Child Psychologist's Experience Helps her Relate to Other Parents of Children with Special Health Needs

Stacy Carmichael was the go-to baby sitter for parents of children with special health care needs in her hometown of Sibley, Iowa, population 3,000.

"Then, when I went to college, I knew I wanted to work with that population but I wasn't sure in what capacity: teacher, doctor or psychologist," said Carmichael, who became the clinical child/pediatric psychologist for St. Mary's Center for Children in February 2007.

"I double-majored in biology and psychology, so I really got to see the integration of biology, environment and behavior, and how that all interacts to help shape a person's development."

As an undergraduate at Buena Vista University in Iowa, Carmichael was introduced to Joseph Matarazzo, one of the founders of health psychology. That meeting helped tip the scales.

"I was just ecstatic to meet this huge figure in the field," she said. "We ate at the Country Kitchen, and he's like, 'You need to go to the University of Florida. ... That's where you need to go.' So I did.

Something ironic, she said — or perhaps serendipitous — happened when Carmichael was a fourth-year graduate student. Inspired by female mentors successfully juggling motherhood, academia and careers, she gave birth to a son, Jaden, now 8.

"And right away, I noticed the early warning signs of autism: lack of eye contact, no babbling/cooing, no reaching/gesturing, unusual staring at objects in the environment, delayed skills in general, no pointing."

Although autism and related disorders now are an area of specialty for Carmichael, at the time, she remembers autism had been covered by one chapter in one book she had studied about child psychopathology.

Still, she knew early intervention would be crucial. She became Jaden's advocate, and he saw a pediatric neurologist at 6 months and began occupational, physical and developmental therapies at 7 months.

"My experience working with children with special health care needs and their families was much more experiential than I had intended it to be," Carmichael said.

"I'm blessed that he chose my family to join. He's delightful and I wouldn't have it any other way. It has allowed me to connect more with parents of children with special health care needs, particularly developmental or neuropsychological difficulties including autism."

In 2003, Carmichael earned a Ph.D. in clinical psychology, with a concentration in clinical child psychology. She was working in Orlando, completing required clinical hours for licensure, when she realized the need for professionals able to diagnose and treat autism spectrum disorders.

"When I first suggested it, I was laughed off," she said. "Now autism is everywhere. You can't go on a Web site. You can't turn on the TV without hearing about autism, so the recognition of the disorder is much different from what it was at that time."

St. Mary's has afforded her several opportunities, Carmichael said. She played a pivotal role in the establishment of CARDS — collaborative autism and related disorders services — a specialized clinic established in January.

In April, she started a psychology clinic for the evaluation of children coping with a variety of issues, including attention deficit hyperactivity disorder, autism, learning disorders, mood disorders, anxiety, depression and social skills problems.

When Carmichael joined the children's center, her first position post-licensure, her initial task was to work as the psychologist on St. Mary's feeding clinic team. Children with feeding disorders often have a history of prematurity, Carmichael explained.

Since they are tube fed, they haven't learned hunger cues, how to suck, how to chew or how to swallow. Many also are very sensitive to the textures of different foods.

Her practice includes children ages 2 to 12, and Carmichael estimates spending about half her time performing evaluations and half providing therapy.

About 40 percent to 50 percent of the children she sees have neurodevelopmental disorders, including autism, developmental delays and cerebral palsy. She said 80 percent of children with neurodevelopment disorders also have feeding disorders. About 20 percent of her patients have attention deficit hyperactivity disorder or other behavioral issues, and 15 percent, learning disabilities.

Carmichael said the remaining children have adjustment disorders, which may arise during life events such as divorce, grief or abuse.

"All the kids are different, and that's one of the rewards," she said. "It's a fascinating field and I find it exciting. I find it intellectually challenging. You're given a problem to solve almost daily, either with assessment or therapy, and you have to be creative in your approach."

Picture Credits: Serge Giachetti / Courier & Press

Child psychologist Stacy Carmichael, left, plays Jenga with her son, Jaden, 8, in their Evansville home.

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