Transition to adult services

Also called Transition, Moving to adult services, Preparing for adulthood

Children's services end at 18 and the communication support often ends with them. Here is how to carry it across the gap.

What it is

Transition is the move from children's health, education and social care to adult services, which happens somewhere between 16 and 25 depending on the service. For a person who uses AAC it is the point of maximum risk: the children's speech and language therapist who built the system signs off, the school that charged the device and knew the vocabulary is left, and the adult services on the other side may have no AAC provision at all.

Families describe it as a cliff. The description is fair.

Who it can help

Young people who use AAC or have a communication difference, from around 14, when planning should start, to 25. Their parents, who usually end up doing the joining-up. Schools and colleges with a duty to prepare the young person for adulthood. Adult services that inherit a person with a device and no idea how to support it.

It is honest to say that adult speech and language therapy for AAC is thin in many areas. Knowing that in advance is the reason to plan.

How it works

In England, the SEND Code of Practice requires preparation for adulthood to be part of every EHCP review from Year 9, and the EHCP itself can run to 25 in education. The Care Act requires the council to assess a young person's adult care needs before they turn 18, if it is likely they will have them, and NICE guideline NG43 sets out how health transition should work: a named worker, planning from 13 or 14, and a handover meeting.

The communication pieces that need to cross the gap are specific. Who owns the device and who will fund the next one; see funding a communication aid. Who will be the speech and language therapist, and whether the specialised AAC service will stay involved. Who will update the vocabulary when the person leaves school and their life changes. Where the communication passport and the low-tech backup go. And the young person's own voice in all of it; see self-advocacy.

Getting started

This week, if the young person is 14 or over, write a list of every piece of communication support they have and who provides it. Next to each, write who will provide it after 18. Every blank is an action.

Ask at the next EHCP review for AAC to be written into the preparing-for-adulthood outcomes, with named provision. Ask the children's speech and language therapist, in writing, what the adult referral route is in your area and when they will make it.

Get the young person's vocabulary ready for adult life: college, work, money, travel, relationships. See adult vocabulary. And make sure the device is registered in the young person's name, not the school's.

Where to get help

IPSEA advises on EHCPs beyond 16 and on transition law. Council for Disabled Children publishes guidance on preparing for adulthood. Contact supports families through transition. Mencap covers adult social care for people with a learning disability. Communication Matters can point to the adult AAC service in your area. NICE guideline NG43 is the health standard and is short enough to take to a meeting.