Developmental and Behavioral Pediatrics, Cohen Children’s Northwell Health, New Hyde Park, NY
At first glance, the Division of Developmental & Behavioral Pediatrics of Cohen Children’s Medical Center might not seem like a hospital setting. Instead of white coats and syringes, boxes of toys and books peep out from every examination and consult room, each with colorful hand-drawn creations of young artists lining the walls. Still, the office is bustling with administrative staff, nurses, doctors, psychologists, and patients—the babbles, laughs, and occasional cries of children audible as one walks down the halls. I spent my summer as a research intern in this office, working on projects with the aim of promoting pediatric health.
Developmental and behavioral pediatrics is a unique specialty in which doctors address medical and psychosocial aspects of young patients. In this division, the pediatricians have stethoscopes and take blood pressure, inquire about trouble concentrating and point parents towards services such as applied behavior analysis; they measure patients’ height and weight, and assess children’s social and emotional developmental markers. One doctor visits the Neonatal Intensive Care Unit (NICU) every Thursday to examine premature babies, and she performs follow-up examinations of the infant NICU graduates every couple of months with in-office visits, monitoring their growth in areas ranging from weight gain to language development. Every week, a cardiology clinic takes place in a collaborative effort to address the increased risk of developmental delays in patients with congenital heart disease. The office is truly a learning environment, with summer and year-long interns, residents, fellows, psychology externs, psychologists, and attending doctors all working collaboratively.
Most mornings, I was the first intern to arrive at the office, flipping on the lights of the empty conference room to settle in my usual spot and pore over projects, journal articles, and statistical analyses. Fellow interns would trickle in one by one, filling the chairs around the big table until excited discussions about Autism Spectrum Disorder, the American Academy of Pediatrics, and manuscript submissions filled the air. These conversations mingled with good-humored chatter about weekend plans and the latest news, moments that were not related to research but which were testaments to the relationships and true friendships that had been built over the weeks spent together. Under the guidance of two practicing pediatricians and with the sometimes-rambunctious and always-passionate team of interns, I worked on several projects relevant to pediatric health care and the well-being of children.
One project was a secondary analysis of the 2017 Youth Risk Behavior Survey dataset, for which I examined the prevalence of driving when using marijuana among high school students in the United States and its association with other unsafe behaviors. Considering the recent changes in the legal status of recreational marijuana in many states and evidence indicating that marijuana use impairs driving and increases accident risk, this study was directly tied to teenagers’ safety. I also collaborated with several other interns on a project about oral health care provided by pediatric residents. Although the American Academy of Pediatrics recommends that practitioners provide oral health services, our research team found that pediatric residents across the nation do not always do so, and many preventive and developmental oral health topics are not adequately covered in the residency curricula. This study brought attention to an important and often-overlooked matter in pediatric health care and the training of future pediatricians. Another collaborative project was an experiment assessing the effect of Internet information on parents’ trust in a pediatrician’s diagnosis of Autism Spectrum Disorder and their likelihood of seeking a second opinion. We found that parents who saw online information that seemed to contradict the doctor’s diagnosis were less trusting and more likely to seek a second medical opinion than those who did not read online information, suggesting that Internet information significantly affects the relationship between parents and pediatricians. However, “Dr. Google” is not always an accurate source of medical information, and arriving at a diagnosis of a developmental disorder requires observation and in-person assessments. Given that delays in an accurate diagnosis may lead to delays in helpful services and treatments that influence the child’s outcome, this study illuminated the need for the medical community to adapt to the digital age and be proactive in addressing parental concerns. One of my final projects was to collaboratively develop a study on pediatricians’ and pediatric residents’ knowledge and practices regarding menstrual health and feminine hygiene. The American Academy of Pediatrics advises that pediatricians provide their female patients and their parents with anticipatory guidance on these important and potentially sensitive topics; discussing menstruation and feminine hygiene product use is critical, given health concerns such as Toxic Shock Syndrome and that inexperienced female patients may be unsure of what to expect. This project was submitted to the Institutional Review Board during my final weeks at the internship, and I plan to continue working with fellow interns while I am back at Williams once data collection is complete.
The research I conducted this summer was completely different from other forms of research that I have been exposed to at Williams and during previous summers. I was familiar with working in a laboratory with mice, bacteria, or chemicals on projects that last years and for which I can contribute only little, due to limited time. This summer, I was able to see most of my projects to the end, performing research that was directly relevant in the clinical setting. I learned that I enjoy both forms of research, and that each comes with different implications, benefits, and hardships. I was also pleasantly surprised to be able to apply the statistics I learned in Williams courses to real-life research, and in the process, I learned much more about non-parametric and complex survey data. More than anything else, performing statistical analyses of risky behaviors in U.S. teenagers and oral health care provided by pediatric residents inspired me to continue learning statistics at Williams. Additionally, as a pre-medical student who loves children, working in a medical setting where I routinely encountered children was a joyful and enriching experience that affirmed my passions. The words of wisdom and advice from doctors, matriculating medical students, and peers will be valuable as I prepare to embark on the path towards becoming a physician. Finally, perhaps the most meaningful aspect of this internship for me was the chance to befriend and work with a group of exceptionally bright and exceedingly kind individuals from diverse backgrounds. As I reflect upon this incredible experience, I would like to express my sincerest gratitude to Ms. Anne O. Burleigh P09, P13, P16, the O’Herron-Burleigh Internship Endowment Fund, as well as to the Williams College ’68 Center for Career Exploration, for making this valuable internship possible.