Topical Symposium: Interdisciplinary Models for Improving Healthcare Transition and Adult Healthcare Provision in Individuals with Intellectual and Developmental Disabilities (IDD)

Jessica Sanders, MD, University of Colorado, Denver, CO; Sarah McSwegin, LCSW, Children's Hospital Colorado, Aurora, CO; Eleanor Floyd, MD, University of Colorado and Children's Hospital Colorado, Aurora, CO; Cristina Sarmiento, MD, University of Colorado and Denver Health, Denver, CO; Michael Puente, MD, University of Colorado and Children's Hospital Colorado, Denver, CO; Dan Wood, PhD MB.BS FRCS Urol, University of Colorado School of Medicine, Aurora, CO

Description: Youth with intellectual and developmental disabilities (IDD) face unique challenges when transitioning from pediatric to adult healthcare. They struggle with access to care and experience poorer health outcomes when transitioning to adulthood.  This interactive, interdisciplinary topical symposium will explore unique programs designed to overcome some of these barriers and improve the healthcare transition process for this vulnerable population.  We will frame our symposium with a case of a young adult patient with intellectual disability and multiple complex medical problems. This patient will begin in our Developmental Pediatrics Transition Clinic, and will ultimately “visit” other clinics. Through this case, participants will learn how providers in different disciplines and at different institutions work together to care for each of these patients’ needs. A social worker, who is the co-leader of the Transition Clinic, will describe the Transition Clinic’s structure, patients served, metrics utilized, and patient outcomes, including employment outcomes. As in real life, we will identify unmet medical and transition-to-adulthood needs in this patient, and present questions to the audience about what path to take next to address these needs… Through this case-based session that incorporates polling and interactive question-and-answer, participants will learn about this innovative interdisciplinary, asynchronous model developed to help meet the complex medical, developmental, and social needs for youth and young adults with IDD as they transition to adulthood.

Target audience: will include clinicians from all specialties and career development stages, as the interactive presentation will challenge all participants to think in innovative ways of how to help patients in Developmental Behavioral pediatric practices approach the transition to adulthood process. Clinicians, administrators, and clinician-researchers will benefit from this discussion of diverse viewpoints and experiences in the transition-to-adulthood process.

Learning Objectives: 1) Describe a model of an interdisciplinary Transition Clinic housed within a Developmental Pediatrics department, 2) Compare at least 3 different models of specialty care for youth and adults with intellectual and developmental disabilities, 3) Understand how asynchronous specialty care can contribute to well-integrated, complex care for patients with IDD.

Keywords: Clinical Practice, Interprofessional Practice

Lectureship Presentation: Margaret Montoya, JD

Professor Emerita of Law, UNM School of Law  
Consultant on Racial and Health Equity

Margaret Montoya was among the first cohort of students of color at Harvard Law School.  She was a member of the UNM law school faculty for 28 years after practicing law in Massachusetts, New York, and New Mexico. She worked to create access programs for students and faculty of color in law and medicine. She is a founding member of LatCrit (https://latcrit.org/), a group that centers the Latinx experience in critical legal theory.  In 2002, she began combining her work in critical legal theory with issues of health equity. She served for years as the Senior Advisor to Chancellor of the UNM Health Science Center. She and reproductive health colleagues founded CERCL-FP (Centering Equity, Race, and Cultural Literacy in Family Planning), a collective of dedicated intersectional multidisciplinary professionals who employ critical race theory (CRT) and reproductive justice (RJ) frameworks to analyze and dismantle interpersonal and structural racism within all sectors of family planning healthcare. CERCL has developed an antiracism training program called Racial Literacy, which uses the CRT and RJ skills and knowledge to address the gaps in medical education pertaining to racism and inequities. Prof. Montoya has been active in local political issues involving early childhood education, COVID vaccine equity, and served in the Governor’s Advisory Council for Racial Justice.  She has been a mentor to numerous law students, law graduates, and junior faculty.  Her work has been recognized with symposia, an annual writing retreat, and numerous academic and community awards. As a wife, step/mother, and grandmother, she seeks to combine her professional and personal lives.

Research Spotlight: The Impact of Abuse, Neglect, and Social Experience on Behavior and Development: A 30-Year Perspective

Lane Strathearn, MD,PhD, University of Iowa, Iowa City, IA

Brief Description:

Infancy is a time of rapid neural development, in which repetitive, attuned social experiences are transformed into neural connections that become the foundation for social and cognitive development. Likewise, pregnancy, childbirth, lactation, and caregiving experience appear to prime a mother's brain to respond to infant cues by engaging specific neuroendocrine systems, including the dopamine reward and the oxytocin affiliation systems. Our research over the past three decades has explored the impact of early experience—both positive and negative—on child development. Drawing upon a 30-year longitudinal study from pregnancy (Mater-University of Queensland Study of Pregnancy, or MUSP), we have shown that child maltreatment, particularly emotional abuse and/or neglect, is associated with a wide range of long-term adverse health and developmental outcomes, including cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring.

 Overall, our innovative research program has helped focus attention on the profound long-term impact of abuse, neglect, and early social experience on many outcomes relevant to developmental and behavioral pediatrics.

Learning Objectives

Upon completion of this Spotlight Research Presentation, participants should be able to: Explain basic neural mechanism through which early experience impacts child development, including dopamine and oxytocin pathways; List the developmental and behavioral outcomes associated with child abuse and neglect, particularly psychological maltreatment; Identify psychosocial risk factors for ongoing developmental and behavioral concerns, in order to provide appropriate support for families.

Keywords: Research

Topical Symposium: Fetal Alcohol Spectrum Disorders: Recognition, Diagnosis and Management Strategies in Developmental-Behavioral Pediatric Practice

Yasmin Senturias, MD, Atrium Health, Charlotte, NC; Susan Butross, MD, University of Mississippi Health Care, Jackson, MS; Kimberly Burkhart, PhD, Catherine Lipman, MD, Rainbow Babies and Children’s Hospital, Cleveland, OH; Prachi Shah, MD, University of Michigan, Ann Arbor, MI; Denise Bothe, MD; Rachel Tangen, PhD, Rainbow Babies and Children’s Hospital, Cleveland, OH; Susan Barner, MBA, NC FASD Informed, Chapel Hill, NC; Kimber Mork, LCSW, Atrium Health, Charlotte, NC, Lea Moon, parent of a teenager with an FASD, Charlotte, NC

Brief Description:

Fetal Alcohol Spectrum Disorders are a spectrum of conditions arising from prenatal alcohol exposure. They are characterized by central nervous system abnormalities, facial dysmorphia, growth deficits, and birth defects. Children with FASD exhibit neurobehavioral features which include problems in these three domains: self-regulation, neurocognition, and adaptive skills in the background of prenatal alcohol exposure.  Studies show that the full range of FASDs in the United States may be as high as 1 to 5 per 100 school children (or 1% to 5% of the population) and is likely encountered in every Developmental and Behavioral Pediatric practice. However, many children remain undiagnosed or are diagnosed at an older age when traditional treatment modalities have been unsuccessful.  In this session, members of the newly formed SDBP FASD Special Interest Group will discuss clinical signs and symptoms of FASD as well as pathways to a diagnosis and differential diagnoses; share information on the different diagnostic systems for FASD and resources for clinicians, including scripts to guide discussion of the diagnosis with families; present treatment strategies ranging from early intervention services, developmental therapies, behavior management, parent education, child educational services, social skill intervention, medical care, medication management, and community supports. We will highlight multidisciplinary management of children with FASDs as well as existing evidence-based strategies. We will also feature a panel of experts from the FASD SIG as well as a parent who will share her experience in raising a child with an FASD. She will also share the perspective of her son who is living with an FASD.

Target audience:

The target audience is all developmental behavioral pediatricians, APPs, pediatricians, psychologists, licensed clinical social workers and other professionals who see patients with a history of prenatal alcohol exposure or who have signs and symptoms of FASD. This session will provide them tools in recognition and management of FASDs.

Learning Objectives

Discuss clinical signs and symptoms of FASD and provide pathways to a diagnosis and differential diagnoses; share information on the different diagnostic systems for FASD and resources for clinicians, including scripts to guide discussion of the diagnosis with families; discuss perspectives from a panel consisting of diagnosticians who will discuss approaches to diagnosis and a parent who will discuss the impact of the diagnosis on the family.

Keywords: Advocacy, Clinical Practice, Education, Interprofessional Practice

SDBP Business Meeting

The SDBP member business meeting includes: SDBP meeting update; Financial Report; JDBP update; Committee/SIG/Section outgoing chairs and acknowledgment of service; 2022 Research Grant recipients;

Recognition of outgoing and new Board of Directors and transition of presidency; Incoming Presidential Remarks