Rachel Amgott, NP
(term expires 2022)
Boston Medical Center
Jennie Olson, RN MS CPNP PMHS
(term expires 2021)
The purpose of the Advanced Practice Clinician (APC) Section is to provide a forum within the SDBP organization which represents the special interests and promotes the professional development of advanced practice nurses (APRN’S) and clinicians working in developmental and behavioral pediatrics.
- To provide an opportunity for networking with APC colleagues in developmental and behavioral pediatrics.
- To increase APC membership in SDBP.
- To increase APC representation on SDBP committees.
- To align with other professional organizations to support and promote the role of advanced practice clinicians in developmental and behavioral pediatrics.
- To share professional education opportunities and patient care resource information.
Useful Resources/External Links
2019: These comprehensive courses will improve participants’ skills in prescribing the range of psychopharmacologic agents to pediatric and adolescent patients through a developmental lens.
Topics covered include ADHD and Complex ADHD (tics, depression, anxiety), Autism, Intellectual
Disabilities and Genetic Disorders, Monitoring Tools, Collaborating with Families, and Resources for Families.
Click here for more details and access to recordings.
2018: Walk through engaging, three-part case studies on ADHD and autism, designed to review the diagnostic presentation and appropriate assessment tools, formulation of diagnosis with interpretation of developmental and behavioral assessment measures, treatment options including psychopharmacology, family support and ongoing monitoring of a child with multiple common developmental and behavioral concerns.
Click here for more details and access to recordings.
What is an Advanced Practice Clinician?
Advanced Practice Clinician (APC) is an umbrella term that typically includes physician assistants (PA) and advanced practice registered nurses (APRN). In some facilities, APCs are referred to as Advanced Practice Providers (APP). APRNs are nurses with post graduate education in nursing (a master’s or doctoral degree). APRNs that work in Developmental and Behavioral Pediatrics are typically nurse practitioners (NP) or clinical nurse specialists (CNS). PAs are not nurses, and have their own course of study, typically through master’s degree programs. While education and training for APRNs and PAs differ, they often serve a similar role in the Developmental and Behavioral clinic. APCs can examine patients, diagnose disorders, prescribe medication, and provide treatment. The scope of practice of APCs is determined by the state in which they work. APCs are a vital part of the Developmental Behavioral Pediatric workforce.
Resources for APCs interested in specializing in DBP
Are you an APC interested in Developmental and Behavioral Pediatrics (DBP)? Are you wondering where to start in gaining extra education and experience? Here are some resources that may be helpful for you.
There are limited formal training programs for APCs looking to specialize in DBP. The majority of APCs gain experience and expertise on the job and working with physician and APC mentors. However, there are a few programs that may be helpful in your professional development. There are also new programs with more formal training in development across the country.
- Leadership Education in Neurodevelopmental and Related Disabilities (LEND). LEND programs provide graduate level interdisciplinary training to improve the health of infants, children, and adolescents with disabilities. They prepare trainees from diverse professional disciplines to assume leadership roles in their respective fields and by ensuring high levels of interdisciplinary clinical competence. LEND programs are often associated with University Centers for Excellence in Developmental Disabilities (UCEDD). There are 52 LEND programs located in 44 states, with an additional six states and three territories reached through program partnerships. LEND programs are funded by the Autism CARES act and are administered by the HRSA Maternal and Child Health Bureau (MCHB). Many LEND programs are associated with graduate degree programs, but some are also open to individuals already working in their field. Contact your local LEND program to determine if you may be eligible for this training opportunity. https://www.aucd.org/template/page.cfm?id=473
- KySS Mental Health Fellowship (Child and Adolescent) The Keep Your children/yourself Safe and Secure mental health fellowship is an online program through the Ohio State University that provides a comprehensive overview of mental health problems in primary care settings. It includes 16 self paced online modules and you can earn a total of 50.1 CEU. The cost is $945 with ongoing open registration.
- APRN Scholars Program at Almost Home Kids - Almost Home Kids (AHK) is an affiliate of the Ann and Robert H. Lurie Children’s Hospital of Chicago. They have created a year long intensive training program to train APRNs in Developmental Behavioral Pediatrics, Mental Health, and Complex Care. The program is available at no cost to scholars, and can be done in Chicago or remotely with 10 days in Chicago for clinical experiences. Please see their website for more details and how to apply.
- Children’s Specialized Hospital Developmental Behavioral Pediatric APN Fellowship - Children’s Specialized Hospital in Mountainside, New Jersey offers an intensive 12 month fellowship in DBP. Fellows complete their training alongside first year DBP medical fellows, receiving the same education and training. This is an in person program where fellows are considered employees of CSH and are paid a salary. They accept one fellow per year, and are on the fifth year of this program.
- The University of Arizona College of Nursing Autism Spectrum Disorder Certificate - The University of Arizona offers a post-master’s certificate in Diagnosis and Management of Autism Spectrum Disorders for APRNs. Applications are accepted from June 1 to November 30, for a year long program starting in January.
- The University of Pennsylvania School of Nursing Integrated Nursing Care of Autism Spectrum Disorder Certificate - The University of Pennsylvania offers a 3 semester certificate program for bachelor’s and master’s prepared nurses, including nurse practitioners. This is an on-campus program.
- SDBP-NAPNAP Symposium - The Society for Developmental Behavioral Pediatrics (SDBP) and the National Association of Pediatric Nurse Practitioners (NAPNAP) have partnered to create an excellent learning opportunity for APRNs working in or interested in learning about DBPeds. The symposium is presented in conjunction with the SDBP Annual Meeting, and is the Friday prior to the opening of the Annual Meeting. The next symposium is scheduled for October 9, 2020 and will be a virtual event. The symposium is also recorded and portions are available for CME through NAPNAP on the Peds CE website. Currently topics from the 2019 symposium “Psychopharmacology for Children and Adolescents with Developmental Disability: Prescribe Medication without Frustration” is available for CME credit. https://ce.napnap.org/courses. Registration for the upcoming symposium “School Daze: Helping Parents Navigate Educational Services” is through the SDBP website. https://www.sdbp.org/meetings/
- Developmental Behavioral Pediatrics Course: An Intensive Clinical Update for Primary and Sub-Specialty Care - This in person conference is put on by the American Academy of Pediatrics (AAP). It is a comprehensive review and update of developmental and behavioral pediatric topics. This is a fantastic comprehensive course, but it is only offered every other year. The next scheduled course is December 2-6, 2020 in Atlanta, GA. This is a very useful course for individuals new to Developmental and Behavioral Pediatrics. https://shop.aap.org/2020-developmental-behavioral-pediatrics-course-an-intensive-clinical-update-for-primary-and-sub-s/
- 2020 PREP DB Peds - PREP DB Peds is an online subspecialty review published monthly by the AAP that includes clinical scenarios with relevant content, additional reading suggestions, questions, and critiques. There are 6 questions and critiques presented each month, and you can review and respond on your own schedule. CME credit is available. https://shop.aap.org/2020-prep-dbpeds/
- PNCB Pediatric Updates Modules - The Pediatric Nursing Certification Board has continuing education Pediatric Updates Modules available on their website. A certain number of modules are required for PNPs who are certified through PNCB. However, the CE is available to everyone. Currently there is a psychopharmacology module (7.5 psychopharmacology contact hours) and two developmental behavioral modules (7.5 contact hours each). Offerings change from time to time, and modules expire, so there are not always developmental and behavioral modules available. https://mypncb.pncb.org/pncbssa/ecssashop.shopping_page#_ga=2.41102688.355756652.1593199301-1936892079.159113
- Steven J. Parker Memorial Developmental Behavioral Pediatric Conference: Clinical Problems in Primary Care - The Boston University School of Medicine and Tufts University host an annual two day conference focused on Developmental Behavioral Pediatric topics. It is designed for practicing clinicians who have an interest, passion or emerging expertise in developmental and behavioral pediatrics and want to take their knowledge and skill to the next level. It is appropriate for primary care, as well as specialists in Developmental Behavioral Pediatrics. https://www.bucme.org/live/8625
- Spectrum of Developmental Disabilities Conference - Johns Hopkins University and the Kennedy Krieger Institute host an annual 3 day continuing education conference in mid to late March. Topics vary, but always have a focus on Developmental Disabilities. Typically every other year is devoted to autism spectrum disorders. https://eventscalendar.kennedykrieger.org/event/the_42nd_spectrum_of_developmental_disabilities_conference_language_gateway_to_neurodevelopmental_disabilities#.XvZYDmhKjZs
- Pediatric Psychopharmacology Update Institute - The American Academy of Child and Adolescent Psychiatrists holds an annual two day in person CME event at the end of January in Brooklyn, NY. This is a comprehensive overview and update of pediatric psychopharmacology. Typically around 11-12 psychopharmacology contact hours available. https://www.aacap.org/AACAP/CME_and_Meetings/Future_AACAP_Meetings.aspx
- DBMH Resource - This is an excellent website from the NAPNAP DBMH SIG that has a wealth of resources around DBMH topics. Everything on the website is free and in the public domain, so there is material you can use in your practice. Resources are organized by topic and by age. Resources include screening tools, practice guidelines, articles, and patient education handouts. There is so much great information here! http://www.dbmhresource.org/
- PNCB PMHS Exam Resources - On the Pediatric Nursing Certification Board (PNCB) website for the PMHS exam, there is a list of resources to help study for the exam. This includes textbooks, practice guidelines, articles, and websites that are helpful for clinicians and families. There is a lot of great information here that may be helpful to you, whether you intend to take the PMHS certification exam or not.
- UW DBP home page - This website was developed and is maintained by Dr. Sam Zinner, DBP at the University of Washington and Seattle Children's Hospital, for training residents and fellows. Information is organized by content type and then by specific disorder. There is so much information here and many helpful links and family resources. https://depts.washington.edu/dbpeds/index.html
Information for Physicians and Practices Interested in hiring a DBPeds APC
It is important to note that there are very few formal training programs in Developmental Behavioral Pediatrics for advanced practice clinicians. However, this should not deter you from considering an APC for your DBPeds practice. APCs are often well suited to DBPeds practice, as many are trained in holistic family centered care. APCs maintain national certification through their certifying board, as well as a state license. Many APCs who end up in this specialty have previous experience or training in general pediatrics or family practice. The majority of APCs who practice in DBPeds have received on the job training and support from physician and APC mentors and colleagues.
The first thing to be aware of when hiring an APC is that each state has their own rules and regulations that dictate APC practice. What an APC can do in your practice will be determined by the scope of practice in your individual state. In some states, APCs may not be able to diagnose autism spectrum disorders, prescribe controlled substances, or order certain therapies, such as Applied Behavior Analysis or durable medical equipment. In other states, an APC may be considered an independently licensed provider and have full diagnostic and prescriptive priveleges. It is important to be familiar with the requirements of APCs in your state as this will help guide you on what an APC can do in your practice, and the amount of supervision or collaboration required. The American Association of Nurse Practitioners (AANP) provides an easy to use interactive map on their website (https://www.aanp.org/advocacy/state/state-practice-environment) that allows you to see at a glance if your state has full, reduced, or restricted practice for nurse practitioners. It also provides further information regarding requirements for nurse practitioners to practice in each state, as well as the associated laws or practice acts. The American Academy of Physician Assistants (AAPA) provides a state by state breakdown of PA laws and regulations for members on their website https://www.aapa.org/advocacy-central/state-advocacy/state-laws-and-regulations/. A convenient guide for both NPs and PAs can be found at: http://scopeofpracticepolicy.org/practitioners/.
Many states require a collaborative practice agreement between the APC and the supervising or collaborating physician. If you are part of a larger institution or academic center, your employer may have a standard collaborative practice agreement that you can use. If not, there are templates of collaborative practice agreements available online. It is important that a collaborative practice agreement has been developed and approved by both the physician and the APC before the APC starts working in your practice. It should be reviewed annually.
If you are hiring an APC who does not have previous DBPeds experience, it will be necessary to develop a training plan that you are both comfortable with. This may include didactic information through books or continuing education courses, specialized training in formal assessments that they are expected to perform as part of their job (ADOS, Bayley, etc), and shadowing DBPeds providers in your practice. The length of this training will vary depending on the APC’s experience and comfort. The benefit of this approach is that you can train the APC to fit in with the standards and expectations of your existing practice. After the initial training period, it is helpful to have a physician or experienced APC available for the new APC to go to when questions arise regarding complex patients or challenging situations. The most successful physician-APC relationships have been found to have an ongoing mentoring component with open bi-directional communication.
Finding the right APC for your practice can be a long and difficult process. Consider advertising on national websites, such as the NAPNAP job center https://careerconnection.napnap.org/ or the SDBP job bank https://www.sdbp.org/resources/job-bank.cfm. You may also want to advertise locally through the newspaper or online employment sites. Some states have a monthly or quarterly nursing or medical journal that will post job opportunities. Talking to APCs in your local area may also lead to individuals interested in DBPeds who may already be living and working in your area. While it may take time to find and train the right APC for the job, the addition of an APC can positively impact your practice in many ways.