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Child-to-adult transition: a survey of current practices within the European Reference Network for Rare Neurological
Lorenzo Nanetti1, Mary Kearney2, Sylvia Boesch3
1Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133, Milan, Italy.
Insights
Healthcare transition for youth with rare neurological diseases varies significantly across European centers. Standardized transition protocols are uncommon, highlighting challenges in managing this critical care phase.
Area of Science:
- Neurology
- Pediatric Healthcare
- Rare Diseases
Background:
- The transition from pediatric to adult healthcare is crucial for young individuals with chronic conditions, especially rare neurological disorders.
- This process involves addressing medical, psychological, and educational needs to foster patient autonomy.
Purpose of the Study:
- To assess current practices for the child-to-adult healthcare transition in centers within the European Reference Network for Rare Neurological Diseases (ERN-RND).
Main Methods:
- A 20-question survey was developed by the ERN-RND working group to evaluate transition procedures.
- The questionnaire was distributed to healthcare providers (HCPs) within the ERN-RND network.
Main Results:
- Twenty ERN-RND members from 10 European countries participated (75% neurologists, 25% pediatricians).
- Transition typically occurs between 16-18 years, but pediatricians often continue care beyond 40 years.
- Only 5 out of 20 centers utilize a standardized transition procedure; others manage it ad-hoc.
Conclusions:
- Significant variability exists in transition practices among ERN-RND centers.
- The study provides data on current transition programs and identifies challenges in managing rare neurological disorder patient transitions.
Background:
Transition from child-centered to adult-centered healthcare is a gradual process that addresses the medical, psychological, and educational needs of young people in the management of their autonomy in making decisions about their health and their future clinical assistance. This transfer is challenging across all chronic diseases but can be particularly arduous in rare neurological conditions.
Aim:
To describe the current practice on the transition process for young patients in centers participating in the European Reference Network for Rare Neurological Diseases (ERN-RND).
Methods:
Members of the ERN-RND working group developed a questionnaire considering child-to-adult transition issues and procedures in current clinical practice. The questionnaire included 20 questions and was sent to members of the health care providers (HCPs) participating in the network.
Results:
Twenty ERN-RND members (75% adult neurologists; 25% pediatricians; 5% nurses or study coordinators) responded to the survey, representing 10 European countries. Transition usually occurs between 16 and 18 years of age, but 55% of pediatric HCPs continue to care for their patients until they reach 40 years of age or older. In 5/20 ERN-RND centers, a standardized procedure managing transition is currently adopted, whereas in the remaining centers, the transition from youth to adult service is usually assisted by pediatricians as part of their clinical practice.
Conclusions:
This survey demonstrated significant variations in clinical practice between different centers within the ERN-RND network. It provided valuable data on existing transition programs and highlighted key challenges in managing transitions for patients with rare neurological disorders.
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