CONTEMPORARY ISSUES Lawrence W. Brown, MD Peter Camfield, MD, FRCPC Melissa Capers, MA Greg Cascino, MD Mary Ciccarelli, MD Claudio M. de Gusmao, MD Stephen M. Downs, MD Annette Majnemer, PhD, FCAHS Amy Brin Miller, MSN Christina SanInocencio, MS Rebecca Schultz, PhD Anne Tilton, MD Annick Winokur, BS Mary Zupanc, MD Correspondence to Dr. Brown: brownla@email.chop.edu Supplemental data at Neurology.org The neurologists role in supporting transition to adult health care A consensus statement ABSTRACT The child neurologist has a critical role in planning and coordinating the successful transition from the pediatric to adult health care system for youth with neurologic conditions. Leadership in appropriately planning a youths transition and in care coordination among health care, educa- tional, vocational, and community services providers may assist in preventing gaps in care, delayed entry into the adult care system, and/or health crises for their adolescent patients. Youth whose neurologic conditions result in cognitive or physical disability and their families may need additional support during this transition, given the legal and financial considerations that may be required. Eight common principles that define the child neurologists role in a successful transition process have been outlined by a multidisciplinary panel convened by the Child Neurology Foun- dation are introduced and described. The authors of this consensus statement recognize the current paucity of evidence for successful transition models and outline areas for future consideration. Neurology ® 2016;87:835840 The child neurologist has a critical role in planning and coordinating the successful transition of youth with neurologic conditions from the pediatric to adult health care system. Appropriate leadership and planning of a youths transition, and care coordination among health care, educational, vocational, and community services providers, may assist in preventing gaps in care, which otherwise may result in a youth running out of medication or delaying entry into the adult medical system through failure to make or keep appointments. Preventable health crises may develop, for which no clear medical specialist has been identified to provide care. Youth whose neurologic conditions result in cognitive or physical disability and their families may need additional support to address the particular legal and financial considerations of the transition they face. Barriers to successful transition have been identified 13 and ample evidence demonstrates that many youth, particularly those with special needs, continue to receive insufficient transition planning. 47 Several models of transition support have been developed and are beginning to be tested, although the available evidence remains insufficient to identify the best models. 5,812 In acknowledgment of this clinical reality, and in response to the 2011 clinical guideline of the American Academy of Pediatrics/American Academy of Family Physicians/American College of Physicians supporting the healthcare transition from adolescence to adulthood in the medical home,in which specialty providers were called to develop a framework for their populations unique needs, 13 the Child Neurology Foundation convened a multidisciplinary panel of experts in 2014 to develop this guideline. The authors of this consensus statement recognize the current paucity of evidence for successful transition models, and so propose 8 common principles that should be incorporated in any transition model, and which define the child neurologists role and responsibilities throughout the transition process. Future areas of From The Childrens Hospital of Philadelphia (L.W.B.); Dalhousie University (P.C.); independent medical writer (M. Capers); Mayo Clinic (G.C.); Indiana University School of Medicine (M. Ciccarelli, S.M.D.); Brigham and Womens Hospital (C.M.d.G.); McGill University (A.M.); Child Neurology Foundation (A.B.M.); Lennox Gastaut Syndrome Foundation (C.S.); Texas Childrens Hospital (R.S.); Louisiana State University Health Sciences (A.T.); patient advocate (A.W.); and Childrens Hospital of Orange County (M.Z.). An expanded version of the consensus statement, including vignettes highlighting the broad applicability of the recommendations over a variety of neurologic disorders of childhood, can be found on the Neurology ® Web site at Neurology.org. Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. © 2016 American Academy of Neurology 835 ª 2016 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.