Adolescent Health Transition Project
General Resources

Transition Big Picture

group of females in a circleTeens and young adults who have chronic illness, physical disability or developmental disability are a diverse group, but all need quality health care and educational supports to transition to adult life and be successful in attaining their maximal level of independence and participation in the community.

Youth whose disabilities require specialized instruction in school and those who have a disability that is categorically eligible, qualify for Special Education services. This group includes youth with diagnoses ranging from learning disabilities to severe intellectual and physical disabilities. IDEA 2004, the federal law that secures special education services for children with disabilities, mandates that Special Education students receive transition services. These services are provided through the Transition IEP, which must be initiated by the beginning of the school year in which the student turns 16. Some states require this service begin at age 14, but Washington State follows the federal mandate of 16.

There is no specific requirement for health issues to be included in the Transition IEP, but health is increasingly being recognized as an important and relevant component of planning for the future of students in Special Education. The Transition and School section of this website offers resources for IEP teams and parents to utilize in thinking about and planning for including health issues and health needs in the transition plan. A young person whose disability or health condition does not qualify them for Special Education may still qualify for reasonable accommodations under Section 504 of the Rehabilitation Act. Schools and school districts vary group of male teenswidely in the degree to which they initiate 504 accommodations. One reason for this lack of enthusiasm is the fact that there are no funds provided to states for implementation of these accommodations. When a student asks for accommodations under Section 504, districts usually document their actions in an individualized plan called a 504 Plan. The plan provides only for what is necessary to allow the student equal access to all of the educational opportunities the typical student has access to as part of their school experience. There is no requirement to provide any planning for future needs or transition to adulthood in a 504 Plan.

Similarly, students who have health conditions may have an Individualized Health Plan (IHP) (sometimes this doubles as the 504 Plan), but the IHP is designed to make sure the student is safe and healthy during school hours. There is no mandate to plan for the future in the IHP. Often the IEP team members view health issues as the purview of the family and school nurse and not relevant to the educational plan. The school nurse may see the relevance of student health needs to student outcomes in post-school life, but low staffing levels frequently leave the school nurse little time for doing more than maintaining a minimum level of safety for students during the school day.

In summary, the Special Education Student will have a Transition IEP by age 16, which may or may not address issues related to the student’s health. Other students are unlikely to have any such planning or preparation. Parents of students with health conditions or disabilities which do not qualify them for Special Education may be caught entirely by surprise when school ends at age 18 and their son or daughter has gaps in the skills necessary for independence and self care. The need to transition to adult oriented health care may be even further down the list of priorities or concerns for these parents.


This project is housed at the Center on Human Development and Disability (CHDD) at the University of Washington
Box 357920, Seattle, WA 98195-7920 | 206.685.1350 | Fax: 206.598.7815
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