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LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Discuss the state of transition of health care services in adolescents and young adults with special health care needs.
Describe the various pathways for transition to adult living (independent or supported), postsecondary education, employment, and community participation.
Recognize that there are multiple models for transition.
Identify facilitators, challenges, and barriers to successful transition to adulthood.
Describe the role of the physical therapist in transitions through the life course.
Recognize the numerous resources available for all stakeholders in the transition of youth with special health care needs.
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The longevity of children and youth with special health care needs (CYSHCN) has resulted in an increase in adolescents with disabilities attending nonpediatric traditional settings. Improving the transition from pediatric to adult care providers is a national priority that has been addressed by the Health Resources and Services Administration (HRSA),1 an agency of the US Department of Health and Human Services, the American Academy of Pediatrics,2 the American Physical Therapy Association (APTA) Academy of Pediatric Physical Therapy,3 the Association of Maternal and Child Health Programs,4,5 and many other stakeholders. Title V (of the Social Security Act) funds support programs for children with special health needs to facilitate the development of family-centered, community-based, coordinated systems of care, which include transition of care.6
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There is a need to educate pediatric physical therapists and physical therapist assistants on their role in transition of care. In addition, adult care physical therapists and physical therapist assistants require knowledge on adolescent development, chronic childhood neurodevelopmental disabilities, and techniques to guide adolescent and young adult patients through the transition process.
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The purpose of this chapter is to describe the various paths and strategies for successful transition from adolescence to adulthood. The authors of this chapter acknowledge that transition occurs during various critical time frames in the lives of families and children with special health care needs; such as from early intervention to school-based services, from elementary to middle school, or from middle school to high school. However, the focus and objectives of this chapter are to describe and assist with the transition of adolescents with health care needs to an adult model of health care, community participation, and adult living (independent and supported).
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CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
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Children and youth with special health care needs (CYSCHN) is a broad umbrella term that covers a range of children and youth with chronic health conditions and disabilities. The term CYSHCN includes children with chronic conditions (eg, cystic fibrosis, type 1 diabetes mellitus), children with neurodevelopmental disabilities (eg, autism, cerebral palsy, spina bifida), children with more medically complex health issues (eg, cancer), and children with behavioral or emotional conditions (eg, attention-deficit disorder). CYSHCN are defined by the ...