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TYPE OF TOOL
NAME OF TOOL AND DESCRIPTION
WHERE TO FIND
ASSESSMENT
Assessment: Comprehensive across developmental continuum HRTW-KY Life Maps
Life Maps
are developmentally appropriate transition questionnaires that allow families and young people to identify their own individual needs. The Life Maps cover a range of topics from health promotion and health problem management to independence and work issues and transition to adult health care. These clinical tools encourage staff to provide family-centered care that focuses on the individual needs of the young person. Families, youth, and clinicians can document directly on the tool.

chs.ky.gov/
commissionkids


Click on Youth Transitions on Left side and scroll down to Life Maps

Life Maps:
Infant
Toddler
School Age
11-13
14-16
17-21
Care Giver
Older

All Life Maps and related Teaching Sheets are on the website at http://chfs.ky.gov/ccshcn

Assessment: Comprehensive across the developmental continuum KY Transition Checklist
This Developmental Transition Checklist has been integrated into the Title V program’s computerized record system and is provided as an example of a developmental provider checklist that is built into the computerized documentation system.
Kentucky Transition Developmental Checklist [doc]
Assessment: Comprehensive across developmental continuum: Condition specific Developmental Pathways
Shriners Hospital for Children - LexingtonThese parent/youth completed assessment tools were specifically developed to identify the comprehensive unmet needs of children and youth with specific of orthopedic conditions (CP, JRA, Spina Bifida, and other orthopedic conditions) across the developmental continuum. They are designed to help families and youth consider developmentally appropriate expectations that prepare the child/youth for a successful transition into adult systems of care. These tools also provide the clinician with space to document interventions and track outcomes.
shrinershq.org/choices/
Assessment: Comprehensive, Transition focused
HRTW-OH Transition Profile
This profile is a user friendly, at a glance, assessment of what a student has already accomplished for transition and what still needs to be done. It can be used for initial and updated assessment. It also is a prompt to review the wide range of adult life domains including education, employment, health care, long term housing, community connections, and government supports. It can be used with families and youth or as a joint planning tool with school and professionals.
Adolescent Transition Profile
[word] [pdf]
Young adult 13 –15 and16-21 transition assessment
Shriners Hospitals for Children (SHC) - Intermountain These two tools, one designed for younger teens and one for the older youth are comprehensive and patterned after the KY Life Maps and Lexington SHC Hospital Developmental Care Plans. The range of topics includes health promotion and health problem management, independence and work issues and transition to adult health care. Youth can complete these tools and discuss with their care coordinator. These tools have been selected by SHC as model assessment tools.
Transition Assessment 13-15
[word] [pdf]

Transition Assessment 16-21
[word] [pdf]
Assessment: Comprehensive, Transition issues "Transitioning to Independence: How Ready Are You?"
Shriners Hospital for Children - Northern CaliforniaThis short 2-page screening/assessment tool focuses on identifying if youth have developed the skills they need to proactively manage their own health and health care and are planning for their educational/vocational future. Available in English and Spanish.
Transitioning to Independence: How Ready Are You (English)
[word] [pdf]

Transitioning to Independence: How Ready Are You (Spanish)
[word] [pdf]
Assessment: Health focused Are You Ready to Manage Your Own Health Care?
There are two versions, one for youth with physical and one for youth with mental health conditions. These tools identify specific skills that must be mastered to effectively manage health and allow the youth and/or provider/family to assess if these skills have been developed.
communityinclusion.org/
transition/familyguide.html


communityinclusion.org/
transition/pdf/
moreresources.pdf

(pages 6 and 7 of this pdf file – pages 58-59 of booklet)

Mental Health Checklist
cmhn.org/checklist.pdf
Assessment:Youth transition assessment and planning tools New Mexico CMS
Youth Transition Plan
in English and Spanish
Comprehensive checklist from New Mexico’s Children’s Medical Services including health knowledge, daily living, education and employment, living arrangements, transportation, recreation/social relationships, emergency plans, and record keeping.

Making the most of your transition from adolescence to adulthood
Booklet with variety of checklists related to health care, education, employment, recreation with list of NM resources – adaptable for other states.
Youth Transition Plan (English)
[word] [pdf]

Youth Transition Plan (Spanish)
[word] [pdf]

Transition Booklet
[word] [pdf]
Assessment: Health Skills Health Skills Checklist
One-page list of health care skills that youth with chronic illness and disabilities can use to determine what they know and what they need to practice.
4girls.gov/4girls.cfm?
page=disability/
med_health_chart.htm
Assessment: Autonomy Washington Adolescent Health Transition Project (AHTP)Adolescent Autonomy Checklist
These checklists developed by the Youth In Transition Project (1984-1987) at the University of Washington Division of Adolescent Medicine based on a model developed by the Children's Rehabilitation Center at the University of Virginia can be used by youth, families and providers to measure progress towards developing the skills necessary for adult independence.
depts.washington.edu/
healthtr/index.html
Assessment: Life Skills Casey Life Skills Assessments
Free on-line Life Skills assessments for age groups between 11 and 25. In English, Spanish, and French.
Also available are Life Skills Guidebooks and manuals for programming.
caseylifeskills.org/
Assessment: Health and Independence - focused self - assessment HRTW-AZ Arizona Racing to the FutureMedical Teaching Exam
List of questions for youth to complete as they get ready to see the doctor

Youth Transition Survey: 8-page self assessment tool for youth
How Well Do You Know Yourself?
[word] [pdf]

Youth Transition Survey
[word] [pdf]
 

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The HRTW Center is headquartered at the Maine State Title V CSHN Program. Activities are coordinated through the Maine Support Network's Center for Self-Determination, Health and Policy. The Center is funded through a cooperative agreement (U39MC06899-01-00) from the Integrated Services Branch, Division of Services for Children with Special Health Care Needs (DSCSHN) in the Federal Maternal and Child Health Bureau (MCHB), Health Resources and Service Administration (HRSA), Department of Health and Human Services (DHHS).
Lynda Honberg, HRSA/MCHB Project Officer.