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Growing Up: Health Care for Adolescents and Young Adults With Chronic Conditions

DAVID S. ROSEN, MD, MPH
Am J Dis Child. 1992;146(8):901-902. doi:10.1001/archpedi.1992.02160200023012.
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Sir.—As a specialist in adolescent medicine with a background in both pediatrics and internal medicine, I read with great interest the editorial comments by Dr Fulginiti on pediatric care of young adults.1 In the main, I agree with the premise of Dr Fulginiti's editorial. Adolescence should be defined developmentally rather than chronologically and pediatricians should be prepared to address the health care needs of adolescents, whatever their age. In some cases, this will involve individuals in their third decade of life receiving care by pediatricians. Dr Fulginiti calls these older individuals "young adults," but, ignoring semantics, we rightly justify their ongoing pediatric care by recognizing that developmentally they are adolescents and that their health care needs are those of adolescence.

I take strong issue, however, with one point in Dr Fulginiti's editorial. Dr Fulginiti seems to imply that for individuals with chronic medical conditions, indefinite pediatric care may

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