Ep47: Complex Adolescent Transitions—Congress 2019

Everyone knows that adolescence is a turbulent time. Teens are faced not just with changes to their bodies, but to their moods and thought patterns as well. They might also be saying goodbye to familiar carers in the paediatric department, and in Episode 11 we heard how important it is to ensure a smooth transition to adult services, which tend to be more anonymous.

This is especially true for young people with special needs such as diabetes, transplant management or intellectual disability, though they are the least likely to received dedicated transition support. The three speakers in this podcast explain that improving this transition process doesn’t require going way above and beyond regular practice, it just needs a little more coordination.

They were recorded at the 2019 RACP Congress. First, Dr Fran Mouat outlined Starship’s transition program for young patients with diabetes, and some of the data showing its impact on glycaemic control after they’ve left paediatric care. Dr Rachael Harry leads a transition program for adolescents who’d undergone transplants early in life. With a moving case study, she described how all the medical care in the world needs to fit in with the lifestyle that every young adult aspires to. Finally, Dr Colette Muir described what this period is like for adolescents with developmental disabilities.

Intellectual disability is associated with a lower quality of care throughout the lifespan, often because of “diagnostic overshadowing”—the phenomenon by which the complaints of such patients get attributed to the disability itself, rather than being investigated thoroughly in their own right. The RACP is a signatory to an international consensus statement called Equally Well, and has also published a position paper about transition of young people with chronic disability needs.

Guests

Dr Fran Mouat FRACP (Starship Children’s Hospital, Auckland, Co-Chair of National Clinical Network for Intersex Disorders)
Dr Rachael Harry FRACP (New Zealand Liver Transplant Unit, Auckland)
Dr Collette Muir FRACP (Starship Children’s Hospital, Auckland, New Zealand).
Links to additional resources can be found at www.racp.edu.au/podcast.