Massachusetts General Hospital, USA; Harvard Medical School, USA
Brandeis University, The Heller School for Social Policy and Management, USA.
Autism. 2015 Apr;19(3):262-71. doi: 10.1177/1362361313518125. Epub 2014 Feb 4.
Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care is so difficult, we interviewed pediatric health care providers with extensive experience serving youth with ASD. We gathered information about the strategies and interventions they use to transition their patients with ASD to an adult provider. Five interventions or strategies are currently being used. These include providing families with written medical summaries to give to adult providers, compiling lists of available adult providers or community resources, coordinating care and communication between individual pediatric and adult providers, making transition-specific appointments, and using checklists to track transition progress. Other interventions or strategies were identified as needed but not currently in practice, and these focused on education and training. For example, informational workshops were suggested to train families and youth about transition. Training adult providers and medical students was also seen as important. Several respondents additionally identified the need for a transition center where all services could be coordinated in one place. With large numbers of youth with ASD becoming young adults, it seems that pediatric practices might want to consider some of the activities described here. Some of these activities, such as family educational seminars and written medical summaries, are likely relatively easy for a practice to implement.
全国范围内,很少有自闭症谱系障碍(ASD)的年轻人报告接受过帮助他们从儿科医疗保健系统过渡到成人医疗保健系统的服务。例如,只有五分之一(21.1%)的 ASD 年轻人接受过任何过渡规划服务。为了更好地了解为什么从儿科到成人医疗保健的过渡如此困难,我们采访了在为 ASD 年轻人提供服务方面经验丰富的儿科医疗保健提供者。我们收集了有关他们用于将 ASD 患者过渡到成人提供者的策略和干预措施的信息。目前正在使用五种干预措施或策略。这些措施包括向成年提供者提供书面医疗摘要,列出可用的成年提供者或社区资源,协调个别儿科和成人提供者之间的护理和沟通,进行特定于过渡的预约,以及使用清单跟踪过渡进展。其他干预措施或策略被确定为需要但尚未实施,这些措施主要集中在教育和培训上。例如,建议举办信息研讨会,对家庭和年轻人进行过渡方面的培训。培训成年提供者和医学生也被认为很重要。几位受访者还指出需要一个过渡中心,可以在一个地方协调所有服务。随着大量 ASD 年轻人成为年轻人,儿科实践似乎可能需要考虑这里描述的一些活动。其中一些活动,如家庭教育研讨会和书面医疗摘要,对于实践来说可能相对容易实施。