Transition of care from child neurology to adult neurology practices is a lifespan issue and consistently reported as challenging because ofand  several logistic reasons. The Child Neurology Foundation's (CNF) Transitions Project Advisory Committee seeks to enhance existing resources with coding and reimbursement strategies, for use by child and adult neurologists.

The CNF created a framework to guide child neurology teams in starting the transition discussions early. The consensus statement, The Neurologist’s Role in Supporting Transition to Adult Health Care (2016) was endorsed by the AAN, AAP AES, and CNS.

The statement identifies 8 Common Principles, as a foundational framework to develop resources for use in practice to aid in successful transitions. The Principles have been used to engage providers; through surveys/focus groups, with AAN child and adult neurologists. CNF sought parent/caregiver perspectives through focus groups and surveys, incorporating Principles’ themes.

Survey of AAN child neurologists found most “keeping” patients >22yrs of age [92% w/pts > 18yrs]; and the majority report unsuccessful transitioning due to: 1) not finding adult provider to accept patient; 2) family’s resistance to transfer; 3) family request to defer transfer. Survey of AAN adult neurologists: Never/rarely received transition document or formal transfer letter; rarely/never discussed patient w/child neurologist. Focus group: 80%/66% of child/adult neurologists, want materials on transitions; 66%/68% of child/ adult neurologists, want to be involved in future transitions trainings or efforts. Family project results: families not being advised of transitions until much later than the recommended. 

Successful transitions continue to be a challenge for child neurologists, adult neurologists and the patients and families they serve. Understanding the constraints of stakeholders, available resources and insight into how coding strategies, used in concert with such resources, will ease the transition challenges from child to adult neurologist can facilitate successful transitions.