How to Prepare an Autistic Teen for a Transition to Adult Healthcare
Start years before the move, not months. Getting an autistic teen ready for the transition to adult healthcare works best as a slow handover, with the teen taking on one piece of their own care at a time while the pediatric team they know is still there to catch things.
If you’re the teen reading this, most of what follows is for you as much as for your parents.
What changes in the transition to adult healthcare
Pediatric care is built around families. Appointments tend to be longer, staff expect a parent in the room, and a lot of coordination happens quietly in the background. Adult care usually assumes the patient books their own appointments, explains their own symptoms, remembers their own medications and follows up on referrals. Appointments are often shorter and less flexible.
The age of the move varies by practice and by country, often somewhere between the late teens and early twenties, so ask your pediatrician when their practice usually hands over. In many places, turning 18 also changes who can see medical records and talk to the doctor. A parent may no longer be told anything unless the young person agrees. Families can explore options such as signed consent forms or supported decision-making, where the young adult chooses trusted people to help them understand information and make decisions. Legal rules differ widely, so check with the practice and, if needed, a disability rights organization in your area.
Building the skills, one appointment at a time
Most of this is practice. Ask the doctor to speak to the teen first and the parent second. Let the teen check in at reception, or explain why they’re there, even if a parent fills in the gaps afterward. Some teens prefer to write what they want to say beforehand or to type it on a phone during the appointment. Both are completely legitimate ways to communicate with a clinician.
From about the mid-teens, many practices offer part of each appointment alone with the teen. That can feel uncomfortable at first for everyone, but it’s where young people learn to raise things they’d rather not say in front of a parent.
A written health summary helps enormously: diagnoses, current medications as prescribed, allergies, sensory needs, how the teen communicates best, and what makes appointments easier. It can grow out of a communication passport you’ve used at school, with the teen writing more of it each year. Our piece on self-advocacy at different ages covers the wider skill behind all of this.
Finding the next doctor
Ask the pediatric team for names of adult clinicians they trust with autistic patients, and whether they can send records and a handover letter. Request a first appointment that’s about getting to know each other rather than a crisis. Accommodations such as a quiet waiting area, the first slot of the day or longer appointments are still reasonable to ask for in adult care.
A good first step this week: have the teen book their own next appointment, by phone or online, with a parent nearby if they want. It’s small, and it’s the whole transition in miniature.
The Autistic Self Advocacy Network publishes resources written by autistic people about decision-making and healthcare as an adult. Your pediatrician remains the best person to plan the handover timeline with.
