Developmental-Behavioral Pediatrics Fellows
Hannah Perrin, Class of 2019
MD: University of Michigan Medical School in Ann Arbor, MI
Residency Program: UCSF Benioff Children's Hospital in Oakland, CA
Mentor: Irene Loe, MD
Research: My research aims are to identify and understand barriers to educational success in young children and inequities in access to health care services. My research focuses on school readiness skills in preschool-aged children with biologic risk factors. Using a combination of direct observations and parent questionnaires, I am comparing school readiness skills in children born preterm, children born full-term with Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, and children born full-term without ADHD symptoms. In addition, I am examining the receipt of therapeutic intervention services in these three groups of children.
Yair Bannett, Class of 2019
MD: Hadassah School of Medicine, Hebrew University in Jerusalem, Israel
Residency Program: Assaf Harofeh Medical Center, Tel Aviv University in Zerifin, Israel
Mentor: Lynne Huffman, MD
Research: My scholarly project investigates clinical practices of primary care providers in the identification and management of developmental and behavioral (DB) conditions. This project involves the quantitative analysis of objective data from electronic health records; I also plan to use qualitative research methods to further clarify current trends and barriers to the provision of DB-related care. Ultimately, I will translate the results of this research experience, in combination with my clinical training, into solutions developed to address current primary care challenges. To accomplish this, I will be involved in QI interventions designed to explore different health care models, both in the United States and in Israel, with the long-term goal of improving DB-related care in the community.
Prior Experience: Before coming to Stanford for fellowship, I practiced for several years as a primary care pediatrician in Israel. I became increasingly interested in expanding my role as a community-based pediatrician, and completed a two-year certification course in developmental and behavioral pediatrics. In the year before fellowship, I divided my time between primary care practice and a community-based Child Development Center, where I worked as a developmental pediatrician.
Sarah Dubner, Class of 2020
MD: University of Pennsylvania, School of Medicine in Philadephia, PA
Residency Program: University of Washington in Seattle, WA
Mentor: Heidi Feldman, MD, PhD
Research: My research interests involve understanding how biological and environmental experiences shape children’s neurobiology in order to design early interventions to promote positive neurodevelopmental trajectories. My fellowship research focus is on diffusion MRI as a tool to understand associations between perinatal inflammation and neurodevelopmental outcomes in premature infants. With guidance from an interdisciplinary team lead by my mentor, Dr. Heidi Feldman, I developed a retrospective cohort study of children born preterm at LPCH, examining the relationships between clinical markers of perinatal inflammation, near-term age diffusion tractography measures of white matter, and cognitive, language, and motor outcomes at 2 years.
Prior Experience: Before entering fellowship at Stanford, I practiced as a neonatal hospitalist and as a general pediatrician in the High Risk Infant Follow-Up and Neurodevelopmental Foster Care Clinics in the Division of Neonatal and Developmental Medicine at Stanford. My interest in understanding perinatal factors contributing to common cognitive and behavioral outcomes led me to seek out additional educational opportunities. I entered developmental-behavioral pediatrics fellowship at Stanford for advanced clinical and research training to better care for my patients, understand the etiology of their strengths and differences, and eventually design interventions to enhance developmental outcomes.
Myong-Sun Choe, Class of 2021
MD: Tokyo Women's Medical University in Tokyo, Japan
Residency Programs: Keio University School of Medicine in Tokyo, Japan & St. Joseph's Children's Hospital, New York Medical College in Paterson, NJ
Prior Experience: Before pursuing advanced educational opportunities in developmental-behavioral pediatrics, I conducted infant brain research in Boston at Massachusetts General Hospital and Boston Children's Hospital. My research used MRI to perform volumetric brain analysis in infants who were growing normally.
A conversation with recent graduate Lauren Hubner
Writer for the Division of Neonatal and Developmental Medicine, Laura Hedli, interviews Lauren Hubner about her fellowship experiences at Stanford.
What made you choose Stanford?
One factor that drew me to Stanford was the impression I got after interviewing with the DBP faculty: anything is possible here! No matter what your area of interest—social determinants of health, barriers to care for children with special healthcare needs, long-term health implications of necrotizing enterocolitis—there’s someone here at Stanford also interested in that topic. Someone has probably written a book or a chapter about the topic, or there is a lab group, or a postdoc studying it with whom you can connect. The possibility of being surrounded by all those people invested in the health of children, who have dedicated their life’s work to these various areas of interest was inspiring.
As a resident at Children’s Oakland, you were able to shadow members of our DBP section for a few days here at Stanford. For candidates who may not have that opportunity, what was something that you learned about the program during your visit?
I was impressed by the true team dynamic at Stanford and the opportunity to work as part of an interdisciplinary/transdisciplinary model. That’s something that, in theory, distinguishes DBP from other fields, but it’s something that’s actually realized at Stanford. I saw collaborative appointments as well as collaborative educational sessions and didactics. Everybody’s opinion and expertise was valued. I noticed that the Stanford fellowship is a small program, both in terms of fellows and attendings. There was a lot of mentorship that seemed to happen on a daily basis; that experience sometimes was scheduled and sometimes was impromptu. I got to see that in person when I visited, and now I’m seeing it every day.
Let’s talk about your research on shared decision-making.
The importance of the concept of shared decision-making was first introduced to me by my research mentor, Dr. Lynne Huffman. She has been interested in the topic for some time and got me excited about learning more about it too. When I began my fellowship, I was very interested in family dynamics and the possible influence of certain family factors on the health of the child. Then, I started wondering about the parent’s or family’s interactions with the health care system, and specifically how their participation (or lack of participation) in health care decisions might influence the child. I wanted to know more about the family’s experience or perception of shared decision-making in a clinical visit. How could parents and families be encouraged and empowered to participate more in their child’s care?
How did that direction shape your project?
For my fellowship research project, I have been working on a secondary data analysis of a national survey, exploring the topic of shared decision-making. At the start I focused on the perception of shared decision-making among families of children with autism spectrum disorder, as opposed to families of children with other conditions. Now I am designing a pilot intervention study on the topic of shared decision-making. I want to begin to explore ways to inspire, motivate, and prompt families to engage with their child’s doctor in shared decision-making.
The division between research and clinical work, what is that like for DBP fellows?
As DBP fellows, we continue our clinical work throughout the three years. That may be different from fellowship programs in other fields.
In addition to certain research days and afternoons built into our week throughout the years, during our second and third years we have a month dedicated to research. During this time we have fewer clinical responsibilities. This allows us to really focus on solidifying a research idea, designing a study methodology, analyzing data, or last year I used some of this time to work on writing a paper.
What about offsite experience?
Depending on the year of training, a fellow has the opportunity to participate in a number of rotations and offsite clinical experiences. There is some experience working with Child Psychiatry, both in the outpatient and inpatient setting. There are rotations in the Adolescent Medicine. We also get to attend a variety of clinics through our DBP section. We have a clinic in Capitola where fellows go once a month and other community sites where we go to get a different clinical perspective.
Do you mentor residents or medical students?
As a third year fellow, I’m now acting in a consultant role at Gardner Packard Children’s Health Center, which is one of the Pediatric Residency Primary Care Continuity clinic sites. I have the opportunity there to consult with residents about patients who have developmental-behavioral concerns.
During fellowship training I also have had the opportunity to engage with residents by leading didactic educational sessions, and less formally, by discussing clinical questions in our clinic workroom as they arise. I have also been able to get involved with teaching and mentoring as a TA for a Stanford undergraduate course led by Dr. Heidi Feldman, and by giving lectures to medical students on DBP topics.
What is one of the most rewarding aspects of being a developmental-behavioral pediatrics fellow?
Getting to work with the amazing patients and dedicated families who come to our clinics. Many come to us with longstanding and significant concerns, looking for answers, support, and guidance. I appreciate that as a field DBP acknowledges the importance of having adequate time to dedicate to families so that we can try to better understand their specific concerns and goals for their child. This is critical as we work with families to craft unique recommendations and suggest next steps.
Emily Whitgob, Class of 2018
Dana Won, Class of 2018
Lauren Hubner, Class of 2016
Christina Buysse, Class of 2015
Nidia Alduncin, Class of 2014
Aaron Nayfack, Class of 2013
Maria Salinas, Class of 2012
Brian Tang, Class of 2011
Hubner, L. M., Feldman, H. M., & Huffman, L. C. (2016). Parent-reported shared decision making: Autism Spectrum Disorder and other neurodevelopmental disorders. J Dev Behav Pediatr, 37(1), 20-32.
Brahmbhatt, K. and Whitgob, E. (2016). Diagnosis and management of delirium in critically ill infants: Case report and review. Pediatrics, 137(3):e20151940
Feldman, H. M., Buysse, C. A., Hubner, L. M., Huffman, L. C., & Loe, I. M. (2015). Patient protection and affordable care act of 2010 and children and youth with special health care needs. J Dev Behav Pediatr, 36(3), 207-217.
Loi, E. C., Buysse, C. A., Price, K. S., Jaramillo, T. M., Pico, E. L., Hansen, A. B., Feldman, H. M. (2015). Myofascial structural integration therapy on gross motor function and gait of young children with spastic cerebral palsy: a randomized controlled trial. Front Pediatr, 3:74.
Hansen, A. B., Price, K. S., Loi, E. C., Buysse, C. A., Jaramillo, T. M., Pico, E. L., & Feldman, H. M. (2014). Gait changes following myofascial structural integration (Rolfing) observed in 2 children with cerebral palsy. J Evid Based Complementary Altern Med, 19(4), 297-300.
Alduncin, N., Huffman, L. C., Feldman, H. M., & Loe, I. M. (2014). Executive function is associated with social competence in preschool-aged children born preterm or full term. Early Hum Dev, 90(6), 299-306.
Loe, I. M., Chatav, M., & Alduncin, N. (2014). Complementary assessments of executive function in preterm and full-term preschoolers. Child Neuropsychol, 1-23.
Nayfack, A. M., Huffman, L. C., Feldman, H. M., Chan, J., Saynina, O., & Wise, P. H. (2014). Hospitalizations of children with autism increased from 1999 to 2009. J Autism Dev Disord, 44(5), 1087-1094.
Whitgob, E. "The discriminatory patient and family: strategies to address discrimination towards trainees." American Association of Medical Colleges Learning to Serve Lead Meeting, RIME portion; Seattle, WA. (upcoming 2016)
Whitgob, E. "I don't want someone like you taking care of my child: Identifying strategies to address discrimination toward physicians by patients and families." Academic Pediatric Association Region 9 & 10 Joint Meeting; Monterey, CA. January 2015.
Whitgob, E., Bogetz, A., Bachrach, L., Stuart, A., Blankenburg, R. "Identifying strategies to address discrimination towards physicians by patients and families."
- Academic Pediatric Societies Annual Meeting; San Diego, CA. April 2015.
- Association of Pediatric Program Directors Spring Meeting; Orlando, FL. March 2015.
Hubner, L. M. "Communication prompts in developmental-behavioral pediatric visits to increase shared decision-making (SDM): a pilot randomized controlled trial." Presentation and discussion at Neonatal and Developmental Medicine Research Update Meeting; Stanford, CA. April 2016.
Hubner, L. M. "Communication prompts in developmental-behavioral pediatric visits to increase shared decision-making (SDM): a pilot randomized controlled trial." 2016 Maternal and Child Health Bureau Developmental and Behavioral Pediatrics Fellowship Training Annual Meeting; Stanford, CA. March 2016.
Hubner, L. M. "Educational interventions for school-aged children." Physical Medicine and Rehabilitation Resident Pediatric Didactic Series; Stanford, CA. February 2016.
Whitgob, E. "Chronic medical conditions in children involved in the child welfare system." Presentation and discussion at Neonatal and Developmental Medicine Research Update Meeting; Stanford, CA. February 2016.
Whitgob, E. "Maltreatment of children under age 2 with specific birth defects: A population-based study." Presentation and discussion of this Van Horne et al. 2015 paper at Neonatal and Developmental Medicine Journal Club; Stanford, CA. December 2015.
Hubner, L. M. "Medical augmentation of labor and the risk of ADHD in offspring: A population-based study." Presentation and discussion of this Henriksen et al. 2015 paper at Neonatal and Developmental Medicine Journal Club; Stanford, CA. October 2015.
Hubner, L. M. "Attention-Deficit/Hyperactivity Disorder." Adolescent Medicine Educational Meeting; Stanford, CA. May 2015.
Hubner, L. M. "Exploring shared decision-making in families of children with neurodevelopmental disorders." Presentation and discussion at Neonatal and Developmental Medicine Research Update Meeting; Stanford, CA. May 2015.
Hubner, L. M. "Parent-reported shared decision-making: autism and other neurodevelopmental disorders." Presentation of research project for the Child Psychiatry Consult service; Stanford, CA. March 2015.
Hubner, L. M. "Exploring shared decision-making in families of children with neurodevelopmental disorders." 2015 Maternal and Child Health Bureau Developmental and Behavioral Pediatrics Fellowship Training Annual Meeting; Philadelphia, PA. March 2015.
Hubner, L. M. "Exploring shared decision-making in families of children with neurodevelopmental disorders." 2015 Western Society for Pediatric Research Annual Regional Meeting; Carmel, CA. January 2015.
Hubner, L. M. "Adult talk in the NICU with preterm infants and developmental outcomes." Presentation and discussion of this Caskey et al. 2014 paper at Neonatal and Developmental Medicine Journal Club; Stanford, CA. October 2014.
Hubner, L. M. "Strengthening shared decision-making in families of children with autism spectrum disorder." Presentation and discussion at Neonatal and Developmental Medicine Research Update Meeting; Stanford, CA. May 2014.
Hubner, L. M. "Strengthening shared decision-making in families of children with autism spectrum disorder." 2014 Maternal and Child Health Bureau Developmental-Behavioral Pediatrics Fellowship Training Annual Meeting; Boston, MA. March 2014.
Hubner, L. M. "Autism and mental retardation among offspring born after in vitro fertilization." Presentation and discussion of this Sandin et al. 2013 paper at Neonatal and Developmental Medicine Journal Club; Stanford, CA. December 2013.
Bentley, B., Whitgob, E. "Neonatal abstinence syndrome." Early Start Partners Symposium; San Jose, CA. April 2016.
Whitgob, E., Bogetz, A., Chua, I., Hilgenberg, S., Blankenburg, R. "I don't want someone like you taking care of my child: Identifying strategies to address discrimination toward physicians by patients and families." Association of Pediatric Program Directors Spring Meeting; Orlando, FL. March 2015.