superintendent working with student

Number of Fellows per Rotation: 1-2

Length of Rotation: 2 blocks of 5.1 weeks

Time of Rotation: Second-year

Location: St. Louis County Special School District Schools


The goal is to provide the fellow with an understanding of the factors impacting a consultation in a school setting or related to optimizing child function in a school environment. Adequate consultation in a school setting hinges on understanding the uniqueness of the school environment.


To develop competence in the following areas:

Patient Care

The fellow will learn consulting skills at various schools within the St. Louis Special School District and the 4444 clinic with up to two weekly consultations with the SSD.

  • Understanding presentations of functional impairment in school settings including behavioral and educational difficulties
  • Observing and interpreting family relationships and teacher-child relationships and their relevance to presenting problem
  • Understanding how psychiatry symptomatology can be exacerbated or moderated by the school environment
  • Work effectively with the professionals involved in teaching
Medical Knowledge

The fellow will gain medical knowledge through a combination of supervised clinical activities, mandatory divisional didactics, and supervised reading of pertinent or related literature.

  • Understand specific learning disabilities and their relationships to behavioral disorders
  • Develop concepts of psychiatric presentations in a school context
  • Understand the academic and social implications of various psychiatry disorders including ADHD and depression
Practice-Based Learning

In addition to supervised clinical activities and self-initiated and suggested readings, the fellow will participate in 1:1 supervision by the attending faculty and other divisional supervision including individual and team supervision.

  • Continuing to appraise oneself of current knowledge concerning the pathogenesis and etiology of psychiatric disorders in particular as they relate to school functioning and outcomes
  • Becoming familiar with models of school consultations
  • Understand the structural and organizational aspects of the school or school systems
  • Gaining knowledge of special education laws
  • Appreciate the pros and cons of 504 plans and IEPs

The fellow will demonstrate sensitivity and compassion to children, adolescents, and their families/caretakers affected by psychopathology and will continue to develop relationships with other professionals or professionals in training, including supervisors, colleagues, students, and allied professionals.

  • Developing intra-professionally by managing their emotional reactions to youth psychopathology and the attitudes of other professionals towards youth psychopathology
  • Convey information both written and especially oral as clearly as possible without the use of jargon
  • Demonstrating a commitment to continued professional development
  • Perform a consultation that respectfully addresses the specific questions paused by the school teacher, school counselor, or school administrator
  • Appreciate the professional role of the consultant versus the primary provider
Interpersonal/Communication Skills

The fellow will effectively communicate with patients, their families, school teachers, school counselors, and school administrators.

  • Talking with and obtaining a history from school personnel
  • Tailoring communication to the needs of school professionals
  • Respectfully appreciate that the teaching of children with psychopathology can be anxiety-provoking to non-mental health professionals
System-Based Care
  • Understanding the roles of other professionals including teachers, special education teachers, aides, school psychologists, school counselors, school nurses, and principals
  • Understanding the constraints of the systems within which these other professionals operate
  • Understanding the limitation of community mental health care for children and its impact on psychiatric presentations in a school setting

Measurement of Objectives

  • 360 evaluations
  • Standard program evaluations
  • Feedback from other professionals

Description of Rotation

The fellow will observe and participate in the evaluation of children referred by the St. Louis Special School District for psychiatric evaluations.