Adolescence and ADHD: Practical proposals regarding the transition of care

This paper aimed to provide an overview of assessment and care strategies for adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) during the transition from childhood to adulthood, so as to assist healthcare professionals in structuring transition programs within a comprehensive care pathway.

These practical proposals emerge from the 'Adolescent Transition' working group of the National Coordination for Adult ADHD which includes psychiatrists, addiction specialists, child psychiatrists, a pediatrician, a psychologist, and a users' association representative. The proposals are based on the results of a survey conducted within the Coordination, the MILESTONE study, current literature, and practitioner experiences.

Appropriate reception after the transition of care and support arrangements are essential to optimize the effectiveness of the framework and prevent the risk of disengagement. This involves placing the young person at the center of care, actively engaging them in decision-making while integrating family and support networks. Clinical assessment addresses ADHD-related complications and co-occurrent disorders (e.g., mood, anxiety, personality, neurodevelopmental disorders), adaptive strategies, self-esteem, social skills, executive functions, emotional regulation, treatment adherence, and awareness of the disorder. Psychoeducation, cognitive-behavioral therapy, emotional regulation strategies, and cognitive remediation are advised, alongside functional adaptations such as school accommodations and student support programs. Integration of ADHD care pathways across pediatrics, psychiatry, addiction services, prison healthcare, and university services supports continuity of care, structured handovers, and access to multidisciplinary resources.

The complexity of adolescence and emerging adulthood in individuals with ADHD necessitates an integrated approach that considers developmental, emotional, cognitive, and social dimensions. Early identification, continuity of care, and individualized interventions are key to improving long-term outcomes. Coordinating services across health, education, and social sectors strengthens the support system and reduces the risk of treatment discontinuity. Targeted training for adult care providers and structured transition pathways are critical to ensure the effective care.

Comprehensive assessment and tailored interventions for adolescents and young adults with ADHD, combined with family involvement and structured care pathways are essential to facilitate a successful transition to adulthood. Existing or upcoming transition programs should be evaluated so that the most effective approaches can be replicated.