Patients with the pediatric neuromuscular diseases (Muscular Dystrophy, Spinal Muscular Atrophy) are surviving longer, and are requiring adult pulmonary providers to assume care with an understanding of the pediatric approach, and bridging them to adult ventilatory support. The adult onset neuromuscular disorders are also increasing in prevalence (amyotrophic lateral sclerosis), coupled with advancing technology in airway clearance and NIPPV allow us to provide these patients longer survival and greater quality of life and independence. The session will address identification of neuromuscular respiratory failure, intervention options by disease stage and bridging these patients from pediatrics to the adult environment, and life prolonging to end of life care.