Transitioning cognitively impaired young patients with special health needs to adult-oriented care: collaboration between medical providers and pediatric psychologists.
OBJECTIVE
Cognitive disability places adolescents with special health needs at risk for poor health outcomes. Consequently, medical providers are faced with the challenge of deciding how to prepare cognitively impaired young adults for successful transition from child-centered to adult-oriented care. We provide a case example to illustrate this complex issue, describe research linking cognitive impairments to functioning in the context of chronic disease management, summarize current transition practices, offer recommendations to facilitate transition planning, and discuss how pediatric psychologists can assist this process.


RESULTS
Concurrent cognitive impairments and pediatric chronic illness impose significant limitations on adolescents' self-care, disease management, and transition to adult care. There is also great variability in transition practices across pediatric centers, despite published transition guidelines, and little is known about how to develop successful transition planning for cognitively impaired adolescents.


CONCLUSIONS
Transitioning cognitively impaired adolescents is a salient challenge in need of greater attention and further research. A multidisciplinary approach to transition that is tailored to the developmental, cognitive, and adaptive needs of this population can maximize the likelihood that transition will be successful.
Herzer
Michele
M
Division of Behavioral Medicine and Clinical Psychology, Center for Promotion of Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. michele.herzer@cchmc.org
Goebel
Jens
J
Cortina
Sandra
S
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000328:Adult; D003299:Cooperative Behavior; D006233:Persons with Disabilities; D006301:Health Services Needs and Demand; D006801:Humans; D002666:Psychology, Child / Q000458:organization & administration*