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Transitions

The Center for Infants and Children with Special Needs at Cincinnati Children's helps patients and families with the difficult task of making transitions.

The Center for Infants and Children with Special Needs at Cincinnati Children's Hospital Medical Center helps patients and families with the difficult task of making transitions.

Explanation | Obstacles | Planning for Adulthood | Life Skills | Resources

Explanation

"Transition" is generally defined as the passage from child-centered activities to adult-oriented activities. It occurs in three main aspects of life:

From pediatric health care to adult-oriented care
From school to work
From home to community

However, there are many other transitions that adolescents experience, including:

Hospital to home
Home to school
School to work
Adolescent to adulthood

As you prepare to make transitions, learn more about Vocational and Transition Programs, Postsecondary Education Options, Employment and Estate and Future Planning.

Obstacles

There are many obstacles that make the transition process to adulthood difficult. Some examples include:

Worsening disabilities with age
Loss of support systems
Aging caregivers
Loss of insurance coverage
Guardianship status
Mental health issues for patient or family members
School-provided support services are difficult to replace (occupation, physical and speech therapies, as well as nursing, transportation and school psychology services)
Adult physicians' limited knowledge or comfort level with pediatric conditions

Planning for Adulthood

Planning for the transition from adolescence to adulthood begins at age 14 years. Consideration should be given at that time to both career goals and life skills training, given the adolescents strengths, interests and challenges. This helps create a vision for adult life.

By age 16 years these elements should be included in the school Individualized Education Plan (IEP), and links to community resources / agencies should be facilitated.

Remember that public special education services are available until age 22 years; therefore, a decision about "deferred graduation" must be made at or prior to 18 years of age. Learn more about special education and postsecondary options.

Life Skills

Life skills is a term that is used to describe tasks that are needed for an adult to be able to take care of themselves. When evaluating what type of support an adolescent may need, it can be helpful to categorize each task by:

Can do by self
Need help from family / friends
Need help from community resources

Examples of life skills, include:

Get and keep a job
Have money to support self
Budget money and pay bills
Balance and use a checkbook
Plan, shop and cook meals
Clean house
Read and follow bus schedule
Participate in social activities
Fill prescriptions and take medicine
Make and keep appointments
Manage a home emergency
Maintain appropriate personal hygiene

Common Community Agencies

MRDD (Board of Mental Retardation and Developmental Disabilities)
Social Security Administration Disability Program and Social Security Work Initiatives
The Ohio Rehabilitation Services Commission
Department of Job and Family Services -- MEDICAID

Resources

The following list of resources are designed to aid in the transition planning process:

Postsecondary Options has information on transition, vocational, college and other educational opportunities.
Division of Developmental and Behavioral Pediatrics at Cincinnati Children's
Transition Clinic, Division of Developmental and Behavioral Pediatrics at Cincinnati Children's
Adolescent Health Transition Project is designed to help smooth the transition from pediatric to adult health care for adolescents with special health care needs. This site is a resource for information, materials and links to national resources, as well as sites specifically designed for use by the teen with special health care needs.
Portable Medical Summary Sheet and Health History Summary for Teens can be dowloaded to record important health and contact information.
Transition Timelines for Children and Adults with Special Needs can be downloaded.
Checklists for health, independent living and leisure skills are available.

Children's Medical Services Network has fact sheets and booklets on health care transition including "Envisioning My Future" and "Since You're Not a Kid Anymore."

Colleges with Programs for Learning Disabled Students provides information on resources and supports in higher education.

Healthy and Ready to Work initiative promotes a comprehensive system of care for children with special health care needs who are approaching adulthood who may need assistance in making the transition from pediatric care to adult health care and to postsecondary education and / or employment.

Institute for Community Inclusion (ICI), based at the University of Massachusetts and Children's Hospital of Boston, promotes the inclusion of people with disabilities in all aspects of community life.

Postsecondary Options for Students with Intellectual Disabilities

Transition Planning for Adolescents with Special Health Care Needs: A Guide for Health Care Providers

National Center of Medical Home Initiatives for Children with Special Needs web site, managed in cooperation with the American Academy of Pediatrics, provides information about multiple transition-related issues.

National Center on Secondary Education and Transition provides technical assistance and disseminates information focused on areas of national significance for youth with disabilities and their families. Includes publications to support parents in the role as mentor, advocate and guide to their student with a disability.

Ohio Department of Education has information on writing an IEP and transition planning.

Special Child is an online publication dedicated to parents of children with special needs. Special Child offers articles on various topics, including "The Transition Years."