Curriculum and Training Content

NC-LEND Curriculum
The NC-LEND curriculum is designed to develop future leaders and increase the number of professionals trained to conduct screenings, assessments, and evidence-based interventions. Our curriculum includes broad interdisciplinary training in neurodevelopmental disorders with an emphasis on ASD, especially with respect to increasing early identification. All NC-LEND faculty work to develop the leadership capabilities of the trainees, particularly with respect to potential roles they will play in the emerging health care system for children with ASD/DD and their families. The NC-LEND curriculum is built upon the most recently proposed MCH leadership competencies (i.e., MCH Workforce Development, Diversity and Health Equality, Interdisciplinary/Interprofessional Training and Practice, and Science, Innovation, and Quality Improvement), and these competencies are considered in all clinical and didactic training activities. A life course framework is emphasized throughout the NC-LEND program for explaining health and disease patterns, including health disparities, in various constituencies over the life course, and focuses on a broad scope of social determinants (e.g., socioeconomic status, environmental factors, community characteristics) that create persistent inequalities in health/care for a wide range of disease and conditions across population groups.

Training Content
The training content for the NC-LEND Curriculum is comprehensive. In addition to addressing specific disability content, particularly for ASD/DD, the curriculum covers the MCH content areas of ASD/DD, Leadership Skills, Systems of Care, Public Health Perspectives, Cultural Competency, Life Course/Social Determinants of Health, Communication Skills, Health Equity and Diversity, Quality Improvement, Family-Centered Care, Emerging Issues, Research, Technology, and Interdisciplinary Clinical Experiences. Many of these content areas are cross-cutting with respect to how training is conducted (e.g., didactic versus clinical), particularly with respect to Leadership, Life Course, Interdisciplinary Training and Practice, Cultural and Linguistic Competency, and Family Centered Care. Further, NC-LEND has access to world class technology that facilitates the imparting of the training content through distance learning strategies, course management software for our DDAL course, web-based conferencing, telemedicine consultations to rural regions of the state, and social networking tools for our trainees and faculty.

Research
NC-LEND faculty maintain a longstanding history of conducting translational, clinical, and applied research in ASD/DD, and research objectives form key components of each trainee’s ITAP. NC-LEND trainees play a major role in faculty research projects. Trainees are mentored in the application of evidence-based principles to inform clinical research and practice. All trainees are required to engage in research as part of their ITAP and they are required to submit their research projects in poster format and/or oral presentation at the NC-LEND Symposium conducted in the late spring of each training year.

• Challenges in Early Management of Children with ANSD: Analysis of the Timeline from Diagnosis to Intervention
• Development of an EHDI Resource Guide for Spanish-Speaking Families in North Carolina
• Hearing Screenings for Non-Hospital Births in North Carolina
• Management of Hearing Loss in Children with Down Syndrome

• Dwarfism: Types, History, and Support
• My Ears Can Hear: Developing Children’s Literature in a Newborn Hearing Screen Era

• An IDD Fellowship for Nurse Practitioners in NC

• Exercise for People with Prader-Willi Syndrome
• Lower Extremity Orthoses: A Primer
• Vestibular Dysfunction Associated with Hearing Impairment

• Act Early Website Preview
• Development of Siblings with ID
• Earlier Autism Diagnosis and Intervention
• School-Based Interventions for Executive Function Following Childhood TBI

• Newborn Hearing Screening: A Deeper Look Using Process Flow Charts and System Support Mapping
• Resource Guide for Parents and Families of Children with Special Health Care Needs in North Carolina
• Substance Use During Pregnancy: Debunking the Myths

• A Coaching Approach: Education Coaching as a Support Offered to Advocacy Trainees in an Inclusive LEND Course
• Five Years of LEND Self-Advocacy Training-An Interview with the First Trainee
• Sexual Violence and People with IDD

• Access to Community Healthcare for Patients with Intellectual and Developmental Disabilities
• Proposed Intervention: The Incredible Years Parent Training Program for Children with Developmental Delay

• A Case Study Implementing the PODD Communication System with an Adult Female with Angelman Syndrome
• Early Turner Syndrome Feeding Experiences

Long-term trainees also attend the research Seminar Series and monthly Research Forum as part of their research training. These opportunities further strengthen the research training capabilities of NC-LEND and create opportunities for our trainees and fellows to contribute to at least one academic product/grant during their training, and to prepare NC-LEND graduates with respect to incorporating research findings into policy and practice. A major resource available to all LEND trainees is the UNC Intellectual and Developmental Disabilities Research Center (IDDRC). The UNC-IDDRC is an interdisciplinary program with the overarching goal of supporting and promoting research relevant to understanding the pathogenesis and treatment of ASD/DD. The UNC IDDRC is a critical component of the CIDD, which is the focal point for clinical services, research, and training relevant to ASD/DD on the UNC campus. The IDDRC is integrated around three research themes: (1) Autism and Related Neurodevelopmental Disorders; (2) Brain and Behavior Development; and, (3) Early Detection/Intervention. Overall, the UNC IDDRC has had a major impact on ASD/DD research and scientific training at UNC and serves as an excellent resource for LEND trainees to link with faculty conducting research relevant to ASD/DD.

Interdisciplinary Leadership Training Program (IDLP) and the Maternal and Child Health Leadership Consortium
The UNC Maternal and Child Health Leadership Consortium is a well-established and nationally recognized leadership training program initiated in 2001 in collaboration with colleagues in the Schools of Public Health and Social Work. It has since formed a core component of the leadership curriculum of NC-LEND. The model represents four integrated elements of optimal leadership: understanding one’s self, roles, skills, and context(s) as a leader. There are multi-day and several separate full-day workshops that focus on assessing one’s individual leadership beliefs, strengths, styles, and priorities; conflict resolution/team building; and parent-professional partnership/cultural competence. Trainees/fellows also participate in a series of tailored “Leadership in Action (LIA)” sessions following each primary workshop. The purpose of each LIA is to reinforce learned skills through activities that involve the application and leveraging of skills in simulated MCH organizational and community contexts.

Clinical Preparation
Based on our exemplary interdisciplinary clinical services model, which is family-centered and culturally and linguistically appropriate, our trainees have field experiences in ASD/DD relative to their individual training goals. NC-LEND faculty and long-term trainees participate in a range of clinical and community services specific to the MCH mission. All clinical training occurs under the direction of NC-LEND faculty members and opportunities are available via center-based interdisciplinary clinical programs, hospital and dental school-based interdisciplinary clinical programs, and community MCH/Title V and related community interdisciplinary programs.

While NC-LEND maintains a number of clinics for DD in general, we have embarked on offering an increased number of disability-specific clinics to increase the specificity of our instructional efforts with trainees. Interdisciplinary clinical teams at the CIDD and larger hospital setting serve as training vehicles to familiarize trainees with evidence-based techniques and promote innovative, family-centered, cultural/linguistic competent practice models. Through all of our clinics, trainees experience how individual family situations, social determinants, and the communities in which they live can impact a child’s health-related quality of life, access to health care, and other translational outcomes.

The CIDD’s diagnostic and behavioral clinic practices are consistent with the guidelines and recommendations recently published in ATN/AIR-P in Pediatrics. At present, 12 interdisciplinary clinical teams meet our NC-LEND standards for training (for more information on the clinics offered at the CIDD, please click here). Also, consistent with NC-LEND standards, five interdisciplinary group clinics occur throughout the year: Social Skills Groups, Raising Special Kids, Let’s Talk about Sexuality, Social Smarts, and Chill Skills. Clinics occur on a regular basis and are incorporated into the trainee’s ITAP in accordance with their leadership goals and objectives. Further, NC-LEND has strong, active training relationships with over a dozen different hospital-based clinics and services. Similarly, NC-LEND is capable of offering a wide variety of community-based programs ranging from health promotion and disease prevention in the public schools to behavioral and emotional health in the state hospital system, many of which are located in settings with underserved populations. Currently, we have clinical training opportunities in multiple community-based sites.

Other training curriculum components include ASNC family mentorship, hybrid training for diversity, and active engagement in initiatives and programs focusing on emerging issues. Additional accomplishments, events, and activities of our trainees, fellows, and faculty can be found on our NC-LEND Facebook page or in the latest edition of the CIDD newsletter.