Insights from Dr. Wendy Gray, a pediatric psychologist at Rady Children’s Hospital Orange County (Rady Children’s)
Key takeaways
- Start transition planning early: Begin discussing the move to adult healthcare around age 12 so teens can gradually build essential skills like managing medications, scheduling appointments, and understanding their health needs.
- Shift responsibilities with support: Parents move from primary managers to supervisors while teens take on more ownership, meeting privately with their pediatrician and practicing real‑world healthcare tasks.
- A smooth transition sets the stage for adult independence: Early preparation prevents last‑minute stress, ensures continuity of care, and helps teens grow into confident adults who can navigate the healthcare system on their own.
From pediatric to adult care
As children grow into adolescence and young adulthood, one important—but often overlooked—milestone is the shift from pediatric to adult health care. This transition is more than just switching doctors; it marks a new phase of independence, responsibility, and self-advocacy in managing health.
For many families, navigating this change can be confusing or even emotional. But, with early planning and open communication, it’s possible to ensure a smooth and empowering handoff that sets your child up for a lifetime of informed, engaged healthcare decisions.
Here, Dr. Wendy Gray, pediatric psychologist with Rady Children’s, offers helpful information to successfully guide this key transition.
Why making this transition needs to be a priority
One key reason to prioritize the transition to adult care is to prepare teens for the future. While many families focus on the present, they may overlook teaching important healthcare skills. Parents’ deep involvement, though rooted in love, can sometimes prevent teens from developing the independence they’ll need once they turn 18 and begin managing their own health, especially if they move away for college.
“When they’re on their own for the first time, they really don’t know how to do much of the basics like getting a refill from the pharmacy, scheduling a doctor’s appointment, communicating with insurance,” states Dr. Gray. “So, that’s one of the reasons why we recommend helping adolescents build those skills while mom and dad are still involved.”
Key strategies to begin the transition
The best way to support a child’s transition to adult care is to start early and focus on building independence in managing healthcare. Parents should consider all the tasks they handle for their own and their child’s care—making a list can help identify what skills the child will need. A common surprise is that at age 18, most states consider teens legal adults, meaning they gain full control over their medical information, and parents may no longer have access without consent.
While the exact timing can vary based on a child’s maturity and cognitive ability, it’s recommended to start discussing the transition to adult care around age 12. This early start helps avoid the all-too-common surprise of being told at a final pediatric visit that it’s time to move on. According to national guidelines, the actual transfer to adult care typically happens between ages 18 and 25, depending on the provider and institution policies.
“As long as we make this a part of the conversation, we can start slowly preparing for that process so you do not end up in a situation where it’s a surprise at your last clinic visit and you have a lot of questions or you feel like you’re trying to figure out a lot of things all at once,” advises Dr. Gray. “That’s what we’re trying to avoid.”
Understanding roles: Parent, child, pediatrician
Each person plays a key role in the transition to adult care. Parents are central to the process, gradually shifting from being the primary manager of their child’s healthcare to a supportive supervisor. This means teaching and modeling basic skills early, like managing medication or calling in a prescription, and slowly handing over responsibility as the child gains confidence.
The child’s role is to begin taking on more independence, including meeting privately with their pediatrician and answering questions directly. Though it may feel awkward at first, these experiences help build the confidence and knowledge needed for adult healthcare.
“They may not even want to do it because, to be honest, it’s a lot easier when someone does something for you that you don’t want to do,” cautions Dr. Gray. “But ultimately, it’s in their own best interest to start developing some of that independence. The role of the pediatrician or any pediatric provider is really to have those one-on-one meetings with a teenager to start modeling the fact they are going to be owners of their healthcare once they turn eighteen.”
Not all pediatricians will have recommendations for an adult care provider, often due to insurance limitations. In these cases, families can turn to word of mouth, ask other parents, check with their insurance plan for in-network options, and research providers online, such as reading reviews, to find the best fit for their child.
Raising a future adult: A mindset shift
Parents should trust the foundation they’ve already built—children often learn by observing, even if they don’t seem engaged. By modeling and explaining healthcare tasks, parents help their child absorb important skills. For additional support, the Got Transition website offers valuable resources specifically for parents to help guide their child through the shift to adult care.
“One of the things I’ve heard a colleague say in raising her own children is, ‘I am not raising a child, I am raising a future adult.’ When you think about that, it really changes your mindset about what you need to do to foster this child’s independence and get them to the point where you know they will do what they need to do. Or, if they don’t know the answer, they will know to come to you or to go to someone else they trust to get the answers they need,” assures Dr. Gray. “This is truly an investment in your child’s future success, even though I understand stepping back can be anxiety provoking.”
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