At MMWR, Rebecca Leeb and colleagues have an article titled "Support for Transition from Adolescent to Adult Health Care Among Adolescents With and Without Mental, Behavioral, and Developmental Disorders — United States, 2016–2017."
They find that adolescents with diagnosed mental, behavioral, and developmental disorders (MBDDs) -- including autism -- are likely to disengage from and experience gaps in health care as they approach adulthood.
Consistent with recent findings (2,3), this study found that a minority of U.S. adolescents receive recommended transition planning. Overall, rates of transition planning are higher among adolescents aged 15–17 years than among their younger peers (aged 12–14 years) suggesting that PCPs might be addressing transition to adult care as the transition becomes imminent. However, among adolescents aged 15–17 years, only 21.5% of those without MBDDs and 19.5% of those with MBDDs were receiving transition planning guidance, indicating a significant gap in transition planning for all adolescents.
Three subgroups of adolescents with MBDDs might be especially vulnerable to transition planning gaps. First, adolescents with ASD and other developmental disorders were least likely to meet the transition measure, suggesting that PCPs should work with families to better address the transition needs of these adolescents (3). Second, although adolescents with behavioral and emotional disorders had similar or higher levels of transition planning than did adolescents without MBDDs, only one in five adolescents with emotional disorders, and one in seven adolescents with behavioral disorders met the transition measure. Adolescents with behavioral and emotional disorders are at increased risk for disengagement from health care services during the transition to adult care, which can result in poor health outcomes (1,6,8). Finally, fewer than 20% of adolescents receiving medication, behavioral treatment, or both for MBDDs met the transition planning measure; this group might benefit from an increased emphasis on transition planning. Treatment continuity from adolescence into young adulthood is critical to long-term mental and physical health, and support during transition can increase the likelihood of maintaining adherence to current treatment (1,4,5). Together, these findings suggest increased attention to the transition needs of adolescents with MBDDs is warranted.