Treating pediatric patients with developmental and behavioral disorders is dynamic work that requires strong listening skills, intuition, deductive reasoning, and mental agility.
The Advanced Practice Providers in Pediatric Developmental and Behavioral Health describe it as both challenging and fulfilling.
Kelly Ruemmele, CPNO-PC, APRN, PMHS, and Katherine Mays, PA-C, are APPs in the division supervised by Dr. Alexa Coon, a board-certified developmental pediatrician, who is one of only 758 in the U.S. serving 19 million children with developmental disorders.
“Within this specialty, our Advanced Practice Providers evaluate, treat, and manage infants, children, and adolescents with a variety of developmental and behavioral concerns best addressed through a biobehavioral approach,” Ruemmele says.
This includes assessing and monitoring the progress of children at risk due to biological and social factors, diagnosing conditions such as autism spectrum disorder, ADHD, and anxiety.
Due to the impact of COVID-19, Ruemmele notes that delays in diagnoses of autism and ADHD have been observed, as children were schooled at home and behaviors did not surface until returning to school over a year later.
“Many of our patients also experience anxiety in addition to ADHD. To address these delays, our team has established an ‘Autism Clinic Day’ specifically for children under 4 years of age seeking autism evaluations. We have also gained proficiency in administering the ADOS, a tool used for diagnosing autism,” she says.
One challenge the team faces is the lengthy waitlist, sometimes up to a year, which limits their ability to see all patients in need of assistance. Additionally, patients with autism often lack access to resources such as ABA therapy, speech therapy, occupational therapy, and physical therapy. Ruemmele says providing a diagnosis of autism can be an emotional experience for families, with reactions ranging from denial to relief to the need for grieving. Non-English-speaking patients present an additional challenge, as translating their medical history can be difficult.
The Advanced Practice Providers in the division work independently while also seeking advice from each other when it comes to patient management.
“Building relationships with our patients and their families as we watch them grow is a rewarding aspect of our work. Each patient is unique, like a puzzle piece in the autism symbol, and we strive to fit all the pieces together,” Ruemmele says.
Success may be measured by improvements in patients' grades and quality of sleep. Ruemmele says many families face challenges such as tantrums, sleep disturbances, and academic struggles.
“We provide hope and support to help them see positive changes,” she adds.
The excellent care provided at UTMB has not gone unnoticed. Katherine Mays was recently honored with the REACH Pediatric Mental Health Advocate Award by the Houston chapter of the National Association of Pediatric Nurse Practitioners.
Learn more about Pediatric Developmental and Behavioral Health services at UTMB.
APP Corner is a monthly feature showcasing UTMB's Advanced Practice Providers.