00:00The transition from the paediatric age to the adult age is a transition that we define
00:08as a transition that involves the transition of delivery of care from the paediatric environment
00:14to the adult environment of these patients, who are very complex patients.
00:18Unfortunately, this transition is not absolutely simple, especially because in Italy, but
00:23actually also abroad, there are no structured paths that allow this transition,
00:28if not actually anecdotal, or maybe in reference centers, in level centers.
00:33And this step is made even more difficult by the fact that while in the paediatric age
00:38there is the figure of the child neuropsychiatrist, who, by training, is able to cure both
00:43epileptic crises, cognitive disabilities and behavioral problems,
00:49in the adult age this does not happen, because the neurologist, in fact, has a training
00:53to cure epileptic crises, cognitive disabilities and rehabilitation, but very often when
01:00behavioral problems are important, he needs, for example, a colleague psychiatrist
01:05who can support him.
01:06Unfortunately, there is no network for which, in the same environment where we see these
01:11patients, we have available the psychiatrist, the physiatrist, the food specialist.
01:17So, this possibility of building the network is demanded to the neurologist himself, who
01:21maybe with, let's say, personal knowledge, but also with a will, not little, is able
01:28to build this network of professional colleagues who take care of the patient to have
01:33an approach, let's say holistic, which sees at 360 degrees what a syndrome is.
01:38Syndrome, in fact, means that there is not only one symptom, but there are many symptoms
01:43and in considering the patient, we must absolutely consider them all.
01:47There would be a need for institutionalized paths, in which the transition follows a path
01:54that certainly cannot be carried out in a single moment, in a single day, but for example
02:00with structured ambulatories that start in adolescence, around 14-15 years old,
02:05they provide the ambulatory together with visits, with the presence of the child neuropsychiatrist,
02:11the neurologist and other professional figures, such as the psychiatrist, the physiatrist,
02:15but also the social worker, in some cases the psychologist is very important, and slowly
02:20accompany the patient to move towards what is the environment of the adult,
02:25so that he does not find himself in an environment where he is unknown, where he does not feel
02:30welcomed, where he does not feel understood and where clearly what is the risk is that he returns,
02:35he takes a step back to return to the pediatric environment.
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