Published
- Parents
- Adolescents
- Young adults
- Caregivers of children with chronic conditions
Prepared · sources accessed (UTC) · physician review still to be recorded
Moving toward adult care is a gradual transfer of knowledge and responsibility. It starts before the final pediatric appointment and involves more than finding a new clinician. The young person needs a usable account of their health, a way to request help, and support suited to their abilities and preferences.
This guide connects concerns that arise across childhood and adolescence with the practical handover into adult care. Use it alongside the existing pediatric-to-adult primary-care guide. The objective is a transition that keeps care understandable and reachable, including for people who continue to need substantial support.
Bring developmental concerns as observations
Describe what you have noticed, where it happens, and whether an ability has changed. Examples include difficulty being understood, participating in play, completing a familiar task, or managing a new demand. Bring observations from more than one setting when available, with the child’s own perspective when they can provide it.
CDC encourages families to discuss developmental concerns and bring age-appropriate milestone information. A milestone checklist is not a validated screening tool or a diagnosis. Depending on the concern, a clinician may recommend formal screening or further evaluation; families can also contact early-intervention or school evaluation systems. See CDC’s guidance for concerned families.
Ask what the next step is meant to clarify and who will check that it occurs. A referral should not end the conversation about what the child needs while waiting. If an acquired skill has been lost or symptoms have changed suddenly, describe that explicitly when seeking clinical advice rather than waiting for a routine developmental review.
Connect school absence, sleep, and recurring symptoms
A missed-school log becomes more useful when it records a pattern rather than only a total. Note symptoms, sleep opportunity, medication changes, demands at school, and what helped the young person participate again. Avoid deciding in advance that a recurring symptom is either entirely physical or entirely emotional.
At the appointment, distinguish the child’s description from adult observations: “She says she feels dizzy before class” is different from “The school called after she missed breakfast.” Both may be relevant. Ask which symptoms require medical investigation, what information would help, and what interim attendance or activity guidance is appropriate.
The existing family media and screen-time plan can support a discussion of routines without making screen use the assumed cause of illness. School documentation and educational support processes belong in the companion school-health handover guide, which complements the clinical plan.
Make home, school, and clinic instructions agree
For a chronic condition, identify which instructions each setting needs. A school may need an emergency action plan and medication authorization, while the next clinician needs diagnostic history and treatment response. Sharing every private detail with every setting is not the same as sharing the information needed for safe participation.
Ask the treating team to clarify the current plan, including routine care, symptoms to report, and urgent actions. Then check practical questions: Who supplies medicines? Who knows how to use equipment? Who contacts the family? Who updates the plan after a clinical change?
Keep a dated copy and identify the person responsible for each update. If a school instruction and a clinic instruction differ, ask the responsible professionals to resolve the discrepancy. The child or family should not be expected to choose between conflicting clinical directions.
Discuss privacy and consent before access changes
As children grow, privacy, consent, and access to records become more complicated. HHS explains that parents are generally minors’ personal representatives, with important exceptions that depend on the service, applicable law, and circumstances. The rules are not identical for every visit or every type of information. See HHS’s explanation of parents and minors’ records.
Ask the clinic to explain its California-specific process for private time with adolescents, consent, portal access, messages, billing communications, and emergency contact information. Avoid promising absolute confidentiality or assuming a parent can always view every result. A young person should know the limits before disclosing sensitive information.
Plan for the adult system as well. Discuss which supporters the young adult wants involved, what authorization is needed, and how access will work. Do not wait for an expired portal permission or an unanswered refill request to reveal that the administrative rules have changed.
Practice prescriptions, appointments, and insurance tasks
Choose one skill at a time. The young person might first explain what a medicine is for, then request a refill with support, then learn how to contact the clinic about a problem. The aim is useful participation, not passing a test of independence.
Got Transition’s readiness framework supports assessing skills, identifying priorities, and building a plan with the young person and caregivers. It treats readiness as part of an ongoing transition process rather than a single transfer event.
Practice with the actual system: find the appointment number, identify the pharmacy, locate the insurance card, and learn where an after-hours instruction appears. Ask who will prescribe during the interval between services. Confirm that the receiving clinician accepts the referral and has the necessary records; sending documents alone does not establish that care has transferred.
Adapt the transition for disability or complex care
Some young adults will manage tasks independently; others will use continuing assistance, communication tools, or formal support arrangements. Record what the person can do, what support helps, and how they express preferences. Do not equate a communication difference with an inability to participate in decisions.
California DDS explains that people with intellectual or developmental disabilities retain rights to autonomy and that supported decision-making is among the alternatives to conservatorship. The appropriate arrangement depends on the individual and applicable law. See DDS’s decision-support resources.
Prepare a concise clinical summary: diagnoses, significant procedures, current treatments, allergies, equipment, communication needs, key specialists, and unresolved issues. Explain which records support an important diagnosis rather than copying a long problem list without context. Pair the summary with accessible visit preparation and a results-and-referrals organizer.
Fictional worked example: a refill gap reveals an incomplete handover
Leena, 17, has a childhood-onset condition and uses a communication tablet. Her family has a new adult-clinic appointment, but nobody has identified the clinician responsible for prescriptions before that visit. Leena can explain what the treatment helps her do, but her parent has always arranged refills.
The family asks the current team for a handover discussion. Leena chooses which questions she wants to ask. The teams identify a prescription contact, confirm receipt of the summary, and arrange an accessible first appointment. A supporter helps Leena practice a refill request using her device.
The example does not assume that adult treatment will remain unchanged. It separates the immediate continuity task from decisions that require the receiving clinician’s assessment, while keeping Leena involved in both.
Printable home-school-clinic handover
Complete one row at a time. Keep the clinical copy private and share a narrower version where only selected information is needed.
| Task or information | Young person’s role | Supporter / professional role | Confirmed date |
|---|---|---|---|
| Explain current condition and priorities | ______ | ______ | ____ |
| Maintain medicine and allergy list | ______ | ______ | ____ |
| Request a refill and identify backup contact | ______ | ______ | ____ |
| Book and attend the first adult visit | ______ | ______ | ____ |
| Confirm records reached the receiving team | ______ | ______ | ____ |
| Review consent, privacy, and portal permissions | ______ | ______ | ____ |
| Update school or workplace clinical instructions | ______ | ______ | ____ |
| Arrange communication, equipment, and transport | ______ | ______ | ____ |
My preferred way to communicate: ______
The person I want involved in decisions: ______
The question still awaiting an answer: ______
Questions readers ask
Does adult care always mean changing doctors?
No. Some people stay with a family-medicine practice. Responsibilities, consent arrangements, and expectations can still change, so a transition discussion remains useful even when the clinician is the same.
Should parents stop helping at a particular birthday?
Support should reflect the person’s needs, preferences, and legal arrangements. Gradual practice can increase participation without abruptly removing help. Ask the clinic how to authorize ongoing involvement appropriately.
What if the receiving service has a long wait?
Tell the current team the actual appointment date and identify prescriptions, equipment, tests, or symptoms that need attention before then. Ask for an interim plan and escalation contact. The family and caregiving hub offers related preparation resources.
Sources and scope
Primary sources: CDC developmental concerns, Got Transition readiness, HHS minors’ records guidance, and California DDS decision support.
Prepared November 5, 2026, Pacific. human clinical and California consent/confidentiality review pending. This guide organizes a clinical transition. It does not diagnose a developmental condition, determine decision-making capacity, or supply a universal minor-consent rule.