{"id":6011,"date":"2019-04-30T00:00:00","date_gmt":"2019-04-30T00:00:00","guid":{"rendered":"https:\/\/prd-www.mccdn.io\/vitals\/?p=6011"},"modified":"2025-10-16T23:55:59","modified_gmt":"2025-10-16T23:55:59","slug":"transitioning-to-adult-care-challenges-developmentally-disabled","status":"publish","type":"post","link":"https:\/\/updates-www.mccdn.io\/vitals\/transitioning-to-adult-care-challenges-developmentally-disabled\/","title":{"rendered":"Transitioning to adult care poses unique challenges for developmentally disabled","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

Ty Walker has cerebral palsy. At 18, he\u2019s legally an adult \u2014 yet with his developmental disorder, not just any medical clinic will be appropriate to his special needs.<\/p>\n

A new clinic has become a growing destination for youths and adults with developmental disabilities because, its leaders say, we can do better than a system that just spins young people and adults into the world without support.<\/p>\n

The year-old MultiCare Adult Developmental Clinic<\/a> provides a \u201cone-stop shop\u201d to medical and community connections for patients with developmental disabilities as well as their families. The clinic aims to make it easier for a pediatric patient to transition to an adult patient and maintain a network of connected providers and community resources.<\/p>\n

Walker has been concerned for some time about who will take care of him now that he\u2019s growing out of being a pediatric patient. He saw several specialists during one visit to the clinic and got referrals from the MultiCare team.<\/p>\n

\u201cI\u2019ve grown out of being with the kids, and I\u2019m ready to join the adult community,\u201d says Walker, from Spanaway. \u201cI\u2019m looking for a person I can trust. I\u2019m not an ordinary patient. I\u2019m looking for someone who is interested in my life, someone who can help me be healthy the rest of my life.\u201d<\/p>\n

The Walkers were not sure who they were going to turn to for Ty\u2019s care. And that has been a source of dread, because they have been through this before.<\/p>\n

\u201cWe have a 25-year-old developmentally disabled daughter,\u201d says Ty\u2019s father, Gerard Walker. \u201cWe have experienced the hardship and issues firsthand of trying to find care for her as an adult.\u201d<\/p>\n

The Adult Developmental Clinic was designed to support not just patients and families, but also providers who want to serve these patients and may not have a lot of experience with the developmentally disabled population.<\/p>\n

\u201cWe do a fresh 360 view of people to define their needs, and we can offer this in one clinic visit so they don\u2019t have to go to five offices all throughout town,\u201d says Alan Gill, MD<\/a>, the clinic\u2019s cofounder. \u201cWe help them with transition and connect them to both medical care and groups that can help them connect to the world for the rest of their lives.<\/p>\n

\u201cThen we help them find the care providers that they need,\u201d he continues. \u201cOur intent is to provide ongoing support, not take over all of their care.\u201d<\/p>\n

The Adult Developmental Clinic formally began last spring on the first and third Thursday of each month at MultiCare East Pierce Family Medicine in Puyallup<\/a>.<\/p>\n

\u2018We have nobody to send them to \u2026\u2019 but not anymore<\/h2>\n

Transitioning to adult care is challenging for developmentally disabled patients for many reasons. Parents and children are accustomed to the nurturing environment of a pediatric hospital such as Mary Bridge Children\u2019s Hospital, for one.<\/p>\n

These patients are then expected to graduate to an adult world where there may not be enough available primary care physicians and other providers who feel educated about, and comfortable caring for, individuals with developmental disabilities.<\/p>\n

The world could do better training care providers about that population, Dr. Gill says. And then there\u2019s the challenge of finding a specialist both appropriate and willing to take on a special population.<\/p>\n

Dr. Gill and cofounder Allyson Stoker, ARNP,<\/a> along with their allies, began the long process of developing the clinic several years ago. There were not a lot of national models. They designed a unique team by recruiting local practitioners who were already doing this work individually, bringing them together to provide a multispecialty evaluation that pulls care together for a child or adult.<\/p>\n

The way this works in practical terms: after each specialist sees a patient, they debrief with Stoker. She hears from each specialist and prepares comprehensive summaries and action items for providers and patients \u2014 a transition care plan.<\/p>\n

This is a labor of love for her. While working in her home clinic at Mary Bridge Children’s Rehabilitation Medicine<\/a>, Stoker heard story after story from frustrated parents about their children trying to enter the adult system. So she quickly signed on for the new clinic.<\/p>\n

\u201cAs my patients with cerebral palsy, for example, were getting to be 16, 17, 18, we started preparing them for the transition \u2026 and it felt like there wasn\u2019t anyone on the adult side who was ready to receive them,\u201d Stoker says. \u201cThat was heartbreaking for me because I\u2019d known these patients for many years.<\/p>\n

\u201cThey would stay with us until they were 21, 22, because there was nowhere for them to land on the other side. And I would hear over and over from the pediatricians, \u2018We have nobody to send them to.\u2019\u201d<\/p>\n

For Dr. Gill, this is personal. He has a brother, son and many patients with developmental disabilities, so he has seen firsthand many of the challenges facing this population. He and colleagues at the Tacoma Family Medicine Residency have been taking patients with developmental\u00a0disabilities for years. The numbers were becoming overwhelming.<\/p>\n

\u201cWe are clearly the largest provider of care for adults with developmental disabilities in Pierce County,\u201d Dr. Gill says. \u201cBy a long shot.\u201d<\/p>\n

What\u2019s in a transition plan?<\/h2>\n

The transition plan contains information from a lot of specialists who patients would normally have to see in several places, presumably over several days:<\/p>\n