High-functioning adolescents and young adults with mitochondrial disease are now attempting transitions to postsecondary environments. This pilot and case study explores factors that interfere with their successful transition through behavior-rating scales addressing academic skills and behavior. In the Behavior Assessment System for Children, Second Edition, Spearman correlation matrices showed that students’ attitude to school was associated with depression and anxiety. Mothers’ reports linked internalizing disorders with somatic symptoms. Two case studies, with Behavior Rating Inventory of Executive Function profiles, show the role executive functions play in academic success. Attention to both cognitive and psychiatric concerns may increase success in academics and enhance the sense of well-being in older students with mitochondrial disease.
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