Service access for youth with neurodevelopmental disabilities transitioning to adulthood: service providers' and decision-makers' perspectives on barriers, facilitators and policy recommendations.

Introduction: Youth with Neurodevelopmental Disabilities (NDD) who are transitioning to adulthood often struggle with accessing services. This limited access can result in poorer health, reduced ability to perform daily activities and engage in independent living and decreased levels of participation in society. Despite Canada's commitment to the UN Convention on the Rights of Persons with Disabilities, British Columbia (BC) youth with NDD face additional barriers. Methods: This study investigated service providers' and decision-makers' perspectives on barriers, facilitators and policy recommendations for accessing BC's health, education and disability services for youth with NDD. We conducted a qualitative descriptive study with 15 semi-structured interviews. We conducted inductive thematic coding to generate themes, which we then organized and interpreted using Bronfenbrenner's ecological model. Results: Findings revealed that fragmented organizational structures, eligibility criteria, limited and unstable funding and enduring stigma impede service access, while coordinated inter-agency collaboration, clear transition planning and early, family-centered interventions may improve outcomes. Discussion: Targeted policy reforms across multiple ecological levels are essential to reduce inequities in service access and strengthen the continuum of support for youth with NDD as they transition to adulthood.