Gaps in helping adolescents with mental, behavioral, and developmental disorders make the transition to adult health care

A CDC study found that in 2016–2017, most adolescents with mental, behavioral, or developmental disorders (MBDDs) did not receive the recommended support from their healthcare providers to help them transition from pediatric care to adult care¹. The American Academy of Pediatrics recommends transition planning for all adolescents starting at age 12 years that includes the healthcare provider speaking with the adolescent separate from family members, discussing the transition to adult care, and coaching the adolescent in taking charge of their own care. This transition planning is particularly important for adolescents with MBDDs to help prevent potential negative outcomes during and after a healthcare transition. Together, healthcare providers and parents can collaborate to close the gaps and help adolescents with MBDDs transition to adult health care.

Read the full scientific article.

Main Findings

• Overall, most adolescents did not receive the recommended transition planning to get ready to move from pediatric to adult health care.
  • Only about 1 in 6 adolescents (aged 12–17 years) with MBDDs received the recommended transition planning.
  • Among younger adolescents (aged 12–14 years) with MBDDs, 1 in 10 receive the recommended transition planning.
• Gaps in planning differed by diagnosis:
  • Although adolescents with depression and anxiety were more likely than their peers without MBDDs to receive transition planning, most did not receive the recommended planning.
  • Adolescents with some developmental disorders, such as autism spectrum disorder (ASD) and developmental delay, were less likely than their peers without MBDDs to receive the recommended transition planning.
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  Youth who change from pediatric to non-pediatric providers are less likely to continue with ADHD medications

• Most adolescents receiving medication and/or behavioral treatment for MBDDs did not receive the recommended transition planning, putting them at risk for stopping treatment.

Closing the Gaps

These steps can increase the proportion of adolescents with MBDDs who receive recommended transition planning:

• Healthcare providers can learn about the recommendations and use them when providing care for adolescents starting at age 12 years, and modify the plans, goals, and timelines to meet the unique needs of each adolescent.
• Parents can ask their child’s pediatric healthcare providers about transition planning for their adolescent.
• Communities can provide transition programs outside of traditional preventive healthcare visits, such as through school-based transition programs.
• Public health can increase healthcare provider training to address the unique needs of adolescents.

About This Study

Researchers analyzed survey information on 29,286 adolescents aged 12–17 years in 2016–2017 using the National Survey of Children’s Health (NSCH), sponsored by the Health Resources and Services Administration’s Maternal and Child Health Bureau. Parents were asked specific questions about the health and well-being of a randomly selected adolescent in their household. Previous research found that most adolescents did not receive transition planning.² The current study looked at gaps in transition planning for adolescents with MBDDs.

About Mental, Behavioral, and Developmental Disorders

In the United States, approximately 1 in 5 (20%) adolescents have been diagnosed with an MBDD.³ It is important to watch for these disorders and how they are treated because they have a significant effect on overall health and relationships throughout life. Treatment continuity is critical to long-term mental and physical health. For adolescents with MBDDs, timely healthcare transition planning may mitigate potential problems that could be caused if healthcare is disrupted.

Our Work

CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) works to provide a better understanding of mental, behavioral, and emotional disorders so affected children and adolescents and their families get the support they need.

More Information

• CDC – Children’s Mental Health
• CDC – Developmental Disabilities
• CDC – Autism Spectrum Disorder
• HRSA – Got Transition^®
• AAP – Recommendations for transition planning

References

1. Leeb RT, Danielson ML, Bitsko RH, Cree RA, Godfred-Cato S, Hughes M, Powell P, Firchow B; Hart LC, Lebrun-Harris LA. Support for transition from adolescent to adult health care among adolescents with and without mental, behavioral, and developmental disorders — United States, 2016–2017. Morbidity and Mortality Weekly Report (MMWR) 2020, 69(34);1156–1160.
2. Lebrun-Harris LA, McManus MA, Ilango SM, Cyr M, McLellan SB, Mann MY, White PH. Transition planning among US youth with and without special health care needs. Pediatrics 2018;142:e20180194.
3. National Research Council. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press; 2015.