Developmental-Behavioral Pediatrics Fellowship Program - Residency + Training Program

Residency + Training Program
Apply on ERAS

Developmental-behavioral pediatrics rotation for pediatric + family medicine residents

The Developmental-Behavioral Pediatrics rotation at Tufts Medical Center offers interdisciplinary services that are child- and family-centered. Assessments are comprehensive, evaluating the whole child with attention to strengths, weaknesses and the child’s role within family, peer group, school and community.

The CCSN provides clinical care and advocacy for children with developmental, behavioral and emotional challenges that affect growth, learning and social functioning.

Detailed information about this experience is available on the Pediatric Residency Program and Family Medicine Residency Program webpages.

Why is developmental-behavioral pediatrics an important rotation?

One in five children has a special healthcare need, and development and behavior are relevant to all children. Yet many pediatricians feel under-trained to identify and manage these challenges. As a primary care provider, you’ll play a central role in:

  • Monitoring developmental and behavioral progress
  • Identifying and addressing concerns
  • Connecting families with services
  • Advocating for children across settings

While developmental-behavioral pediatricians are available for consultation, you’ll remain the primary source of care and coordination for most children, especially those with special needs.

Why this rotation matters

  • The Pediatrics Residency Review Committee (RRC) requires all pediatric residents to complete at least one month of DBP training. At Tufts Medical Center, this is a 4-week intern year rotation.
  • Family Medicine residents at Tufts Medical Center complete a 2-week elective, created in recognition of DBP’s importance in primary care.

What to expect

During your DBP rotation, you'll gain real-world experience and tools to use throughout your residency and career. The rotation includes:

  • Participation in interdisciplinary patient evaluations
  • Discussions with clinicians about real cases
  • Self-directed learning (readings, videos, and modules)
  • Quizzes (pre-test and post-test)
  • Field experiences (e.g., Early Intervention, child care centers, schools)
  • Written and/or creative assignments to help you apply and reflect on what you’ve learned
  • Protected time during some weekdays for independent work

Our goal

By the end of the rotation, you’ll be better prepared to recognize, manage and support developmental and behavioral needs with confidence—whether in the clinic, emergency department, inpatient unit or community practice.

Schedule + experiences
Pediatric residency experience

Overview + structure

A. PLI Core Rotation in Developmental Disabilities

Your rotation will consist of many activities that are designed to provide you with a broad-based, well-rounded exposure to the subspecialty of Developmental-Behavioral Pediatrics (DBP) and to explore normal child development.   Most of your scheduled activities will take place on the 2nd floor of Tufts Medical Center.  In addition to clinics and evaluations within the CCSN, there are several activities that take place outside of the Tufts Medical Center.                              

Weekly Schedule

 MondayTuesdayWednesdayThursdayFriday
AM

0-6 year Clinic

 

 

1st week: 
Observation

 

2nd week: 
Patient Visit

 

3rd week: 
Parent Feedback Visit

 

4th week: 
Field Trip to TCC Day Care

Fellow’s Clinic

 

LEAP Clinic (School Age Clinic)

4th week: 
Brookline School District with Dr. von Hahn



 

DBP Observation and/or Field Trip 
 		Advocacy Rotation
PM

 

Observations and/or Field Trips, Self-Directed Learning (including report writing)

Observations and/or Field Trips, Self-Directed Learning (including report writing)

Noon-3:30 pm: 
Grand Rounds and Didactic lecture blocks


 

Observations & Field Trips, Self-Directed Learning (including report writing)Advocacy Rotation


 

An individualized schedule is discussed with the resident at the time of orientation at the start of rotation based upon the observation schedule with clinical faculty and the residents’ cross-coverage and clinic schedules.
 

Goals + Objectives developmental-behavioral pediatrics experiences

There are two components to a family practice resident’s experience in Developmental-Behavioral Pediatrics (DBP):

  • 2-week PLI Core Rotation in DBP
  • Self-Learning modules, two didactic meetings with attending

1. PLI Core Rotation in Developmental Behavioral Pediatrics

Experience collaborative patient evaluations with an interprofessional team:

  • DBP
  • Social Work
  • Psychology
  • Speech and Language Therapy
  • Autism Resource Consultant

 

During the PLI DBP rotation, through involvement in both direct and observational clinical settings, under the preceptorship of DBP Attendings, Fellows and an interprofessional professional CCSN team:

  1. Learn to review available information from parents, early intervention programs, schools, community agencies and prior medical consultations to inform diagnosis and management

  2.  Understand key components of a comprehensive developmental-behavioral history

  3.  Observe and/or use standardized assessment tools as appropriate

  4.  Demonstrate effective, compassionate and culturally sensitive communication with the patient and family

Autism Spectrum Disorders (ASD): Understand the primary care provider’s role in screening, diagnosing, managing and/or referring children with ASD.

  • Use history and observation to identify children with social interaction difficulties and communication impairments.
  • Recognize developmental milestone red flags for ASD (absence of joint attention- eye contact and pointing- by 9-12 months, absence of pretend play by 18 months, language delays)
  • Know the DSM V criteria for ASD
  • Generate a differential diagnosis for ASD.
  • Be familiar with appropriate long-term management techniques and evidence-based components of an effective educational/behavioral program for children with ASD.

Developmental Delay: Understand the primary care provider’s role in screening, diagnosing, managing and/or referring children with developmental delays

  • Identify children with developmental delay and generate a differential diagnosis for the child with persistent delays, including motor delays (e.g., pre-/peri-natal factors, environmental, metabolic/genetic)
  • Understand the components of the IFSP (Individual Family Services Plan) through Early Intervention (EI).
  • Understand therapy and treatment needs of children with Global Developmental Delay/Intellectual Disability across the age spectrum

School performance: Understand the primary care provider’s role in the promotion of school performance and the evaluation and management of school problems in children and adolescents.

  • Participate in the evaluation of a child with inadequate school performance that includes input from the child, family and school.
  • Observe the evaluation tools used to evaluate children and adolescents during the course of psychoeducational testing
  • Generate a differential diagnosis for the child with inadequate school performance.
  • Understand the medical considerations that contribute to poor school performance (ADHD, Anxiety/Depression, Psychosocial stressors, Chronic illness- asthma/diabetes, sleep deprivation)
  • Understand the scope of Specific Learning Disabilities
  • Provide anticipatory guidance to families of school-aged children about habits that promote school performance (sleep, nutrition, exercise, daily routines, limiting media exposure, completing homework, parental involvement in school activities, etc).
  • Understand the role of a 504 accommodations plan vs. an IEP for children and adolescents with school difficulties
  • Understand key components of an IEP (Individual Education Plan)

Attention Deficit/Hyperactivity Disorder: Understand the primary care provider’s role in screening, diagnosing, managing and/or referring children with ADHD and co-morbid disorders.

  • Use history and observation to identify preschool and school age children with problems of inattention, hyperactivity and impulsivity.
  • Know the DSM V criteria for ADHD
  • Generate a differential diagnosis for ADHD and understand the importance of important co-morbidities (learning disabilities, oppositional defiant disorder, anxiety and depression, etc.)
  • Understand the importance of and how to interpret parent and teacher screening questionnaires (Vanderbilt Assessment).
  • Be familiar with appropriate long term management approaches (pharmacotherapy, behavioral interventions) and the components of an effective educational program and accommodations for children with ADHD (504 plan and IEP).

Developmental consequences of motor disorders, specifically Cerebral Palsy: Understand the diagnosis and management of a young child and adolescent with cerebral palsy

Understand the role of specialists, referral processes and case management across multiple disciplines to care for children with developmental diagnosis. This may include some of the following professionals:

1.Social Worker/Counseling

2. Speech Language therapy

3. Occupational and Physical therapy

4. Clinical Psychology and/or Neuropsychology

5. Educational intervention (preschool and school age)

6.Early intervention services

7.Developmental-Behavioral/Neurodevelopmental Pediatrician

8.Child Psychiatry

9. Pediatric Neurology

10.Autism Resource Consultant/Community Resource Specialist

2. Self-Learning Modules on the pediatric resident's Google Drive to be covered during two didactic meetings during their two-week DBP rotation
 
Family practice residency experience

Overview + structure

The two-week rotation has several components: observations, evaluations, field trips and self-directed learning.  The resident has the opportunity to observe a broad range of professionals, from DBP to speech pathology.  The resident contributes to the data gathering on a patient as a member of the Learning Effectiveness Attention Program Clinic (LEAP).  The DBP rotation includes Field Trips!  The resident observes typically developing children in a large child care center and has the opportunity to observe the delivery of therapy to infants and toddlers in an Early Intervention Class.  

Schedule for the 2-week elective

 		MondayTuesdayWednesdayThursdayFriday
Week 1
 		    
AM7:30 am-12:30 pm  
Early Childhood Clinic		8 am-Noon 

Fellows Follow Up Clinic

7:30 am-Noon

LEAP Clinic 


 

Tri-City Early Intervention (Malden, MA)Family Medicine Continuity Clinic
PM

1-4 pm

Newborn Follow-up Clinic 
 

Independent Study

Noon-3:30 pm

Pediatric GR and resident didactic 
 

Independent StudyFamily Medicine Continuity Clinic
Week 2 

 		     
 AM8 am-Noon 

Woburn Satellite Clinic (von Hahn) 

 		Transportation Children Center (Boston, MA)


7:30 am-Noon

LEAP Clinic


 

Independent Study 
 		Family Medicine Continuity Clinic 
 
 PM

1-5 pm

Woburn Satellite Clinic (von Hahn) 

 

Independent Study

Noon-3:30 pm

Pediatric GR and resident didactic

Exit Interview (Ultmann)Family Medicine Continuity Clinic
Goals + objectives for the Family Medicine rotation in developmental disabilities 

Autism Spectrum Disorders (ASD): Understand the primary care provider’s role in screening, diagnosing, managing, and/or referring children with ASD.

  • Use history and observation to identify children with social interaction difficulties and communication impairments.
  •  Recognize developmental milestone red flags for ASD (absence of joint attention- eye contact and pointing- by 9-12 months, absence of pretend play by 18 months, language delays)
  • Generate a differential diagnosis for ASD.
  • Be familiar with appropriate long-term management techniques and evidence-based components of an effective educational/behavioral program for children with ASD.

Developmental delay: Understand the primary care provider’s role in screening, diagnosing, managing, and/or referring children with developmental delays

  • Identify children with developmental delay and generate a differential diagnosis for the child with persistent delays, including motor delays (e.g., pre-/peri-natal factors, environmental, metabolic/genetic)
  • Understand the components of the IFSP (Individual Family Services Plan) through Early Intervention (EI).
  • Understand therapy and treatment needs of children with GDD/ID across the age spectrum

School performance: Understand the primary care provider’s role in the promotion of school performance and the evaluation and management of school problems in children and adolescents.

  • Participate in the evaluation of a child with inadequate school performance that includes input from the child, family, and school.
  • Observe the evaluation tools used to evaluate children and adolescents during the course of psychoeducational testing
  • Generate a differential diagnosis for the child with inadequate school performance.
  • Understand the medical considerations that contribute to poor school performance (ADHD, Anxiety/Depression, Psychosocial stressors, Chronic illness- asthma/diabetes, sleep deprivation)
  • Provide anticipatory guidance to families of school-aged children about habits that promote school performance (sleep, nutrition, exercise, daily routines, limiting media exposure, completing homework, parental involvement in school activities, etc).
  • Understand the role of a 504 accommodations plan vs. an IEP for children and adolescents with school difficulties
  • Review key components of an IEP (Individual Education Plan) with the family 

Attention Deficit/Hyperactivity Disorder: Understand the primary care provider’s role in screening, diagnosing, managing, and/or referring children with ADHD and co-morbid disorders.

  • Use history and observation to identify preschool and school age children with problems of inattention, hyperactivity, and impulsivity.
  • Know the DSM V criteria for ADHD
  • Generate a differential diagnosis for ADHD and understand the importance of important co-morbidities (learning disabilities, oppositional defiant disorder, anxiety and depression, etc)
  • Understand the importance of and how to interpret parent and teacher screening questionnaires (Vanderbilt Assessment).
  • Be familiar with appropriate long term management approaches (pharmacotherapy, behavioral interventions) and the components of an effective educational program for children with ADHD (504 plan and IEP).

Developmental consequences of prematurity

  • Recognize the spectrum of behavioral, cognitive, and motor outcomes associated with prematurity
  • Define the diagnosis and management of a young child and adolescent with cerebral palsy
  • Review available information from parents, early intervention programs, schools, community agencies, and prior medical consultations to inform diagnosis and management 
  • Understand key components of a comprehensive developmental-behavioral history and conduct a thorough physical and dysmorphology exam
  • Observe or use standardized assessment tools as appropriate
 
Formulate a differential diagnosis
 
Demonstrate effective, compassionate, and culturally sensitive communication with the patient and family to assure patient and family understanding, mutual decision making, and the development of a management plan

Recognize the role of specialists, referral processes, and case management across multiple disciplines to care for children with developmental disorders. This may include the following professionals:

  1. Social Worker/Family Counseling
  2. Early intervention services
  3. Educational intervention (preschool and school age)
  4. Clinical Psychology and/or Neuropsychology
  5. Child psychiatry
  6. Community Resource Specialist
  7. Developmental-Behavioral/Neurodevelopmental Pediatrician
  8. Occupational therapy
  9. Physical therapy
  10. Speech/language therapy
  11. Physical medicine and rehabilitation  


 
Contact
user
Cindy Bruce
Pediatric Fellowship Coordinator