“I’m Not Trying to Be Difficult When I Can’t Do Things”: A Mixed Methods Look at Transitioning from Pediatric to Adult Health Care on the Autism Spectrum



For young adults on the autism spectrum, navigating the transition from pediatric to adult healthcare can be a daunting experience. Familiar routines and trusted healthcare providers are swapped for new environments and unfamiliar faces. A recent study published in June 2024 sheds light on the specific challenges autistic young adults face during this critical healthcare shift.

The research, titled “I’m Not Trying to Be Difficult When I Can’t Do Things”: A Mixed Methods Look at Transitioning from Pediatric to Adult Health Care on the Autism Spectrum employed a mixed methods approach, combining quantitative and qualitative data. This approach provided a deeper understanding of the experiences of autistic young adults transitioning to adult healthcare.

Communication: A Double-Edged Sword


Communication plays a central role in navigating the healthcare system. However, for autistic individuals, whose communication styles may differ from neurotypical expectations, this can be a significant hurdle. The study found that autistic young adults often experience:

  • Misunderstandings: Differences in communication style can lead to misunderstandings between patients and healthcare providers. Autistic individuals may struggle to articulate their needs clearly, while healthcare providers may misinterpret social cues or communication patterns.
  • Frustration: These misunderstandings can lead to frustration on both sides. Autistic young adults may feel unheard or dismissed, while healthcare providers may struggle to connect with their patients.

Beyond Communication: A Lack of Awareness


The research also identified a concerning lack of awareness among some healthcare providers regarding autism spectrum disorder (ASD). This limited understanding can hinder the ability of providers to deliver sensitive and appropriate care. Here’s how a lack of awareness can manifest:

  • Misdiagnosis or Missed Diagnoses: Without a strong understanding of the spectrum of presentations of ASD, healthcare providers may miss crucial diagnoses or misinterpret symptoms.
  • Inappropriate Treatment Approaches: Healthcare interventions that are not tailored to the specific needs of autistic individuals may be ineffective or even counterproductive.

The title of the research paper itself, “I’m Not Trying to Be Difficult When I Can’t Do Things”, powerfully captures the feeling of frustration experienced by autistic young adults who feel their concerns are not being taken seriously. This sentiment underscores the urgent need for improved communication, empathy, and awareness within the healthcare system.

Shifting the Focus: The Importance of a Smooth Transition


A smooth transition from pediatric to adult healthcare is crucial for autistic young adults to maintain and improve their health outcomes. The study highlights several key areas for improvement:

  • Increased Provider Training: Equipping healthcare providers with a better understanding of ASD, including its diverse presentations and sensory sensitivities, can significantly improve patient interactions. Training programs should address communication strategies, best practices for patient engagement, and recognizing and addressing potential sensory overload triggers in healthcare settings.
  • Patient-Centered Care: Moving away from a “one-size-fits-all” approach and creating a healthcare environment that is tailored to the specific needs and preferences of autistic individuals is essential. This might involve offering alternative communication methods, such as visual aids or written communication tools. Additionally, providing sensory-calming tools in waiting rooms or examination rooms can create a more comfortable environment for autistic patients.
  • Open Communication: Encouraging open and honest communication between autistic young adults, their caregivers (if applicable) and healthcare providers is vital for ensuring all parties are on the same page. This might involve incorporating communication techniques that cater to the autistic individual’s preferred communication style.

Building a More Inclusive Healthcare System: The Road Ahead


The research provides valuable insights into the challenges faced by autistic young adults during the transition to adult healthcare. By implementing the suggested strategies, healthcare providers and institutions can begin to create a more inclusive and supportive environment for all patients. This includes:

  • Advocacy: Autistic young adults and their families can play a crucial role in advocating for change within the healthcare system. Sharing their experiences and working with healthcare providers can help raise awareness and promote positive change.
  • Collaboration: Collaboration between healthcare providers, autistic individuals, and advocacy groups is essential to develop effective strategies and best practices for supporting autistic patients throughout their healthcare journey.

By working together, we can create a healthcare system that is truly inclusive and welcoming for all, regardless of neurodiversity.



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