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. Author manuscript; available in PMC: 2017 Jul 12.
Published in final edited form as: Autism. 2013 Oct 10;18(4):471–475. doi: 10.1177/1362361313477247

Table 1.

Psychiatry Training Program Survey

1. Form completed by:
a) child and adolescent psychiatry fellowship program director b) general psychiatry program director
2. How many trainees are in your program?
3. If general program, how many FTE months per year of child/adolescent care for your trainees?
a) 0 b)1–2 c)3–4 d) 5–6 e)7–8 f)9–10 g)11–12
4. Number of hours per year in formal lectures on autism/pervasive developmental disorders?*
5. Number of hours per year in formal lectures on intellectual disability (mental retardation)?*
6. Number of hours per year in formal lectures on DSM-IVTR learning disorders (reading disorder, mathematics disorder, disorder of written expression, LD-NOS)?*
7. Number of hours per year in informal didactics (small group or individual supervision, informal didactic teaching in clinic or on rounds) on autism/pervasive developmental disorders?*
8. Number of hours per year in informal didactics (small group or individual supervision, informal didactic teaching in clinic or on rounds) on intellectual disability?*
9. Estimated total number of ON-SITE (i.e., excluding school consults, visits to specialty clinics/facilities, etc.) outpatient cases with any diagnosis seen by each trainee per year?
a)0 b)1–10 c)11–20 d)21–30 e)31–40 f)41–50 g)51–60 h)61–70 i)71–80 j)81–90 k)91–100 l)>100
10. Estimated number of each trainee’s ON-SITE outpatient cases per year involving patients with autism/pervasive developmental disorders?**
  a) psychopharmacology only
11. Estimated number of each trainee’s ON-SITE outpatient cases per year involving patients with intellectual disability (ID) without autism/PDD?**
  a) psychopharmacology only
12. Estimated number of each trainee’s ON-SITE outpatient cases per year involving patients with autism/pervasive developmental disorders:**
  a) age < 4 years old b) age 4 to <13 c) age 13 to <18 d) adult (age 18+)
13. Estimated number of each trainee’s ON-SITE outpatient cases per year involving patients with intellectual disability without autism/PDD:**
  a) age < 4 years old b) age 4 to <13 c) age 13 to <18 d) adult (age 18+)
14. Estimated number of each trainee’s OFF-SITE cases per year for patients with autism/pervasive developmental disorders and/or intellectual disability without autism/PDD?**
  a) PDD b) ID
15. Estimated number of each trainee’s total outpatient cases per year involving patients with DSM-IVTR learning disorders?**
  a) on-site b) off-site
16. Estimated total number of inpatient cases seen by each trainee per year?***
  a) inpatient b) ER c) consult d) residential
17. Estimated number of each trainee’s inpatient cases per year involving care/consultation for patients with autism/pervasive developmental disorders?**
  a) inpatient b) ER c) consult d) residential
18. Estimated number of each trainee’s inpatient cases per year involving care/consultation for patients with intellectual disability without autism/PDD?**
  a) inpatient b) ER c) consult d) residential
19. Research work for trainees in autism and ID:**
  a) # trainees/year involved b) #medical or other students/year involved
20. Electives for trainees in autism and ID:**
  a) # trainees/year involved b) #medical or other students/year involved
21. What resources are needed to improve the training of residents in autism & ID at your institution?
22. Please list other opportunities your program offers for trainees to get exposure to autism & ID:
23. Program name (optional):
24. Other comments:

Content includes the full text of the survey, which respondents viewed in a user-friendly, web-based format.

*

Number of hours: a) 0, b)1–3, c)4–5, d)>5

**

Cases/year: a)0, b)1–5, c)6–10, d)11–15, e)16–20, f)21–25, g)26–30, h)31–35, i)36–40, j)41–45, k)46+

***

Cases/year: a)0, b)1–10, c)11–20, d)21–20, e)31–40, f)41–50, g)51–60, h)61–70, i)71–80, j)81–90, k)>90