The expanded Nemours/Alfred I. duPont Hospital for Children, designed by patients, families and caregivers, is an environment that promotes children’s physical, emotional and spiritual healing.
Nemours/Alfred I. duPont Hospital for Children
Advanced Training for Predoctoral Psychology Students
The Division of Behavioral Health at Nemours/Alfred I. duPont Hospital for Children offers a psychology externship for advanced predoctoral students (3rd year students and above) in clinical, school, and counseling psychology. Positions are offered, dependent upon the availability of opportunities and the match of interests between supervisors and applicants. In the Division of Behavioral Health, we serve infants, children and adolescents who are hospital inpatients and outpatients, referred from ambulatory services of the hospital, and the community.
Training & Rotations for Externs
Within the Department of Pediatrics, the Division of Behavioral Health includes psychologists and psychiatrists. We have an APA-approved Clinical Doctoral Psychology Internship and Postdoctoral Fellowship program. In Psychology, there are over 40 doctoral-level licensed psychologists, psychology residents (interns), postdoctoral fellows and extern students. We serve infants, children and adolescents in need of psychological evaluation and treatment.
Our externship positions typically last 9 to 12 months, depending on the needs of the student and clinic. There is no stipend available for externship training. Externship rotations are organized by type of training experience (i.e., intervention, evaluation rotations). Additional training experiences, such as involvement in group treatments, are available to supplement any training experience so long as the training experiences do not conflict with one another. There is one position per rotation unless otherwise indicated. Externship rotations are one day per week unless otherwise indicated. Students seeking a two-day placement can apply for multiple rotations.
In addition to clinical experiences, externs are welcome to participate in other educational activities available through our externship program and the hospital, including didactic seminars and grand rounds.
Our externship program provides a rich variety of clinical intervention and evaluation experiences, in a range of settings, under supervision by our faculty. Rotations are organized by type of training experience (i.e., intervention, integrated primary care, evaluation rotations), and some rotations include a combination of intervention and evaluation opportunities. Specific days of the week in which rotations are offered is noted where applicable. If a rotation has flexibility for another day of the week, that will be noted in the description.
The Autism Behavior Consultation Clinic (ABC) is designed to provide brief, targeted behavioral services for children with Autism Spectrum Disorder (ASD) or other developmental disorders and their caregivers. Intervention focuses on empirically-based approaches to behavior management and addresses a wide range of behavioral and developmental concerns, including aggression, tantrums, compliance, self-help skills and toileting concerns. Appointments are 45 minutes and therapy focuses on evidence-based, short-term, goal-oriented techniques.
Externs see patients on Wednesday afternoons and receive live supervision via one-way mirror. Third year students and above are encouraged to apply, and externs are able to combine this with another rotation for a 2-day placement.
The Autism Feeding Clinic in the Swank Autism Center provides consultation, evaluation, and treatment for children who are diagnosed with Autism Spectrum Disorder (ASD) and present with comorbid feeding disorders. Externs in this clinic will have the opportunity to participate in multidisciplinary feeding evaluations, as well as provide evidence-based behavioral interventions for children diagnosed with ASD and restrictive/selective eating. With supervision, externs will participate in outpatient feeding therapy sessions, which include a combination of direct service and parent training to address behavioral feeding concerns. There will also be opportunities for consultation with other members of the patient’s care team.
The days for this rotation are flexible. Live supervision will be provided via one-way mirror. Advanced 4th and 5th year students are encouraged to apply and externs are able to combine this with another rotation for a 2-day placement.
The Behavior Consultation Clinic (BCC) is designed to provide evidence-based therapy in a fast-paced, "real world" setting for children ages birth to 5 years and their parents. Presenting problems include a wide range of behavioral and developmental concerns that commonly present in early childhood, such as behavior, sleep problems, toileting concerns, picky eating, separation anxiety, specific phobias and selective mutism.
Appointments are held on Friday, are 45 minutes long and live supervision is provided via a one-way mirror. Externs frequently coordinate care with medical and child care providers. There are opportunities to participate in resident teaching. Advanced 4th and 5th year students are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement.
The Behavioral Developmental Access Clinic (BDAC) is designed to provide assessment and intervention experiences with a broad range of complex early childhood concerns including medical, behavioral, social, emotional, attentional and developmental challenges in children under age 4.
Externs see patients on Wednesdays and will be able to participate in consultation, follow-up, feedback and brief assessment screening visits while learning how to conceptualize complex diagnostic presentations and identify appropriate interventions. Third year students and above are encouraged to apply, and externs are able to combine this with another rotation for a 2-day placement.
This position offers the opportunity to provide therapy (individual, family and group) and consultation (classroom teachers, nursing staff) services in a school-based setting for children with a variety of chronic illness conditions. The First State School at Wilmington Hospital (Christiana Care Health System) is one of the first and only hospital-based schools in the United States dedicated to providing integrated specialized medical and therapeutic care (e.g., nursing as well as psychological, occupational, physical and speech therapies) with traditional classroom schooling. Physicians may refer kindergarten age to high school age patients to the First State School because of medical necessity. Typical diagnoses of children attending the First State School include diabetes, sickle cell anemia, hemophilia, kidney and liver disease, asthma, cancer and gastrointestinal disorders. Therapy work is predominantly targeted towards medical adherence, adjustment to illness, coping with stressors and enhancing school academic and social functioning.
Externs will see patients and work with the interdisciplinary team on Wednesday. Externs will be on-site a minimum of 1 day per week. There will be opportunities for the extern to consult with the child’s medical team (hospital and school-based), classroom teachers and educational diagnostician (e.g., behavior plans; accommodation plans) and consulting psychiatrist. Fourth year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement.
This externship provides opportunities to complete initial diagnostic evaluations, therapeutic intervention, and consultation services with children and adolescents referred from the Division of Gastroenterology. Presenting conditions include adjustment to organic gastrointestinal diagnoses (i.e., Inflammatory Bowel Disease, Celiac Disease, motility disorders, etc.) and functional gastrointestinal disorders (i.e., functional abdominal pain, Irritable Bowel Syndrome, encopresis, etc.). Externs will gain experience using behavioral, cognitive-behavioral, and acceptance-based strategies within this pediatric population. Potential opportunities to work and/or collaborate with other disciplines in multidisciplinary clinics isare available.
Date of rotation is flexible. Placements available at Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE (Monday, Wednesday, Friday) and/or the Nemours duPont Pediatrics, Specialty Care Center, in Deptford, NJ (Tuesday, Thursday). Third year students and above are encouraged to apply.
Externs on this rotation will work within an interdisciplinary pediatric pain program providing cognitive behavioral therapy for pain management to youth experiencing chronic pain/physical symptoms and collaborate with other disciplines (e.g., social work, physical therapy, physicians, nurses, etc.). Extern responsibilities include conducting intake evaluations, individual therapy, collaborations with other disciplines, and writing notes.
Date of rotation is flexible with Thursday availability preferred. Third year students and above are encouraged to apply. This rotation can be a 2-day experience if interested, and can also be combined with another rotation for a 2-day placement.
Externs on this rotation primarily provide Parent-Child Interaction Therapy (PCIT) to young children (2-6 years old) with disruptive behaviors and/or emotional concerns and their caregivers. PCIT is an empirically-supported treatment that is considered the "gold standard" for moderate to severe disruptive behavior problems in young children. On occasion, other evidence-based psychotherapy services may also be offered in conjunction with PCIT. The most common reason for referral is disruptive behavior, but children also present with anxiety, emotion regulation difficulties, attention concerns, toileting/sleep concerns, and parent-child or sibling conflict. Externs will receive training in implementing PCIT with fidelity. Externs see patients on Monday afternoons and receive live supervision via one-way mirror as well as group supervision. This experience often involves coordination with schools and/or other multidisciplinary team members as appropriate.
Dates for this rotation will be Monday afternoon. Advanced 4th and 5th year students are encouraged to apply, this experience can be combined with another to create a 2-day placement.
Integrated Primary Care Consultation and Treatment
We have several training opportunities offering experience in integrated primary care settings. These rotations focus on implementing brief therapeutic interventions, assessment and consultation services with professionals, including pediatricians, nurse practitioners and other care providers in pediatric primary care offices. One full day is spent in clinic, focusing primarily on short-term, goal-oriented interventions. Patient populations are sociodemographically diverse and includes a wide variety of ages and presenting conditions including behavioral disorders, ADHD, mood disorders, anxiety disorders, elimination disorders, developmental delays, learning disabilities as well as many concerns of early childhood including eating and sleeping difficulties. The extern will also gain experience utilizing brief screening measures (e.g., Wide Range Intelligence Test, Wide Range Achievement Test-5, Comprehensive Test of Phonological Processing-2) as needed to clarify diagnosis and inform therapeutic and educational interventions. Externs will also have the opportunity to shadow medical providers, present psychology lectures to office staff, and participate in and participate in manuscript reviews.
The Jessup Street rotation also provides the opportunity to participate in integrated well visits and the Parent Child Conduct group program. Integrated well visits are provided to patient families with children 0-8 years old and focus on development, parent/child dyad relationships, attachment, and common early childhood concerns such as sleep and behavior. These visits are performed in conjunction with the medical team. Parent Child Conduct group is held Thursday evening and includes concurrent child and parent group treatment. Responsibilities include gathering baseline data, participating as a co-therapist for child or parent groups and assessing outcome data. Group is held on Thursday evening from 5-7 p.m.
Locations and days in which specific rotations are available are listed below. Third year students and above are encouraged to apply. Rotations can be combined with others to create a 2-day placement.
This externship provides students with opportunities for completing psychological testing within the Swank Autism Center. Externs will help complete diagnostic evaluations for children (ranging from early childhood to adolescence) with concerns for Autism Spectrum Disorder (ASD) and/or related intellectual, behavioral, and/or developmental disabilities. Occasionally, evaluations may also be conducted with children previously diagnosed with ASD who require testing for updated information or additional concerns. Test batteries typically include structured clinical interviewing (including a diagnostic interview adapted from the ADI-R) and measures of cognitive, adaptive and social-emotional functioning, as well as “gold standard” play-based assessment tools related to autism (e.g., ADOS-2). Informal training regarding administration and coding of the ADOS-2 will be provided through supervision with a clinician who has completed clinical and research reliability with this measure. More complex cases may involve additional assessment related to attention, memory, executive functioning, and learning. Externs will assist with test administration, scoring and report writing, and may also have the opportunity to observe/participate in feedback sessions delivering findings and recommendations to families.
This rotation is offered on Friday. Third year students and above are encouraged to apply, and externs are able to combine this with another rotation for a 2-day placement.
This 2-day externship provides students with opportunities for completing both neuropsychological assessment and treatment with patients diagnosed with concussion/mild traumatic brain injury (mTBI). One day of the externship would consist of providing brief, serial neuropsychological evaluations with patients diagnosed with concussion. New patient evaluations are 2 hours and consist of a interview, testing, immediate feedback and education/treatment planning. Follow up evaluations are 1 hour and consist of identifying interim progress, re-evaluating neurocognitive functioning and updating treatment plans. A typical clinic day consists of 1-2 new patients and 1-2 follow up patients. The second day of the externship would consist of providing therapeutic intervention with patients referred from the concussion clinic. Presenting conditions include difficulty adjusting to psychosocial changes due to the injury, as well as anxiety or mood concerns that may complicate recovery from the concussion/mTBI.
The neuropsychological testing rotation is offered on Tuesdays, Wednesdays or Fridays, and the treatment rotation is offered Thursdays or Fridays. Third year students and above are encouraged to apply. Externs are encouraged to complete this 2-day rotation; however if they are only interested in 1 day (either testing or treatment) that can be arranged.
When participating in the Empirically Supported Evaluation and Treatment of Disruptive Behavior Disorders rotation, practicum students have two primary responsibilities. Students complete 3 psychological evaluations per month of children presenting with a number of concerns including difficulty with attention, behavior, learning, anxiety, and mood functioning. Students are responsible for administering and scoring tests and writing comprehensive evaluation reports. Tests to be used include widely used measures of cognitive ability, memory functioning, academic ability, phonological processing, and attention ability, as well as standardized behavior checklists. Students are also exposed to projective and personality testing for adolescents presenting with questions of thought disorders or psychosis. Students also assist in the concurrent Parent Child Conduct Clinic groups. Duties include gathering baseline data, participating as a co-therapist for child groups, and gathering post-group data.
The clinic is scheduled so that evaluations are conducted in the morning, scoring, parent feedback, and writing occurs in the early afternoon, and groups are conducted at the end of the day. The student participates in groups on Wednesday and one additional evening (Tuesday or Thursday). Fourth year students and above are encouraged to apply. Individual supervision is provided. Opportunities to participate in research are sometimes, but not always, available. The supervisor for the testing rotation is Roger Harrison, Ph.D; groups are supervised by Dr. Harrison and Colleen Cullinan, Ph.D.
This rotation involves completion of neuropsychological testing with children and adolescents presenting with neurocognitive or neurobehavioral difficulties associated with medical, neurodevelopmental or genetic disorders. Test batteries typically include measures of intellectual functioning, attention, memory, language, executive functioning and psychosocial functioning. Externs will assist with test selection and planning, test administration, scoring and report-writing, as well as observing feedback sessions with families. Individual supervision will occur weekly and cover administration issues, case conceptualization with regards to neuroanatomy and development, and discussion of differential diagnoses. An expectation to participate in didactic experience is also part of this rotation.
This rotation requires two days per week and one day must be Thursday; there can be some flexibility with the second day but preferably Tuesday to allow the extern to attend feedback sessions and didactics. The clinical case material, supervision and didactics that comprise this experience are designed to provide a broad introduction to pediatric neuropsychology and to prepare the extern for further training in the area of neuropsychology. Fourth year students and above are encouraged to apply.
This externship provides opportunities for psychological testing at the Nemours duPont Pediatrics office in Glen Mills, Pa. This placement would give externs the opportunity to gain experience evaluating young children through adolescents presenting with a range of questions regarding school readiness, qualification for standardized testing accommodations, and learning disorders as well as traditional concerns with mood, anxiety, attention, and development. Test batteries would include cognitive and academic measures as well as measures of memory and attention, executive functioning, phonetic processing and visual-motor functioning.
This rotation is offered on Mondays. Third year students and above are encouraged to apply, externs are able to combine this with another rotation for a 2-day placement.
Nemours/Alfred I. duPont Hospital for Children is like no other in the region — designed by families, for families.
About Our Hospital in Delaware
The Nemours/Alfred I. duPont Hospital for Children is a multispecialty, tertiary care teaching institution located on a 300-acre estate in the scenic Brandywine Valley in Wilmington, Del.
As a program participant, you’ll have access to advanced computer systems for patient care activities, electronic mail, word processing, internet access and library research functions. Among the hospital’s amenities for all staff are:
- free parking
- park-like setting
- gym/fitness center
- on-site child care center for children of staff
- massage therapy
Kathryn Hoffses, PhD
Director of Externship Training, Division of Behavioral Health
Apply for Our Externship
Deadline: January 22, 2019
- Nemours Psychology Externship Application Form
- PENDELDOT Psychology Externship Application Cover Sheet
- Curriculum Vitae
- Two Letters of Recommendation
- (Letter writers to submit directly to Dr. Hoffses)
- Sample Diagnostic Evaluation Report (only required for Evaluation rotations)
- All identifying information removed