As the child with chronic disease grows up: transitioning adolescents with special health care needs to adult-centered health care.

The purpose of this article is to inform readers of the Delaware Medical Journal about the concept of transitional care for adolescents and young adults with chronic health care needs. This is a topic that has recently received national attention and was the subject of a supplement to Pediatrics in December 2002. The concept of transitional care bears special importance in Delaware as every year hundreds of children with chronic disease turn 18 and leave their pediatric providers. It is uncertain that these children resume their care with an adult health care provider, and there is almost always some lag in time as patients attempt to find an adult provider who is knowledgeable about their condition and willing to assume them as a patient. An even greater uncertainty is whether or not adult providers are prepared to take care of this new generation of adults with cyanotic congenital heart disease, spina bifida, cerebral palsy, and other conditions. This article explores some of these ideas and discusses what is available in the transition literature and where to go from here.