Adolescent transition to adult health care is important for every teen. Teens with and without special health care needs may have difficulties with transitioning from pediatric to adult focused medical care. Think about the last time you visited your teen’s pediatric provider’s office… what did the waiting room look like?  Was there a fish tank?  Did the office have child friendly toys, magazines, and books?  Were the colors bright and cheerful?  Now consider your last visit to see your adult medical provider.  My guess is the walls were gray or muted, there was no fish tank, and the magazines included Newsweek and Golf.  Not exactly teen friendly!

Of course, the transition from pediatric to adult centered care involves much more than just a change in scenery.  It includes a shift in focus from the family making decisions, to the autonomy of being responsible for one’s self.  Teens and emerging adults will be expected to know how to make follow-up appointments, arrange for laboratory testing, and get prescriptions filled.  They’ll need to know what medications they take, what insurance coverage they have, and what their medical and family history consists of.  This transition is not just a challenge for the teens, it’s hard for the family to make the shift as well!

The Maternal and Child Health Bureau in cooperation with the US Department of Health and Human Services has made the receipt of transition services for youth with special health care needs a core performance outcome. There are many websites with helpful tips on when to start thinking about transition and how to start the process.  Some of these were discussed in a previous post on chronic illness in teens, but here are some more helpful tips for parents:

  • Start early – Encourage your teen to ask questions of their medical provider.  Let them do the talking during medical visits
  • Build Independence – when you’re leaving the medical office and going to make a follow-up visit, have your teen schedule the appointment and tell what the appointment is for.  You’re there next to them and can add any information that’s needed.
  • Use a checklist – there are checklists available that help show a teen (and their parents) which tasks need to be accomplished to successfully transition.  Some of the items on the checklist include knowing the name of their medical provider, names of medications they take, having access to immunizations, and knowing their insurance carrier.  The Adolescent Health Transition Project has nice examples of checklists for adolescent transition.
  • Go on a meet and greet of an adult provider – it may take time to find an adult medical provider who your teen feels comfortable with.  Most medical clinics allow potential patients to come and meet the providers and have an introduction to the clinic.  This visit can alleviate fears of an unknown place!
  • Talk with your child’s pediatrician about transition – it can be challenging for pediatricians to see their patients grow up!  We get to know our patients and their families over years and enjoy caring for our patients; however as teens become emerging adults, they may have medical concerns beyond our scope of training.  Ask your teen’s pediatrician about starting a plan for transitioning to adult services once your teen enters high school. 

Transition for adolescents and emerging adults encompasses every aspect of their lives.  In school, teens began to prepare for college or vocational school.  They may get their first job that starts the transition to financial independence.  Transitioning to adult centered care and being responsible for one’s own health is another major milestone on the journey of growing up.  For more information check out the Adolescent Health Transition Project through the University of Washington and The Center for Children with Special Needs through Seattle Children’s Hospital for more information.