Question for Child and/or Pediatric Psychologists

[pediatric_psydoc]

I will be starting my internship in the summer in an inpatient psychiatric hospital, and two thirds of the year will be devoted to clinical work with children and adolescents. I plan on applying to a formal postdoc, as one of my goals is to be board certified in child psychology in the future. The postdocs I will apply to are going to include both child psychiatric hospitals and child medical hospitals (I have some practicum experience in a pediatric psychology setting). I am interested in both assessment and intervention for neurodevelopmental disorders, and behavioral interventions for medical illness, and over the year I want to get a better idea of whether I'd like to enter a child clinical or a pediatric setting for postdoc.

My question for psychologists working with children is: what do you enjoy most about the specific populations of children you work with? What made you choose child clinical over pediatric, or vice versa? Any input you can give is much appreciated.


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[ClinicalABA]

I work primarily with toddlers (assessment) and preschoolers (treatment). I love it. The kiddos are just so darn cute and fun, and it's a pleasure to go to work each day. For the most part, assessment and treatment is done in the context of play. On a daily basis, I get paid to blow bubbles, use remote controlled toys, play with play doh, flip a rubber duck off a spoon, and read picture books (bonus points if you can guess which assessment instruments I'm using). I juggle and the kids giggle at me. Then I get to leave the office and go to preschool, where I hang outvon floor and help teachers teach kids how to communicate, play, eat snack, etc. Then I go to a kiddos house and teach parents how to teach their children. There are observable gains on an hourly basis, and I get to see them first hand. I have a battery operated bubble gun in my office!!

 

[pediatric_psydoc]

I work primarily with toddlers (assessment) and preschoolers (treatment). I love it. The kiddos are just so darn cute and fun, and it's a pleasure to go to work each day. For the most part, assessment and treatment is done in the context of play. On a daily basis, I get paid to blow bubbles, use remote controlled toys, play with play doh, flip a rubber duck off a spoon, and read picture books (bonus points if you can guess which assessment instruments I'm using). I juggle and the kids giggle at me. Then I get to leave the office and go to preschool, where I hang outvon floor and help teachers teach kids how to communicate, play, eat snack, etc. Then I go to a kiddos house and teach parents how to teach their children. There are observable gains on an hourly basis, and I get to see them first hand. I have a battery operated bubble gun in my office!!

Thanks for your reply! I actually haven't yet worked with the under age 5 population. What kinds of presenting problems do you see?

 

[ClinicalABA]

For assessments, I see kids where there is a question of Autism. Most have a delay in language development. In most cases, DX is either ASD, global dev. delays, or some sort of speech/language delay. There really isn't much else, psychologically speaking, that I'd diagnose in this young of a population. My home consults are limited to ASD. School consults mainly ASD, with a smattering of general behavior problem stuff not directly related to a specific diagnosis. (Note that all my intervention work is typically billed under my Behavior Analyst certification/licensure, rather than my psychologist credential, so it's all ABA interventions)

 

[deleted407083]

I am an intern at a children's hospital and spend ⅓ of my time doing assessment, ⅓ doing pediatric psych, and ⅓ doing child clinical on an average week. Next year for postdoc, I will be about 4/5 pediatric psych and 1/5 child clinical.

I don't think they are mutually exclusive, in fact there is a lot of overlap working for children's hospitals depending if you do a mix of C-L/Intervention/Assessment. I agree with ClinicalABA, the best part is really playing with the kiddos. I see a lot of my job in the hospital as normalizing their experiences. Many providers often forget that being in the hospital is a tough experience for most kids.

The other piece I have found (from my limited experience) is there is more flexibility in pediatric psych especially working C-L.

Ultimately I think you have to try it to see if it's for you! You can search for places that offer more of a mix of Peds Psych and Child Clinical for postdoc too!


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[singasongofjoy]

My background is in child and I'm currently doing about half child, half adult, mix of ax, individual tx, and group (and parent support groups). Sometimes I get to play with bubble guns too 🙂 I envy your juggling skills, @ClinicalABA - that would be excellent to incorporate into the assessment! I enjoy adults too, but the thing I find so motivating about child clinical is that so early in their developmental trajectory, those incremental changes can have such hugely compounded impacts over the lifespan - bump the slope of that trajectory just a bit early on and that adds up to huge gains 20 years later. That's what motivates me on days when, say, a child bites my butt when I turn around, or one with rumination vomits on my foot. In peds there's not so much opportunity to follow kids for so long to see those gains adding up over time. I like the opportunity to follow for longer period of time, as folks tend to stay involved with our services over a period of years in one way or another even if the extent of their involvement waxes and wanes depending on how things are going for them. It's not uncommon for bmed things to be relevant too - at least in my population, sleep issues and compliance with treatments for concurrent medical problems are common so the peds experience I got on internship is super relevant. There are quite a few places where you can do both peds and clinical, which would be a fun mix if you like both. Variety is always good for keeping things interesting and your skills sharp.

 

[soccercat]

Most of the reasons for choosing the population I work with were personal (age old story of life experience inspiring career choices). What has kept me working with them (on the Ped Psych side) was that I really enjoy the complexity/variety of cases and working in a large team to treat patients. I also always enjoyed hearing new perspectives in group supervision and the ability to bounce ideas back and forth with MDs, nurses, social workers, etc. keeps me learning and open. Not that you can't get that with an all psychologist team, but it's different.

 

[smalltownpsych]

I much prefer adolescents to younger kids. The younger kids just exhaust me. I can also get pretty bored with the play sessions and at times it reminds me of my babysitting days. This is exactly what I was thinking about ten minutes ago in the playroom. Nevertheless, I am pretty effective at it and at times enjoy it, but it can be incredibly emotionally draining. With adolescents, I tend to have a better time "playing" with them as it is fun to banter back and forth and they are open to shifting perspectives so long as you don't try to force them to through too much lecturing and advice. Adults on the other hand are usually too serious to have any fun with at all although I do always have one or two on my schedule that I look forward to.

I also do a little juggling too from time to time, but I much prefer slaughtering the smarter kids at chess or checkers. I rarely let any kid that is older than 5 or 6 win in any game., but usually mix a few games of chance where they can win. I also find they can beat me in memory games no matter how hard I try. Little buggers have an edge in that arena for sure.