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The Transition from Pediatric to Adult Healthcare

You and your child have formed a bond with the pediatrician’s office through yearly well visits and sick child appointments for everything from ear infections to pink eye. However, at age 12, it’s time for your child to start taking on a more active role in his or her healthcare with the goal of becoming independent. This will allow your child to gradually move to adult medicine instead of having a sudden transition when they are young adults.

Start the Transition Early

The transition to adult healthcare shouldn’t be a sudden one. It should be a slow change that involves parents or guardians, the pediatrician, pediatric specialists, and your child. The process can begin around age 12, by encouraging your child to learn how to take an active role in caring for his or her health and any chronic medical conditions.

Between the ages of 12 and 14, the pediatrician will begin spending time alone with your child during appointments. This may not happen until later if you have a child with developmental issues. Meeting with the doctor one-on-one will allow your child to practice the communication skills needed when they move to an adult model of care.

Parents or guardians, the pediatrician, and pediatric specialists can begin the transition by making sure your child:

Choosing a Primary Care Physician

Most children complete the transition from pediatric healthcare to adult healthcare between the ages of 18 and 21, but some may not transition until age 24. If your child sees a family medicine specialist, he or she may not need to choose another physician. Because each young adult is unique, the transition to adult care depends on readiness.

If it’s time to choose a primary care physician, your child should ask the pediatrician for a referral, preferably to one that takes his or her insurance. The pediatrician will need to send the primary care doctor a clinical summary, medical records, and insurance information.

Keep in mind, when your child turns 18, he or she is legally an adult. As an adult, he or she should be able to:

Children with Chronic Health Conditions

Chronic conditions need consistent care. It is important to make a smooth transition from one doctor to another. Chronic conditions may need different care as an adult than as a child so it is important for your child to transition to adults care. Your child may need to see an adult subspecialist if one is available to treat the condition your young adult has. Be sure to ask your pediatrician for a referral.

Children with cognitive or developmental impairments may need more time to transition to adult care. In some cases, parents or a guardian will need to remain involved, advocate for the child, and help make health-related decisions.

Following these guidelines will help your child slowly transition from a pediatric healthcare model to an adult one. By doing so gradually, your child will be ready when the times comes to transition and will not be overwhelmed by the responsibility of taking control over his or her healthcare needs.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Paediatric Society
http://www.cps.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

American Academy of Pediatrics, American Academy of Family Physicians, et al. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011 Jul;128(1):182-200. Available at: http://pediatrics.aappublications.org/content/pediatrics/128/1/182.full.pdf. Accessed January 27, 2017.

Helping adolescents transition to adult health care. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/news/Pages/Helping-Adolescents-Transition-to-Adult-Health-Care.aspx. Updated June 27, 2011. Accessed January 27, 2017.

Moreno M. Transition of care from pediatric to adult clinics. JAMA Pediatr. 2013;157(7):684. Available at: http://jamanetwork.com/journals/jamapediatrics/fullarticle/1703907. Accessed January 27, 2017.

Transitioning to adult care. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/centers-and-services/childrens-hospital-primary-care-center-chpcc-program/transitioning-to-adult-care. Accessed January 27, 2017.

Transition to adult care. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/medical-care/transition-to-adult-care. Accessed January 27, 2017.

Tuffrey C, Pearce A. Transition from pediatric to adult medical services for young people with chronic neurological problems. J Neurol Neurosurg Psychiatry. 2003;74:1011-1013. Available at: http://jnnp.bmj.com/content/74/8/1011.full. Accessed January 27, 2017.

UMHS transition process: helping children with complex medical needs transition from pediatric to adult healthcare. University of Michigan website. Available at: http://www.med.umich.edu/1libr/Pediatrics/CareTransition/TransitioningFromPedsToAdultComplexNeeds.pdf. Published March 2016. Accessed January 27, 2017.

Last reviewed June 2017 by Michael Woods, MD