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This study reveals that few youth with and without SHCN receive transition planning support. It underscores the need for HCPs to work with youth independently and in collaboration with parents and/or caregivers throughout adolescence to gain self-care skills and prepare for adult-focused care.

Nationally, there are low rates of high school–age youth receiving health care transition (HCT) preparation from health care providers. This pilot study implemented and assessed the use of a structured HCT process, the Six Core Elements of HCT, in two school-based health centers (SBHCs) in Washington, DC. The pilot study examined the feasibility of incorporating the Six Core Elements into routine care and identified self-care skill gaps among students. Quality improvement methods were used to customize, implement, and measure the Six Core Elements and HCT supports. After the pilot, both SBHCs demonstrated improvement in their implementation of the structured HCT process. More than half of the pilot participants reported not knowing how to find their doctor’s phone number and not knowing what a referral is. These findings indicate the need for incorporating HCT supports into SBHCs to help students build self-care skills necessary for adulthood.

Previous research has identified a coronal-to-dorsal ‘perceptual assimilation’ in which English and French listeners identify Hebrew word-initial /tl/ and /dl/ as beginning with /k/ and /g/, respectively (Hallé and Best, 2007). However, the acoustic-phonetic factors that contribute to this misperception have not been thoroughly identified, and previous results indicate that /tl/ is misperceived more often than /dl/—an asymmetry that is surprising on phonological grounds. The present study further explored this perceptual assimilation in two experiments with English listeners and Hebrew stop-liquid-vowel syllables ([t,k,d,g] × [l,ʁ] × [a,o,u]). The first experiment, which used the same stimuli as Hallé & Best, replicated previous findings, including the asymmetry between /tl/ and /dl/. The second experiment employed stimuli produced by a different native Hebrew speaker. While coronal-to-dorsal assimilation was observed, the previous /tl/-/dl/ asymmetry was not found: /dl/ was perceived as dorsal-initial somewhat more often than /tl/, suggesting that there can be no consistent phonemic or phonotactic explanation of the rate of assimilation. In support of a phonetic account, we find that misperception rates in both experiments are highly correlated (r > 0.65) with the stimulus-specific degree of anticipatory coarticulation of the lateral, as reflected in the spectral shape of the stop burst.

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