CLINIC TEAMS AND SERVICES

The Adult Autism Assessment Clinic offers evaluations and recommendations for adults who have concerns regarding possible autism spectrum disorder. Referrals to this clinic often include differential diagnosis of high functioning autism with individuals functioning in the average or above average range of intellectual functioning, who may have struggled to succeed academically, vocationally and socially. Many of these persons have received incorrect diagnoses which have interfered with obtaining appropriate services. Other individuals come to the clinic with multiple diagnoses, including an autism spectrum disorder, and may be needing assistance with behavioral or other challenges which interfere with functioning. Evaluations often include consultation, and for young adults this may include assistance with transition planning from school and home-based services to adult educational, residential, and vocational services.

The Angelman Syndrome Clinic serves individuals with Angelman syndrome (AS) and their families from across the country. AS is a genetic disorder caused by a disruption of the expression or function of the UBE3A gene located on the maternal chromosome 15 (q11q13), resulting in moderate to severe intellectual disability, mild to extreme ataxia, lack of or limited verbal communication, seizures, sleep maintenance issues, and mild to severe attention and aggression. The Angelman Syndrome Clinic brings together multiple specialists into one setting to address the complex medical and psycho-educational needs of individuals with AS. Depending on the specific concerns, patients and their families have access to the following clinic team disciplines social work, psychology, speech/language pathology, occupational therapy, neurology, psychiatry, genetics, genetic counseling, and physical therapy. The Angelman Syndrome Clinic occurs once a month, and generally one family is scheduled to see most, if not all, of the clinicians based on their concerns during a “one-stop shop” full day appointment. Appointments with individual disciplines can also be arranged. To request an appointment with the Angelman Syndrome Clinic, please complete the questionnaire at this link or contact margaret.deramus@cidd.unc.edu

Click Here for more information on the Angelman Syndrome Clinic and Research at CIDD.

THE BMDDC is an interdisciplinary evaluation and treatment service for children, adolescents and adults with developmental disabilities co-occurring with complex behavioral and/or psychiatric challenges. The evaluation and treatment team includes a Behavioral Psychologist and a physician trained in both Pediatrics and Psychiatry.

Common referral issues appropriate for this clinic include assistance with self-injurious behaviors, disabling ritualistic behaviors, difficulties surrounding obsessive/narrow areas of interest, and explosive/aggressive behaviors. In addition to addressing the above primary referral concerns the providers in this clinic can consult on or assist in arranging further consultation regarding the following common co-morbid concerns: Anxiety Disorders(with special emphasis on Obsessive-Compulsive Disorder), Mood Disorders, Tic Disorders, Attention Deficit/Hyperactivity Symptoms, Sleep Disorders, Seizure Disorders, Gastro-Intestinal/Toileting issues.

Evaluation services will include multiple disciplines and be problem focused. Diagnostic clarification of the underlying developmental disability will not be an area of focus in this clinic. Underlying developmental disabilities considered appropriate may include Autism Spectrum Disorders (all severity levels) and all developmental disabilities where an intellectual disability is primary feature regardless of etiology. Children and adults with primary Axis I Psychiatric Disorders without a co-morbid developmental disability as described above are not appropriate for this clinic.

Intervention services can include but would not be limited to development of a detailed behavioral management plan, psychopharmacologic consultation and collaborative institution of all recommendations with the family and community providers as appropriate. The period of consultation with the client will vary from one visit to a period of co-management with the family and/or community provider as appropriate.

The Dup15q Syndrome Clinic serves individuals with Dup15q syndrome and their families. Dup15q syndrome is characterized by having an extra copy of a portion of chromosome 15 in the 11.2-13.1 region in combination with a number of symptoms that may include, hypotonia, epilepsy, cognitive delay, motor delays, autism, similar facial features. The Dup15q Syndrome Clinic brings together multiple specialists into one setting to address the complex medical and psycho-educational needs of individuals with Dup15q syndrome. Depending on the specific concerns, patients and their families have access to the following clinic team disciplines social work, psychology, speech/language pathology, occupational therapy, neurology, psychiatry, genetics, genetic counseling, and physical therapy. The Dup15q Syndrome Clinic occurs once a month, and generally one family is scheduled to see most, if not all, of the clinicians based on their concerns during a “one-stop shop” full day appointment. Appointments with individual disciplines can also be arranged. To request an appointment with the Dup15q Syndrome Clinic, please complete the questionnaire at this link or contact margaret.deramus@cidd.unc.edu

To learn more about Dup15q syndrome (click here )

The HDC offers diagnostic evaluations for infants and young children with known hearing loss in combination with developmental concerns. The primary purpose of the clinic is to determine whether or not a child is experiencing developmental deficits, and if so to provide recommendations for treatment. Typical referral concerns include:

• Speech, language, or learning difficulties
• Concerns regarding developmental delays
• Concerns regarding socialization, communication, or sensory dysfunction

The team consists of audiologists, a speech-language pathologist, a psychologist, a learning specialist, and other disciplines as needed based on referral concerns. At the conclusion of the interdisciplinary assessments an interpretive conference will be provided for parents/caretakers to explain the results of the evaluation and strategies to address referral concerns. A report will be provided along with assistance in identifying local resources.

While major public policies and societal attitudes toward individuals with intellectual and/or developmental disabilities have evolved, perceptions toward sexuality have lagged behind. The Let’s Talk About Sexuality psychoeducational series aims to provide accurate and developmentally appropriate information about sexuality development across the lifespan and to empower youth participants to make good decisions and practice healthy behaviors related to personal relationships and their bodies. Let’s Talk about Sexuality is comprised of a seven week curriculum offered in two concurrent group settings ─ one directed toward youth ages 11-16, and the other toward their parents. Included are weekly “family-focused" segments that provide opportunity for interactive family activities designed to explore and clarify family values and to strengthen communication about sexuality. Through this unique family-system approach, we hope to support positive continuous sexuality education in the home through information, strategies, and resources.

Many patients seen in CIDD with newly diagnosed ASD have medical questions, including when to get genetic testing, what to do about behavioral or developmental treatment options (e.g. medications), or presence of neurologic comorbidities (e.g. seizures). Families often become burdened by having multiple providers for their child and would like to consolidate their care under one provider. Many patients seen in CIDD with newly diagnosed ASD have medical questions, including when to get genetic testing, what to do about behavioral or developmental treatment options (e.g. medications), or presence of neurologic comorbidities (e.g. seizures). Families often become burdened by having multiple providers for their child and would like to consolidate their care under one provider. This clinic serves as a medical home for individuals with ASD who require ongoing medical care.

The Neurodevelopmental Clinic is an evaluation and treatment service for children, adolescents, and young adults from birth to 26 years of age with developmental disabilities and co-occurring neurological conditions. Common referral concerns include seizures / epilepsy, headache and other pain disorders, sleep problems, issues affecting tone and coordination, concussion and other brain injury, and tic disorders. Our neurologist can provide neurologic and developmental evaluations, pharmacological consultations, and ongoing management of the above conditions and more. Additional services include healthcare transition counseling for adolescents.

The Neurogenetics Clinic is an evaluation and consultation service for children, adolescents, and young adults with identified neurogenetic disorders. Common referral concerns include questions about development, communication, possible autism, behavior problems, and comorbid medical conditions (e.g., seizures/epilepsy, sleep problems). The clinical team currently includes pediatric neurology, psychology, and speech language pathology.

The focus of this clinic is the neuropsychological assessment of children and adolescents with neurological illness, medical illnesses and disorders, genetic disorders, psychiatric illness and behavior problems, brain injury, developmental disabilities, and complex learning issues. Individuals are referred to the clinic from a variety of sources, including neurology, nephrology, oncology, pediatric rehab, and local school systems. Neuropsychological assessment describes brain-behavior relationships by assessing multiple cognitive domains and relating a patient’s performance within these domains to neuroanatomical and neurophysiological principles. A typical clinic day begins with a parent/child interview to clarify questions and concerns, followed by three to five hours of assessment. Interpretives generally take place on another day in order to have time to score all assessments, develop the diagnostic formulation, and select appropriate treatments and recommendations. Trainees participate in all aspects of the clinic, and gradually move into more independence in regards to interviewing, battery development, and formulation. Trainees participating in this clinic will be exposed to a wide range of clinical presentations, semi-structured clinical interviewing, neuropsychological testing procedures, interpretation of data, clinical interpretive with clients and family members, report writing, and community consultation and information sharing as requested by the families.

The Prader Willi Syndrome Clinic is a once every other month multidisciplinary clinic serving individuals with PWS and their families across NC. PWS is a genetic disorder which results in borderline to moderate intellectual disability, mild to extreme hypotonia, often severe hyperphagia (urge to eat), OCD and autistic-like behaviors, and mild self-injurious behaviors (mostly skin-picking). Many individuals with PWS have obesity-related health concerns as well. The clinic team is comprised of psychology, speech/language, nutrition, PT, medicine and genetic counseling. A medical consultation model is used in providing support to families who come to the clinic. Typically 2-6 individuals and their caregivers are seen each clinic.

The PAACT Clinic offers diagnostic evaluations for children under age 5 years of age. The primary purpose of the half-day clinic is to determine whether or not the child meets criteria for an autism spectrum disorder, provide recommendations for treatment, and refer the family to other resources in their community. This clinic also includes follow-up consultation and parent training for interested families. Common referral concerns include:

• Speech/language delays
• Differences in social interaction with adults and/or peers
• Difficulty with behavior management
• Strong or unusual interests
• Difficulty with change
• Sensory differences
• Repetitive play and/or behaviors

The team consists of a licensed psychologist and a licensed speech language pathologist, as well as graduate students from each of these disciplines. Professionals from other disciplines are included based on the referral questions. The half-day evaluation consists of a thorough child assessment typically using the Autism Diagnostic Observation Schedule, a parent interview, and/or other informal tools to assess for characteristics of autism. Developmental, cognitive, adaptive behavior, and speech and language assessments are supplemented as needed. Parents/caregivers are offered an interpretive conference regarding the results the evaluation, strategies to address their referral concerns, and opportunity to return for follow-up consultation and parent training/therapy. A report of the findings and recommendations is tailored to the needs of the family.

The School-Age Autism Clinic offers evaluations and consultation for school-aged individuals (ages 5-17) when there are concerns regarding possible autism. Evaluations typically involve differential diagnosis of High Functioning Autism and Asperger syndrome, and there may be concerns regarding other psychiatric or behavioral disorders (for example, anxiety, depression, ADHD) as well. Individuals who are evaluated receive consultation and recommendations regardless of diagnostic outcomes. Individuals with preexisting autism-related diagnoses may also been seen for consultation regarding intervention planning, behavior supports and planning, educational supports, and transition planning.

The School-Age Team often consists of clinicians representing all disciplines at the CIDD. Children from preschool through 12th grade may be referred by parents, physicians, or schools for a variety of issues related to developmental disabilities. The clients referred to this team frequently present complex diagnostic and treatment challenges. The interdisciplinary team members, selected based on the referral concerns for each client, conduct individual assessment sessions targeting those questions and needs. Parents have an opportunity to observe and also participate in consultations with each clinician. Following the full-day evaluation, the team meets to consolidate findings, after which the team coordinator meets with the family for an interpretive conference. The role of team coordinator/family advisor is rotated and the School-Age Team is a major component in the LEND (Leadership and Education in Neurodevelopmental Disabilities) training program at the CIDD. Trainees observe and participate in the assessments, team conference, and interpretive conferences. A comprehensive report is generated following the evaluation.

The CIDD runs a number of social skills groups designed to help children, adolescents, and adults develop their social communicative skills. The groups are open to those with a formal diagnosis that impacts their social communication abilities (such as autism spectrum disorder), as well as those simply wishing to improve their social skills. The groups are designed for individuals with verbal skills that would allow them to benefit from the back-and-forth conversations that are part of a group setting.

Click Here for more information about Social Skills Groups at the CIDD

TAND stands for Tuberous Sclerosis Complex-associated Neuropsychiatric Disorders and encompasses cognitive, behavioral, psychiatric, psychological, and psychosocial manifestations in Tuberous Sclerosis Complex (TSC). TAND affects approximately 90% of individuals with TSC and, therefore, represents a significant burden for patients and families. There is a need to diagnose and manage TAND. The goals of the clinic are as follows:
-Perform comprehensive developmental assessments for patients with TSC, which would include ASD evaluations, developmental and neuropsychological testing, and provide appropriate recommendations. These evaluations would be performed through the Neurogenetics Clinic.
-Perform behavioral assessments and provide recommendations for therapy
-Provide ongoing medical treatment for TAND symptoms.
TAND clinic will occur on the 4th Wednesday of the month. This clinic would also be helpful for patients with Neurofibromatosis who have similar cognitive and behavioral difficulties.