Adult healthcare, therapy, and AAC

Finding adult primary care

Look for a practice willing to schedule a longer visit, not just squeeze the same 15 minutes into a bigger body. Ask directly about sensory accommodations — a quiet space to wait, being taken straight to a room, dimmed lights — and about communication support: staff who will talk to the patient first, who are comfortable with AAC, and who welcome a support person in the room without treating them as the only person in the conversation.

Vanderbilt University Medical Center’s Vanderbilt Kennedy Center publishes a Tennessee-specific guide to adult health services for people with disabilities, including how to think about finding a primary care practice, specialists, and assistive technology — a good starting point if you’re not sure where to look first. For dental care specifically, see “Dentistry for adults” below.

Dental care for adults

Ask any dental office directly whether they offer sedation dentistry, or work with an oral surgeon or hospital dental clinic that does, before you need it — not while someone is mid-appointment and overwhelmed. Ask how they handle a patient who needs more time, a quieter room, or a chance to see the tools before they’re used.

Meharry Medical College’s ABLE Clinic in Nashville is built specifically for adults with intellectual and developmental disabilities and other complex needs, with accessible treatment bays and a teledentistry intake before the first in-person visit. New patients apply first, by phone or in person, before scheduling. 615-327-6900 · 1801 Meharry Blvd, Nashville, TN 37208 · Monday–Friday, by appointment.

Tennessee’s TennCare dental benefit for adults is narrower than the EPSDT dental benefit children get automatically — it does not assume the same coverage. Confirm current adult dental coverage with TennCare or your dental plan before assuming a procedure is included.

Gynecology and reproductive health

This is general information, not medical guidance — a gynecologist or primary care provider can advise on any individual’s situation. Respectful care means the provider talks with the patient directly, explains each step before doing it, asks for consent at each part of an exam rather than assuming it once at the door, and works with however the person communicates, including AAC or a written communication passport.

Menstrual management, contraception, and reproductive health decisions belong to the adult receiving care, made with their doctor and — only where legally applicable — a supported decision-maker. If communication support, extra time, or a chaperone of a specific gender would help, say so when booking the appointment, not after arriving.

Mental healthcare

Look for a therapist who describes their practice as autism-informed or neurodiversity-affirming, and ask directly whether they’ve worked with autistic adults before — not just autistic children. Ask how they’d adapt sessions for someone who uses AAC, needs concrete language instead of open-ended questions, or communicates better in writing than out loud.

Therapy and psychiatry are different things: a psychiatrist manages medication, a therapist works through talk-based or skills-based support, and some people need one, both, or neither. Our directory lists adult mental and behavioral health providers. In a crisis, call or text 988, the Suicide & Crisis Lifeline, any time of day.

Speech therapy and AAC

Communication is a right at every age. The American Speech-Language-Hearing Association is direct about this: AAC is for anyone of any age, with no test score or skill someone has to reach first. Using AAC is not giving up on speech — ASHA’s own guidance says AAC helps develop language and can enhance speech, and plenty of people use both together.

A speech-language pathologist experienced with AAC can evaluate or re-evaluate a system as needs change — a childhood device may no longer fit. Funding can come through TennCare, ECF CHOICES, private insurance, or Vocational Rehabilitation for work-related needs. To try a device first, TTAP lends AAC and other assistive technology short- or long-term: 1-833-772-8347. See What is AAC?, how to get a device, and find adult AAC specialists in our directory.

Occupational and physical therapy

Occupational therapy for adults can cover daily-living skills, sensory-regulation strategies that still work in an adult body and an adult schedule, motor planning, and equipment or home setup that makes a task possible. Physical therapy covers mobility, positioning, pain management, and strength — useful after an injury, or as a lifelong condition changes over time. Either can help with a home safety assessment. Find adult occupational and physical therapy providers in our directory.

Feeding and swallowing care

Feeding and swallowing support usually works best as a team: a speech-language pathologist for swallowing safety, an occupational therapist for utensils, positioning, and sensory factors, a registered dietitian for nutrition, and a gastroenterologist for reflux, motility, or tube-related medical questions. This is general information, not medical instruction — a doctor or dietitian should guide any specific plan.

Adults who are tube-fed still need this team. A feeding tube changes how nutrition happens; it doesn’t end the need for a team, and needs can keep changing over time. For feeding-tube and enteral supplies, see the complex bodies hub (linked below) once it’s live.

Leaving pediatric care: a checklist

• Records. Ask for full copies of the chart before the last pediatric visit, if you can — it’s easier to request while still an established patient.
• A written summary of care from each specialist: diagnoses, what’s been tried, what worked.
• A current medication list with dosages and prescribers.
• Who signs consent now. Turning 18 doesn’t automatically require guardianship or conservatorship — supported decision-making is worth exploring before assuming full guardianship is necessary. If there is a guardian or power of attorney, make sure every new practice has that paperwork on file. See legal and financial planning for the fuller picture once that guide is live.
• Insurance changes. A TennCare category can change at 18 or 21, and private insurance dependent coverage has its own age rules — check both before assuming nothing changed.

• Is your office physically accessible — parking, entrance, exam room, an adjustable table?
• How do you communicate with patients who use AAC, don’t use speech, or need extra processing time?
• How long is a typical appointment, and can we schedule a longer one if needed?
• Can a support person, family member, or direct support professional come into the room?
• Do you offer telehealth visits?
• Do you accept TennCare or [our insurance]? Can you confirm that before the visit?
• Is there a quiet place to wait, or can we wait in the car and be texted or called?
• Will you talk directly to me about my own care, even when someone else is also in the room?