Transition of adolescents with severe asthma from pediatric to adult care in Spain: the STAR consensus

Objective: To assess the consensus level among a multidisciplinary expert panel on the transition of adolescents with severe asthma from pediatric to adult care. Methods: A 61-item survey was developed based on guidelines for other chronic pathologies, covering transition planning, preparation, effective transfer, and follow-up. A two-round Delphi process assessed the consensus level among 98 experts (49 pediatricians, 24 allergists and 25 pulmonologists). Consensus was established with ≥70% agreement. Results: Forty-two items (70%) reached consensus. No age range to initiate the transition was agreed upon by the panelists. The main goal to achieve during the transition identified by the experts is that adolescents gain autonomy to manage their severe asthma and prescribed treatments. The panelists agreed on the importance of developing an individualized plan, promoting patient’s autonomy, and identifying home environment factors. They agreed that the adult healthcare team should have expertise in severe asthma, biologics and management of adolescent patients. Pediatric and adult healthcare teams should share clinical information, agree on the criteria to maintain the biological therapy, and have an on-site joint visit with the patient before the effective transfer. Adult healthcare professionals should closely follow the patient after the effective transfer to ensure correct inhaler technique, treatment adherence and attendance to healthcare appointments. Conclusions: This consensus document provides the first roadmap for Spanish pediatric and adult teams to ensure that key aspects of the transition process in severe asthma are covered. The implementation of these recommendations will improve the quality of care offered to the patient.

Youth and Parent Participation in Transition Planning in the U.S.A.: Findings from the National Longitudinal Transition Study 2012 (NLTS 2012)

The purpose of this study was to use data from the United States' National Longitudinal Transition Study 2012 (NLTS 2012) to present descriptive information on youth and parent participation and youth's role in required Individualized Education Program (IEP)/transition planning meetings by disability category and age groupings (14-22 year olds, 14-15 year olds, and 16-22 year olds). The study found that youth and parent attendance in IEP/transition planning meetings was high across disability categories, but the extent to which youth and parents met with teachers to discuss transition goals was much lower. Data from NLTS 2012 and a previous U.S. study, the National Longitudinal Transition Study 2 (NLTS2), were compared for youth's participation with school staff in discussing transition goals. A significant decline in participation was found over the past decade. Logistic regression analyses illustrated differences in youth and parent participation and youth's role by disability category.

Targeting the Transition Goals of Teens Through Executive Function Support

Executive functions, which begin developing in early childhood, are necessary for the tasks of daily life, such as decision making and planning. Despite their early development, often without teaching, many teens with disabilities need explicit instruction to acquire and apply executive functions each day. Gaps in executive functions directly impact a teens ability to achieve post-secondary success, as executive functions support planning, goal setting, and organization. This article provides instruction on how to support teens with disabilities on three executive functions: (a) building habits that form routines, (b) utilizing sensory reminders to manage time, and (c) applying a planning tool. This article also instructs teachers on embedding executive function instruction within transition planning for individualized education programs.

Empowering Transition-Age Students to Use Self-Determination Assessment to Lead IEP Goal Development

Self-determination is a predictor of positive in- and post-school outcomes, including access to general education, competitive employment, and community participation. Emerging research has focused on promoting self-determination for all students given alignments with college and career readiness frameworks and equity-based education. However, it is also important to enhance self-determination as students participate in the Individualized Education Program (IEP) goal development process. Empowering transition-age students to lead the IEP goal development process with support from school personnel has the potential to enhance the alignment of IEP goals based on students’ strengths, preferences, values, and needs and enhance transition planning and college and career readiness. In this article, we provide an example of how to use a self-determination assessment, the Self-Determination Inventory: Student Report (SDI:SR), and an intervention, the Self-Determined Learning Model of Instruction (SDLMI), in the IEP goal development and implementation process to enhance transition planning and college and career readiness.

Early Intervention to Preschool Transition for Children Who Are Deaf or Hard-of-Hearing: A TEAM Approach

Parents, teachers, and administrators report concerns and challenges related to the transition from early intervention (EI) to preschool for children who are deaf/hard-of-hearing. The goal of the current article is to assist teachers, administrators, and specialists involved in the transition of a young child who is deaf/hard-of-hearing from EI into preschool. The TEAM approach involves Transition planning, establishing an Educational team, determining and providing appropriate Accommodations, and Making connections for continued success. Although the TEAM approach may apply to all young children transitioning, the focus of this article is on addressing the unique needs of this particular population. Recommendations and resources are provided.

Implementation of a multi-family autism transition program in the high school setting

Transitioning Together is a multi-family intervention designed to support families of adolescents on the autism spectrum as they prepare for the transition to adulthood. Questions remain regarding its wide-scale adoption and implementation in real-world settings such as high schools. We examined student, teacher, and school-level facilitators and barriers to adopting and implementing Transitioning Together at 30 public high schools across three US states that were participating in the intervention arm of a larger randomized trial, which provided training and coaching for implementation of comprehensive evidence-based autism programming. Seventeen of the 30 schools adopted Transitioning Together. Community socioeconomic status and pre-existing quality of programming for family involvement and transition planning significantly predicted intervention adoption. Thirteen of the 17 schools that adopted Transitioning Together did so with a high level of fidelity (>90%). The areas of fidelity that schools struggled with most related to session structure, facilitating problem-solving and dialogue, and collecting feedback from families. Findings highlight struggles and successes with real-world adoption of the intervention in its current form. Future research is needed to further examine how to facilitate adoption across public high schools and/or other service systems, while maximizing effectiveness, as well as reach to historically underserved autism spectrum populations. Lay abstract Transitioning Together is an intervention that supports families of adolescents on the autism spectrum as they prepare for the transition to adulthood. While it has been delivered successfully and shown to result in positive outcomes for families in the university setting, questions remain about whether and how well it can be widely provided to families in real-world settings such as high schools. In this study, we analyzed predictors, facilitators, and barriers to providing Transitioning Together to families at 30 high schools across three US states, all of which received training from a team of researchers to deliver this intervention. Our findings highlight struggles and successes with real-world use of the intervention. Seventeen of the 30 schools were successful in providing Transitioning Together to families. Schools who had higher community socioeconomic status, higher quality family involvement, and higher quality transition planning programming before changing anything for this study were much more likely to provide this new intervention to families. Schools who used the intervention were mostly able to deliver it as designed and received positive feedback from families who participated. Common parts of the intervention that schools struggled with most included following the structure of the sessions, including group problem-solving and dialogue in the sessions, and collecting feedback from families. Future research is needed to learn how to make it even easier for public high schools and other service systems to provide this intervention to families, in a way that also maximizes its effectiveness and accessibility for historically underserved autism spectrum populations.

Parent Expectations, Deaf Youth Expectations, and Transition Goals as Predictors of Postsecondary Education Enrollment

This study used the National Longitudinal Transition Study–2 (NLTS2) data set to determine the effects of expectations and transition planning goals on the postsecondary education enrollment of deaf youth. Propensity scoring modeling results indicated that high expectations held by deaf youth and their parents significantly predicted postsecondary education attendance at 2- and 4-year college, and career and technical education (CTE) school. College enrollment as a transition planning goal for deaf youth also significantly predicted enrollment in all three types of postsecondary education institutions. Postsecondary CTE school attendance as a transition plan goal for deaf youth did not make a difference in enrollment outcomes for CTE and 2-year college, and significantly reduced their odds of attending 4-year college. Implications regarding expectations and transition plan goals are discussed.

Postsecondary Transition Planning

Understanding one of the major purposes of a student's individual education program (IEP), the postsecondary transition planning section, is key for preservice teachers. Though federal guidelines mandate the transition plan to start by age 16, many states require the development of the plan much earlier. The author believes that for some students, the transition plan is completed too late to have full effect. The chapter will give the preservice teacher the knowledge needed to understand the component of the transition plan and offer some resources and suggestions for assessments to develop the transition plan.

Youth-Centered Transition Planning for Students With Disabilities Who Experience Foster Care

Youth with disabilities who experience foster care (YDFC) often experience poor long-term adult outcomes. However, when educators help them access appropriate services and supports YDFC can reach their maximum potential. This chapter describes a youth-centered approach to transition planning for this vulnerable population and highlights essential elements to consider during the process such as disability, mental health, trauma, resilience, self-determination, culture, and how trauma impacts mental health. The chapter concludes with an example of creating a youth-centered plan, possible tools to use, and additional resources.