skills.
“We feel excited to be part of a bigger community with more resources,” Dr. McKenzie said. “We are hopeful that the experience will be less traumatic and more family-friendly after the move.”
