Traditional Neuropsychology Clinics

This is a multidisciplinary clinic that includes providers from neurology, neurosurgery and psychiatry. Trainees conduct outpatient evaluations of various neurocognitive disturbances ranging from dementia subtypes, subcortical diseases, and neuropsychiatric disorders (OCD, Tourettes, psychogenic), to sequelae of medical disorders, both common and rare. Most adult candidates for deep brain stimulation (DBS) are seen on this clinic and trainees have opportunity to: a) attend monthly consensus conferences where DBS candidates are discussed by the multidisciplinary team (neuropsychology, neurology, neurosurgery, psychiatry, OT, PT, speech); and b) observe DBS surgery. By virtue of being in an embedded clinic, students rapidly develop interprofessional communication skills. .As part of supervision, students present their cases, including history, results, and interpretation, to the team. Hypotheses about the mechanisms of deficit, and further treatment/evaluation recommendations are formulated. Emphasis is placed on user friendly reports and prescriptions for maintaining brain health via a “brain health profile”. This clinic is located off site at the Fixel Institute of Neuological Diseases. Supervision is held on the same day.

During this rotation, trainees see primarily outpatient evaluations on a variety of diagnoses. Most referrals focus on adult learning disabilities/ADHD, traumatic brain injury, and competency evaluations for impaired professionals. We will also occasionally see cases of epilepsy, dementia and general mental health. Occasionally, cases of disability or brain injury will present as forensic evaluations. Trainees learn to administer a structured interview, conduct feedback sessions while administering and interpreting a comprehensive battery of tests. Individual and group supervision are provided.

During this rotation, students will conduct neuropsychological evaluations on patients with a variety of cognitive disorders. Most common disorders include subtypes of dementia , mild cognitive impairment, movement disorders, TBI,, neurocognitive sequelae of medical disorders, and neuropsychiatric disorders. The student will learn a hypothesis-oriented approach using a flexible battery, and will become familiar with major modalities of diagnosis used by interdisciplinary health care teams. A portion of this clinic involves brief assessment of individuals with concussion. This occurs in the context of a multidisciplinary team who see individuals as part of the TBI/concussion program During supervision, we meet as a team and trainees present their cases, including history, results, and interpretation, to the team, where hypotheses about the mechanisms of deficit, and further treatment/evaluation recommendations are formulated. Background readings are provided where appropriate. This clinic is held at the Norman Fixel institute of Neurological Diseases.

The outpatient stroke service occurs within the context of the Stroke Center as part of the University of Florida Department of Neurology. This team focuses on patients who have experienced (or suspected or experiencing) a stroke. Strokes may be recent (within a three month window) or chronic (years after). This is often an older population and thus differential diagnostic possibilities, in addition to focal stroke, include cerebrovascular disease related issues including white matter disease, metabolic issues, neurodegenerative diseases, and normal aging. Neuropsychological assessments last from 3-4 hours and utilize common neuropsychological measures within a flexible/adaptive battery. Because it is a stroke clinic, this adaptive battery may change rather markedly depending on underlying issues. For example, someone with a language disturbance may be heavily loaded on language tasks as we try to tease apart forms of aphasia. Because of the age of the population, a core battery is maintained to assess for contributions from neurodegenerative domains, thus ability/aptitude, executive functions, verbal and nonverbal memory, visuospatial skills, sensory-motor status, and language are all assessed. Goals of assessments include determining if there is impairment, the nature of the impairment (due to stroke or other reasons), prognosis (e.g., recovery curves, participation in rehabilitation), treatment options (cognitive rehabilitation, psychotherapy, pharmacotherapy), and living situation.

This rotation focuses on neuropsychological disorders in young to older adults including individuals with epilepsy, brain tumor, traumatic and acquired brain injury, and neurocognitive sequelae of various medical conditions. . Occasional referrals may focus on other diagnoses, including neuropsychiatric disturbance, adult learning disabilities and ADHD. Students learn to conduct the clinical interview, administer and interpret test batteries, and write concise integrative reports. As a part of this rotation, trainees will become familiar with the neuroanatomical correlates of major diseases and disorders. Trainees will participate in weekly group supervision on the day of the assessment (i.e., morning of evaluation and immediately following). Trainees may have the opportunity to provide feedback, psychoeducation and/or supportive psychotherapy to patients or their family (such activities are logged as therapy contact hours), and may also have the opportunity to conduct bedside evaluations with patients admitted to the hospital (inpatient).

This clinic is embedded within a multidisciplinary context that includes health care providers from neurology. Trainees will conduct outpatient evaluations of various neurocognitive disturbances focusing especially on dementia subtypes, and sequelae of medical disorders, both common and rare. Candidates for memory disorders intervention programs are seen in this clinic. By virtue of being in an embedded clinic, students rapidly develop interprofessional communication skills. As part of supervision, trainees present their cases, including history, results, and interpretation, to the team. Hypotheses about the mechanisms of deficit, and further treatment/evaluation recommendations are formulated. Emphasis is placed on developing practice efficiency, e.g. considering the most expeditious way to address the referral question and providing patient centered and user-friendly reports and prescriptions for maintaining brain health via a “brain health profile”. This clinic is located off site at the Norman Fixel Institute of Neurologic Diseases.

During this rotation, trainees conduct outpatient evaluations of primarily older adults with MCI, typical and atypical dementias. Other patient referrals may include post-surgical, psychiatric, stroke, movement disorders (Parkinson’s etc., post-DBS), TBI, and epilepsy. Trainees participate in weekly group supervision on the day of the assessment (individual supervision is also available and encouraged). There will often be review of selected readings pertinent to specific disorders as well as cultural competence in neuropsychological assessment. Trainees learn to conduct a clinical interview, administer flexible protocols, interpret patterns in the cognitive data to aid differential diagnosis, write concise reports, and conduct feedback sessions. This clinic is held at the Norman Fixel Institute of Neurological Diseases.

During this rotation, trainees conduct inpatient and outpatient evaluations of children and adolescents with a variety of neurological, psychoeducational, and behavioral disturbances. The age range of patients seen on this rotation spans from 2 to 19 years old, allowing trainees to gain exposure to a wide range of pediatric neuropsychology assessment methods and a broad range of developmental issues. Referrals are received from a variety of sources and represent a wide variety of patient groups, including neurology (epilepsy; pre/post brain surgery evals; rare neurological or genetic disorders), hematology/oncology (brain tumors/cancer; pre/post-surgery and chemo/radiation evals), School Problems Clinic (academic difficulties of unknown etiology; opportunities for multidisciplinary work), pediatric ICU and/or pediatric neurosurgery (traumatic brain injury; acute inpt evals), Brooks Rehabilitation Hospital (traumatic brain injury; post-rehab outpt evals), and local pediatricians (developmental delays, cognitive deficits w/mood or behavioral disturbance). Trainees are expected to take primary responsibility for the assessment and report-writing on 1 case per week, participate in weekly group supervisions, and complete supplementary readings of relevance to the disorder at hand.