Use of the international classification of functioning, disability and health as a framework for transition from paediatric to adult healthcare.

With advances in medical technology and healthcare, an increasing number of adolescents with chronic health conditions, including childhood onset disabilities, are now surviving into adulthood (Blum et al. 1993). For adolescents with chronic health conditions growing up and becoming an adult, this important developmental stage represents a challenging period as they are at risk of delayed developmental trajectories, and face numerous barriers in achieving independence and autonomy (Stewart 2009). A recent study by Verhoof and colleagues (2011) shows indeed that adult outcomes for youth with a range of chronic conditions are in need of improvement. It must be recognized that a new generation of adolescents with chronic health conditions have conditions that can have a negative impact on their health and functioning of all the life domains, most of which are preventable. Institutional transition from paediatric to adult services, in particular from paediatric to adult health care for youth can be complex and often requires an integrated effort from the paediatric, adolescent and adult healthcare communities. According to the Society for Adolescent Medicine ‘medical transition’ is defined as a multifaceted, active process that attends to the medical, psychosocial and educational needs of adolescents as they transfer from paediatric to adult care (Betz 2007). Usually a range of healthcare providers, including physicians and allied professionals, interact with adolescents with chronic health conditions at various levels of care throughout their medical transition, requiring clear communication among with the young people, their families and among their colleagues (Callahan et al. 2001). Although there is a growing literature on transition issues and models of care, individual clinicians working with adolescents with chronic health conditions may find it difficult to address this dynamic process effectively. Many current transition programs lack of a universal language and approach to care. It is a challenge for clinicians to oversee medical transition, so it is understandable that adolescents and their families find it difficult to navigate through this process (Callahan et al. 2001). Through a recent article by Gorter (2011), it is suggested that paediatricians adopt a holistic perspective and approach to transitional care by utilizing the concepts in the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) and its Child and Youth version (ICF-CY) framework (Fig. 1) (World Health Organization 2001, 2004).