Care of Adults with Chronic Childhood Conditions

This book addresses the unique healthcare needs of adults with chronic childhood illnesses. It presents a model of primary and secondary prevention for emerging adulthood: primary prevention, in which all young adults are screened for high-risk behaviors and health needs, and secondary prevention, in which young adults with chronic childhood conditions are optimized through coordinated care, connections to community resources and social/family support.

Now in its revised and expanded second edition, this book is organized in seven parts. Part I provides a detailed overview of the health care transition from pediatrics to adult medicine from both a policy and practice perspective. New topics in this section include telemedicine as a tool to optimize transition care and systems of care/models of care that include practical steps on how to get transition/transfer done or care for these patients in the appropriate setting. In Part II, the concept of emerging adulthood as a developmental period is explored and strategies for providing improved comprehensive care for this age group are discussed. A section on addressing health maintenance has been added to this edition. Part III reviews specific chronic childhood conditions, such as attention-deficit/hyperactivity disorder, autism, cystic fibrosis, and diabetes mellitus, and offers clinical cases and summary reports that can be used as a quick guides to each condition. Several new conditions have been added to this section, including metabolic issues/conditions, eating disorders, transgender medicine and childhood endocrine conditions. Section IV is a completely new section that focuses on hospital medicine. Chapters within this section include pre-op clearance, maintaining safety, neurodiversity considerations, ER issues and triaging, emergencies, contact with PCP, adult issues not addressed, pediatric issues often overlooked, inpatient transition policies, procedures, Med-Peds/Transition, palliative care/hospice and unique inpatient cases. In Part V, additional clinical considerations that are not necessarily condition-specific but are highly relevant to the care of young adults with chronic childhood conditions are examined. Part VI describes the socio-legal issues involved in caring for this population. Finally, part VII is another completely new section that focuses on public health and population considerations. Chapters in this section include telemedicine, disaster preparedness, quality improvement, health care services, mental health/psychiatry, neurodiversity and addressing equity and racism. 

Written by experts in the field, Care of Adults with Chronic Childhood Conditions, 2e provides primary care providers with a new framework for the care of young adults and identifies opportunities to influence patient health outcomes over a life trajectory.

Alice Kuo is Professor and Chief of Medicine-Pediatrics and Preventive Medicine at the David Geffen School of Medicine at UCLA and Professor of Health Policy and Management in the UCLA Fielding School of Public Health. 

Her research interests include access to and delivery of developmental services, cognitive and language development in young minority children, and services for children and adults with autism and other neurodevelopmental disabilities. She has published over 80 peer-reviewed articles and 15 book chapters and edited two books on these topics.

Since 2020, Dr. Kuo has been the Principal Investigator of the Autism Intervention Research Network on Physical Health (AIR-P, www.airpnetwork.ucla.edu). In addition to her research, Dr. Kuo has been involved in educational programs at several levels, including the Maternal and Child Health Bureau (MCHB)-funded University of California Leadership Education in Neurodevelopmental Disabilities (UC-LEND) program (www.uc-lend.med.ucla.edu) and the UCLA Maternal and Child Health Center of Excellence (www.mch.ucla.edu). At the post-graduate level, Dr. Kuo was the founding Director of the UCLA Combined Internal Medicine and Pediatrics Residency Program and led the program for 19 years, and she continues to be Director of the combined Internal Medicine/Preventive Medicine residency program at UCLA. At the national level, she was the chair of the Health Care Transition Committee for the Medicine-Pediatrics Program Directors Association for 10 years from 2012 to 2022.

Clinically, Dr. Kuo sees primary care patients of all ages and is board certified in pediatrics, internal medicine and preventive medicine. Dr. Kuo received a B.A. in biology from Harvard University, her M.D. from UCLA, her Ph.D. in educational psychology with a focus on early childhood and special education from UCLA and her M.B.A. in Healthcare Administration from the University of Massachusetts Isenberg School of Management. She completed her medicine-pediatrics residency at Cedars-Sinai Medical Center in Los Angeles and her preventive medicine training at the Centers for Disease Control and Prevention in Atlanta.

Mariecel Pilapil, MD, MPH is Associate Professor of Medicine and Pediatrics at the Zucker School of Medicine at Hofstra/Northwell. She is a primary care physician in the Divisions of General Internal Medicine and General Pediatrics and cares for patients with chronic childhood conditions across the life spectrum. She is also a Co-Director of the Complex Care Clinic in General Pediatrics at Cohen Children’s Medical Center, which is a program that cares for children with medical complexity.            

David DeLaet, M.D., M.P.H., is Associate Professor in the Department of Medicine, Division of General Internal Medicine at the University of Cincinnati College of Medicine in Cincinnati, Ohio.  He also is Adjunct Associate Professor of Clinical Medicine at the Icahn School of Medicine in New York.  Additionally, he is Associate Professor in the College of Arts and Sciences and Medical Director for the Physician Associate Studies Program at Miami University in Oxford, Ohio.  He is a Fellow of the American College of Physicians and Fellow of the American Academy of Pediatrics.  

Cynthia Peacock, M.D. is Associate Professor of Medicine and Pediatrics at Baylor College of Medicine in Houston, Texas. Dr. Peacock is the founder of the Texas Children’s Hospital-Baylor College of Medicine Transition Medicine Clinic and currently one of its Medical Directors.  She is also Section Chief of Adult Developmental Medicine in the Medicine Department at Baylor College of Medicine.  In addition, Dr. Peacock is Director of Adult Transition Medicine Program for Texas Children’s Hospital. Her expertise is on the care of adults with chronic conditions of childhood and the use of the medical home model to deliver transition health care needs.

Niraj Sharma, MD, MPH is an Assistant Professor of Internal Medicine and Pediatrics at Harvard Medical School.  He is the Director of the Medicine-Pediatrics Unit in the Brigham and Women’s Hospital (BWH) Department of Internal Medicine, Division of General Medicine.  He is also Co-Director of the BWH Transition Care Team and is the Associate Director of the Bridges Adult Transition Program at Boston Children’s Hospital (BCH).  He is also the Director Emeritus of the Internal Medicine-Pediatrics Residency Training Program at BWH/BCH.  He is a national leader in the field of transition medicine with numerous peer reviewed publications, presentations, and grants in the field.  He has built clinical programs to improve the transition process at BWH, BCH, and Mass General Brigham Health Care.  He has also held a number of national positions, including former Co-Site Directorand Cabinet Member of the Got Transition National Learning Collaborative and Director of the Medicine-Pediatrics Program Directors Association Transition Committee.