Insights from Dr. Wendy GrayA pediatrician Rady Children’s Hospital Orange County (Rady Children’s)
key takeaways
- Start transition planning early: Start discussing the move to adult health care around age 12 so teens can gradually develop essential skills like managing medications, scheduling appointments, and understanding their health needs.
- Change responsibilities with support: Parents move from primary managers to supervisors, while teens take more ownership, meeting with their pediatrician in private and practicing real-world health care tasks.
- A smooth transition sets the stage for adult independence: Early preparation prevents last-minute stress, ensures continuity of care, and helps teens develop into confident adults who can navigate the health care system on their own.
From pediatric to adult care
As children grow into adolescence and young adulthood, an important – but often overlooked – milestone is the transition from pediatric to adult health care. This change is more than just changing doctors; It symbolizes a new phase of independence, responsibility and self-advocacy in health management.
For many families, understanding this change can be confusing or even emotional. But, with early planning and open communication, it is possible to ensure a smooth and empowering handoff that prepares your child for a lifetime of informed, engaged health care decisions.
Here, Dr. Wendy Gray, pediatrician at Rady Children’s, provides helpful information for successfully navigating this important transition.
Why does this change need to be a priority?
A major reason for prioritizing the transition to adult care is to prepare teens for the future. While many families focus on the present, they may overlook teaching important health care skills. Deep parental involvement, although rooted in love, can sometimes prevent teens from developing the independence they need after they turn 18 and begin to manage their health, especially if they move away for college.
“When they’re first on their own, they don’t really know how to do basic things like get a refill from the pharmacy, schedule a doctor’s appointment, communicate with insurance,” says Dr. Gray. “So, that’s one reason why we recommend helping teens develop those skills while Mom and Dad are still involved.”
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How do I help my child transition from pediatric to adult care?
Key Strategies for Initiating Change
The best way to support a child’s transition to adult care is to start early and focus on building independence in managing health care. Parents should consider all the tasks they need to handle to care for themselves and their child – making a list can help identify what skills the child will need. A common surprise is that at age 18, most states consider teens to be legal adults, meaning they gain full control over their medical information, and can no longer have access to it without parental consent.
While the exact timing may vary depending on the child’s maturity and cognitive ability, it is recommended to begin discussing the transition to adult care around age 12. This early start helps avoid the all too common surprise of being told at the last pediatric visit that it is time to move on. According to national guidelines, the actual transfer to adult care usually occurs between the ages of 18 and 25, depending on the policies of the provider and institution.
Dr. Gray advises, “As long as we make it part of the conversation, we can gradually begin preparing for the procedure so that you don’t end up in a situation where there are surprises at your last clinic visit and you have a lot of questions or feel like you’re trying to figure out too many things at once.” “That’s what we’re trying to avoid.”
Understanding the roles: parent, child, pediatrician
Each person plays an important role in the transition to adult care. Parents are at the center of this process, gradually shifting from being the primary managers of their child’s health care to being a supportive observer. This means teaching and modeling basic skills early, such as administering medication or explaining prescriptions, and gradually delegating responsibility as the child grows more confident.
The child’s role is to begin to take more independence, including meeting with his or her pediatrician in private and answering direct questions. Although it may feel strange at first, these experiences help build the confidence and knowledge needed for adult health care.
Dr. Gray cautions, “They may not even want to do it because, honestly, it’s a lot easier when someone does something for you that you don’t want to do.” “But ultimately, it’s in their own best interest to start developing some of that independence. The role of the pediatrician or any pediatric provider is to really have one-on-one meetings with an adolescent to start modeling the fact that after they turn eighteen they’re going to be the boss of their own health care.”
Often due to insurance limitations, not all pediatricians will have recommendations for an adult care provider. In these cases, families can use word of mouth, ask other parents, check their insurance plan for in-network options, and research providers such as online by reading reviews to find the best fit for their child.
Parenting the future adult: a shift in mindset
Parents should rely on the foundation they have already built—children often learn by watching, even if they don’t seem engaged. By modeling and explaining health care tasks, parents help their child learn important skills. For additional assistance, transition website found Provides valuable resources specifically for parents to guide their child through the transition to adult care.
“One thing I heard a co-worker say about parenting her children is, ‘I’m not parenting a child, I’m parenting a future adult.’ When you think about it, it really changes your mindset about what you need to do to foster this child’s independence and get them to the point where you know they will do what they need to do. Or, if they don’t know the answer, they’ll have to come to you or go to someone they trust to get the answers they need,” assures Dr. Gray. “It’s really an investment in your child’s future success, even though I understand that holding back can be anxiety-provoking.”
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