Growth Milestones - 14 Years
| "The Age of Rapid Changes" |
| | During middle adolescence, puberty is well underway, and is complete in many teenagers. There is a decreased preoccupation with the body and an increased involvement with peers. Parental conflicts develop over independence, since the peer group often serves as the adolescent's reference for their standards of behavior. This age is often called the neglected age of pediatrics, according to pediatrician William Crook, M.D. "It is 'no man's land' between childhood and adulthood." The maturing teen does not want to be treated like a child, and often balks at having to go to the "baby doctor" for checkups. Yet, at the same time, the adolescent does not want to go to a new adult physician who may be unfamiliar with issues important to this age group. The result is that often the youngster ends up going to neither. This is unfortunate since middle adolescence is a period of rapid development during which time checkups are important. This can be a difficult time for parents, who must cope with their adolescent while trying to keep the channel of communication open. Love your teen with no strings attached. Parents do best when they understand the normal characteristics of the middle teen years, otherwise known as the five "I"'s and six "M"'s (courtesy of the Parent and Child Guidance Center, Pittsburg, Pennsylvania) The five "I's" - Impulsive
- Intense
- Idealistic
- Immediate (wanting everything now)
- Industructable (thinking nothing can hurt them, they can not get pregnant, they will not get into an auto accident, etc.)
The six "M's": - Moody
- Messy
- Monosyllabic
- Mouthy
- Money-oriented
- ME-centered.
| Parenting and Behavioral - Basic survival strategies for parents of adolescents are (courtesy of the Parent and Child Guidance Center, Pittsburg, Pennsylvania):
1. Choose your battles carefully. Settle for something less than perfection on issues that don't really matter. Remain calm, and don't match his/her level of emotional intensity.
2. Be available to your adolescent without directing or controlling him/her. The time when they want you is often at teen's choosing, not yours. Be there if possible.
3. Help him/her regulate his/her lifeand consider alternatives.
4. Establish networks with parents of your teen's friends, even if they are new to you.
5. Let teens know they can always call you when in trouble, without fear of recrimination. - Parents should remember that adolescents can be especially worried about their bodies, diets and sexual abilities. Will they be normal? Can they perform? How will others perceive them? Parents need to remember that the adolescent's interest in body changes and sexual topics is a natural, normal development and does not necessarily indicate movement into sexual activity. One must take care not to label emerging instinct/behaviors as "wrong," "sick" or "immoral." ." Nor should parents jump to conclusions about behaviors based soley on hunches or feelings.
- Increased emotionality is a hallmark of the period. Teens can be excessively modest, insecure and feel isolated and alone, as they discover the tenuousness of their peer relationships.
- Adolescents usually require privacy in which to contemplate changes taking place within their own bodies. Ideally the youth should be allowed to have his/her own room, but if this is not possible some private space needs to be made available so the teen can go and not be bothered by older or younger siblings or parents!
- Teasing an adolescent child about physical changes is inappropriate, because it may cause self-consciousness and embarrassment.
- The teenager's quest for independence is normal development and need not be looked upon by the parent as rejection or a loss of control. Examples include (1) young teenagers may not want to join the family on all family outings; (2) Young teens may not want their parents around the school at social functions as chaperones; (3) Young teens may begin to confide in an adult outside the family rather than in mothers or fathers as in previous years.
- To be of most benefit to the growing adolescent, parents need to remain a constant and consistent figure, available as a sounding board for the youth's ideas without dominating and overtaking the emerging, independent identity of the young person.
- Most 14-year olds focus on social life, friends and school. They have chosen friendships with members of the same sex. Sometimes, a teenager's best friends becomes a parent substitute and confidante. These friendships, however, may change abruptly, causing hurt feelings.
- Teens need to learn to respect the rights and needs of others, follow family rules, such as those for curfews, television viewing, and chores. Share in household chores.
- Parents need to serve as a positive ethical and behavioral role model.
- Teach the adolescent techniques for resisting peer pressure.
- Parents should learn the signs of adolescent depression and drug abuse!
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| Characteristics of the "teen friendly" parent: - Praises, approves, supports and shows interest in their adolescent. Attends events in which their son or daughter is a participant.
- Encourages reasonable independence, friendships and interests outside of the home.
- Finds time to be with and listen to the adolescent.
- Is a good ethical and behavorial model.
- Establishes realistic expectations for family rules, with increasing responsibility given to the adolescent.
- Establish and communicate clear limits and consequences for breaking rules. Does not repeatedly warn or threaten. Simply follows the protocol already agreed upon and is consistent.
- Is present at home or makes arrangements for the adolescent's supervision in their absence.
- Assigns chores around the home and provides an allowance.
- Demonstrate interest in the adolescent's school activities and emphasize the importance of school.
- Takes pleasure in their son's or daughter's abilities and achievements
- Respects the adolescent's privacy - bedroom, bathroom, mail, phone calls.
- Enhances the teens self-esteem by providing praise and recognizing positive behavior and achievements.
- Minimizes criticism, nagging, derogatory comments, and other belittling or demeaning messages.
- Is not necessarily the teens best friend. Remembers that their role is to teach and parent
- Shows respect for their teen. Listens to their side without interrupting or judging.
- Gets to know their teen's friends, and avoids making quick judgments based on appearance only. Whenever possible, avoids downgrading their friends.
- Encourages their son or daughter to invite peers home.
- Allows their son or daughter to make age-appropriate decisions and selections (for example, choosing clothes).
- Involves their teen in decision making regarding their role in family chores, supervision of younger sibling, etc.
- Assumes a role in the teen's sex education, perhaps with the help of books recommended by the physician
| Traits of the adolescent who is doing well: - Is in good health or functions up to capacity if has a chronic condition; has good food habits.
- Believes he/she will do well.
- Has self-confidence and a sense of pride and competence.
- Enjoys close interactions with peers (especially same-sex friendships).
- Enjoys recreational activities.
- Recognizes the need for rules and fair play.
- Is energetic, enthusiastic and vital.
- Has reasonable athletic ability.
- Has dramatic, artistic or musical talents.
- Does well in school.
- Takes appropriate responsibility for homework with little prodding.
- Assumes responsibility for his/her own health.
- Is comfortable in asking parents questions.
- Generally cooperative and considerate, although at times is inconsistent and unpredictable
How to talk so your teen will listen Respect - getting what you give Tips for raising teenagers |
Oral Health for the Adolescent - Brushes teeth twice a day with a fluoridated toothpaste and flosses daily.
- Knows what to do in the cause of a dental emergency, especially the loss or fracture of a tooth.
- Has seen a dentist within the last six months unless your dentist determines otherwise based on his/her individual needs/susceptibility to disease
- Does not smoke or use chewing tobacco.
| | Nutrition for the Adolescent 14-year olds seem to eat continuously and appetite rarely is a problem. Unfortunately, many 14 and 15 year olds consume fast foods daily. They eat snacks that are high in calories and fat. - Eat three meals per day. Breakfast is especially important. Do your best to make sure your 14-year old has a nutritious breakfast daily.
- Choose a variety of healthy foods.
- Choose nutritious snacks rich in complex carbohydrates. Limit high-fat or low-nutrient foods and beverages such as candy, chips or soft drinks.
- Choose plenty of fruits and vegetables; breads, cereals and other grain products; low-fat dairy products; lean meats; and foods prepared with little or no fat. Include foods rich in calcium and iron in your diet. Girls may suffer anemia at this time so make sure they are receiving sufficient iron in their diet to replace menstrual losses.
- Select a nutritious meal from the school cafeteria or pack a balanced lunch.
- At this age it is especially important to evaluate your 14-year old's food consumption in relation to the amount of exercise they do. Obesity can be a problem in 14 and 15 year olds. Studies have shown that children who are overweight at this age group have a great chance of being overweight as an adult. Achieve and maintain a healthy weight. Manage weight through appropriate eating habits and regular exercise.
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| *Annual flu vaccines for children with
chronic illnesses like asthma, diabetes and
heart defects. Check with your
doctor. *Vision and hearing, as well as blood
and urine and blood pressure are usually checked at this visit. Other screening done at this age may include a tuberculin test (if indicated). If there is a family history of elevated cholesterol, some physicians will also obtain a screening blood test. *Measure and plot on a standard chart the adolescent’s height and weight. Determine the body mass index. (BMI)
If an adolescent has a BMI >95th percentile for age and gender, or <> *Special referrals should be considered at this age for;
(1) adolescent girls who have not begun breast development or boys who have not experienced testicular enlargement,
(2) Boys or girls who do not follow the normal pattern of pubertal development (for example, menstruation before breast development)
(3) Families that are in prolong conflict - some turbulence is expected in all families, but a decline in the families ability to communicate or prolonged conflict should not be expected.
(4) The adolescent who is a loner |
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Sexuality for the Adolescent - Find a supportive adult who can give you accurate information about sex.
- Ask your doctor about any questions you have about body changes during puberty, including variations from individual to individual.
- Ask any questions you have about birth control or sexually transmitted diseases.
- Having sexual feelings is normal, but you should wait to have sex.
- Not having sexual intercourse is the safest way to prevent pregnancy. and sexually transmitted diseases, including HIV infection/AIDS.
- Learn about ways to say no to sex. If you have already said "yes," talk with your doctor about ways to prevent pregnancy and STDs.
- Pay attention to personal safety from physical or sexual assault (that is, do not accept rides from or hitchhike with strangers.
Talking to teens about sexuality Are you an askable parent? It's time for the big talk - now what? Say "No" to substance use/abuse - Do not smoke, use smokeless tobacco, drink alcohol, or use drugs, diet pills, or steroids. Do not become involved in selling drugs.
- If you smoke, discuss smoking cessation with the health professional.
- Avoid situations where drugs or alcohol are easily available.
- Support friends who choose not to use tobacco, alcohol, drugs,
steroids or diet pills. - Become a peer counselor to
prevent substance abuse.
Health Promotion - Get adequate sleep.
- Exercise vigorously at least three times per week. Encourage friends and family members to exercise.
- Discuss with the health professional
or your coach athletic conditioning, weight training, fluids and weight
gain or loss. - Limit television viewing to an average of one hour per day.
Children riding in Pickup Trucks Ask your neighbor if there is a gun in the house Help steer kids away from alcohol How to choose a safe car for your teen Protect your ears: Turn the radio down | | | | |
Growth Milestones - 16 years
"Friends, Clothes, Music, and More!"
| By the age of 16, most girls have completed the changes associated with puberty and have menstrual periods, and most boys are well on their way to finishing pubertal development, having gained muscle mass and strength as well as secondary sexual characteristics. Questions about identity center on "Who am I?" as 16 year olds sort out values and beliefs in their quest for a clearer sense of self. As friends assume greater importance, 16 year olds spend less time with their families. Teens of this age are extremely sensitive to the social norms of the peer group, including choices in dress, hairstyle, vocabulary and music. They tend to have a small group of friends who share similar values and behaviors. As adolescents deal with issues of independence, they continue to test rules and question authority. Sixteen year olds often become extremely opinionated and challenging, which frequently results in family conflict, especially over issues such as dress, music and social etiquette. New activities such as driving and dating require negotiating additional family rules. When at home, adolescents often seek privacy in their rooms. Middle adolescents have reached the legal age to drive in most states, gaining a mobility that offers risks as well as new opportunities and choices. Shopping malls and fast food restaurants become popular adolescent gathering places. With their increasing mobility and independence, there is potential for exploration of risky behaviors. Substance use and sexual activity increase with each successive year of high school. By 12th grade, almost 87 percent of students have used alcohol, with 39 percent reporting at least one episode of heavy drinking the previous month. Slighly more than 40 percent of seniors report having used marijuana, and more than 8 percent report having used cocaine. By 12th grade, 30 percent of students report occasional use of tobacco, with almost 16 percent smoking frequently. Many regular smokers report some failed efforts to quit. Chewing or smokeless tobacco poses the risk of oral cancer. Alcohol and drugs are major factors in deaths among adolescents, contributing to motor vehicle crashes, homicides and suicides. |
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Parenting and Behavioral - Parents must remember that times are different from those they knew as teenagers. Your adolescent has many more and new obstacles to overcome than you did while still going through the same physical and emotional changes.
- This can be an extremely difficult time. Parents must learn to cope with their adolescent while trying to keep the channel of communication open. Love with no strings attached. You will find yourself growing in wisdom as you struggle with the issues that teenagers force parents to face.
- Basic survival strategies for parents of adolescents are:
1. Choose your battles carefully. Settle for something less than perfection on issues that don't really matter. Remain calm, and don't match your teenager's level of emotional intensity. - 2. Be available to your adolescent without directing or controlling him or her. The time when he or she will want you is often at the teen's choosing, not yours. Be there if possible.
3. Help your teen regulate his or her lifeand consider alternatives.
4. Establish networks with parents of your teen's friends, even if they are new to you.
5. Let teens know they can always call you when in trouble, without fear of recrimination. (courtesy of the Parent and Child Guidance Center, Pittsburg, Pennsylvania) - Feelings of sadness and depression should not be dismissed as "normal" moodiness during this period. Situational losses—including the death of a pet, problems with girlfriends or boyfriends, school failure and parental disappointment—can lead to depression and even suicide. More than one-fourth of high school students during the past year have thought seriously about committing suicide, and more than 8 percent have actually attempted it.
- Effective education in the areas of sex, contraceptives, drugs, alcohol and cigarettes is extremely important. The AIDS problem has increased the importance of educating your child. It is appropriate and important to express your own moral values about these subjects. But try to be flexible and open-minded. Let your child ask questions and express his or her feelings without fear of judgment or punishment.
- Remember, peer acceptance is extremely important to your adolescent. The group sets their standards for behavior and rejection can be devastating. Listen to your child when situations occur that separate him or her from the group. You do not necessarily have to offer advice. Although it is often difficult, learn to adjust to the variations in hair and clothing. Try your best to be flexible.
- Adolescents usually require privacy in which to contemplate changes taking place within their own bodies. Ideally the youth should be allowed to have his or her own room, but if this is not possible some private space needs to be made available so the teen can go and not be bothered by older or younger siblings or parents!
- The teenager's quest for independence is a normal development and need not be looked upon by the parent as rejection or a loss of control. Examples include (1) young teenagers may not want to join the family on all family outings; (2) Young teens may not want their parents around the school at social functions as chaperones; (3) Young teens may begin to confide in an adult outside the family rather than in mothers or fathers as in previous years.
- To be of most benefit to the growing adolescent, parents need to remain a constant and consistent figure, available as a sounding board for the youth's ideas without dominating and overtaking the emerging, independent identity of the young person.
- Teens need to learn to respect the rights and needs of others. They should follow family rules, such as those for curfews, television viewing and chores, and share in household chores.
- Parents need to serve as a positive ethical and behavioral role model.
- Teach your teen techniques for resisting peer pressure.
- Discuss with your adolescent possible contingency plans in the event that a car trip is necessary and the adolescent (or the person who is driving) is drunk or has taken drugs.
- Parents should learn the signs of adolescent depression and drug abuse!
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Characteristics of the "Teen Friendly" Parents: - Praises, approves, supports and shows interest in their adolescent. Attends events in which their son or daughter is a participant.
- Encourages reasonable independence, friendships and interests outside of the home.
- Finds time to be with and listen to their adolescent.
- Establishes realistic expectations for family rules, with increasing responsibility given to the adolescent.
- Establishes and communicates clear limits and consequences for breaking rules. Does not repeatedly warn or threaten. Simply follows the protocol already agreed upon and is consistent.
- Assigns chores around the home and provides an allowance.
- Demonstrates an interest in the adolescent's school activities and emphasizes the importance of school.
- Takes pleasure in their son's or daughter's abilities and achievements.
- Respects the adolescent's privacy - bedroom, bathroom, mail, phone calls.
- Enhances the teens self-esteem by providing praise and recognizing positive behavior and achievements.
- Minimizes criticism, nagging, derogatory comments and other belittling or demeaning messages.
- Is not necessarily the teens best friend. Remembers that their role is to teach and parent.
- Shows respect for their teen. Listens to his or her side without interrupting or judging.
- Gets to know their teen's friends, and avoids making quick judgments based on appearances only.. Whenever possible, avoids downgrading their teen's friends.
- Encourages their son or daughter to invite peers home.
- Allows their son or daughter to make age-appropriate decisions and selections (for example, choosing clothes).
- Involves their teen in decision making regarding their role in family chores, supervision of younger sibling, etc.
- Assumes a role in the teen's sex education, perhaps with the help of books recommended by the physician.
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Traits of the Adolescent Who Is Doing Well: - Is in good health and has good food habits.
- Believes that he or she will do well.
- Has self-confidence and a sense of pride and competence.
- Enjoys close interactions with peers (especially same-sex friendships).
- Enjoys recreational activities.
- Recognizes the need for rules and fair play.
- Is energetic, enthusiastic and vital.
- Has reasonable athletic ability.
- Has dramatic, artistic or musical talents.
- Does well in school.
- Takes appropriate responsibility for homework with little prodding.
- Assumes responsibility for his or her own health.
- Is comfortable in asking parents questions.
- Generally cooperative and considerate, although at times is inconsistent and unpredictable.
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Oral Health for the Adolescent - Brushes teeth twice a day with a pea-size amount of fluoridated toothpaste and flosses daily.
- Takes fluoride supplements as recommended by the health professional based on the level of fluoride in your drinking water.
- Knows how to handle dental emergencies, especially the loss or fracture of a tooth.
- Has seen a dentist within the last six months, unless your dentist determines otherwise based on his or her individual needs/susceptibility to disease.
- Does not smoke or use chewing tobacco.
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| Nutrition for the Adolescent 16-year olds seem to eat continuously! But many eat an inadequate diet, and others are always on a diet. Many teens, especially females, are obsessed with physical appearance. Crash and fad dieting are common responses to the obsession with self-image. As a result, some teens become too thin. Like being overweight, eating disorders such as bulimia or anorexia are common during adolescence. - Make sure your teenager eats three meals per day. Breakfast is especially important. Meals should be eaten with the family or residential group on a regular basis.
- Choose and prepare a variety of healthy foods.
- Choose nutritious snacks rich in complex carbohydrates. Limit high-fat or low-nutrient foods and beverages such as candy, chips or soft drinks.
- Choose plenty of fruits and vegetables; breads, cereals, and other grain products; low-fat dairy products; lean meats; and foods prepared with little or no fat. Include foods rich in calcium and iron in the diet.
- Select a nutritious meal from the school cafeteria or pack a balanced lunch.
- Your teen should achieve and maintain a healthy weight. Weight can be managed through appropriate eating habits and regular exercise.
- It's a good idea for your teen to avoid "empty" calories such as soft drinks, chips, candy and cookies.
- Many girls develop anemia during this time. They need sufficient iron in their diet to replace menstrual loss.
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Sleep - You may think your 16-year-old "sleeps" his or her life away (especially on weekends), but many children this age are actually sleep-deprived. Children this age need nine-10 hours of sleep per night. Lost sleep can not be made up later.
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Immunizations
Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to
seek the advice of your child's health care provider concerning your child's vaccine schedule. - Most children have received the following vaccines and no immunizations are usually given
at this age:  5 doses of DtaP
1 dose of TdaP, to be followed with tetanus boosters every 10 years
4 doses of IPV (polio)
4 doses of HiB
2 doses of Chickenpox vaccine
4 doses of pneumonia vaccine (if born after 1999)
3 doses of Hepatitis B vaccine
2 doses of MMR vaccine
The HPV (humanpapilomavirus) vaccine series (girls)
Meningococcal vaccine
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- A Td (tetanus-diphtheria) booster is recommended every 10 years and is usually given at the 14 or 16 year checkup.
- Annual flu vaccines for children with chronic illnesses like asthma and heart defects. Check with your doctor.
- Vision and hearing, as well as blood and urine, are usually checked at this visit. Other screening done at this age may include a tuberculin test (if indicated) and blood pressure. If there is a family history of elevated cholesterol, some physicians will also obtain a screening blood test.
- Measure and plot on a standard chart your adolescent’s height and weight. Determine the body mass index (BMI) If an adolescent has a BMI greater than the 95th percentile for age and gender, or less than the 5th percentile, refer for dietary assessment and counseling. Adolescents with a BMI between the 85th and 95th percentile need initial evaluation and counseling for obesity.
- Special referrals should be considered at age 16 for:
(1) Adolescent boys who have not begun pubertal development should be evaluated for pubertal delay
(2) Boys or girls who do not follow the normal pattern of pubertal development (for example, menstruation before breast development)
(3) Families that are in prolong conflict - some turbulence is expected in all families, but a decline in the families ability to communicate or prolonged conflict should not be expected.
(4) The adolescent who is a loner - those who do not belong to a peer group at age 16 are considered loners and frequently are depressed, at risk for suicide, involved in truancy or are taking drugs.
(5) The promiscuous teenager - this may be a sign of difficulties in the adolescent's life caused by poor self-esteem, parental hostility, rebellion, self-destruction, or a teen in search of comfort and love. - The physician and his or her staff, as well as the parents, should respect the child's privacy by using appropriate draping during the 16-year examination.
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Sexuality for the Adolescent - Identify a supportive adult who can give you accurate information about sex.
- Get accurate information about birth control and sexually transmitted diseases and learn to recognize the signs.
- Having sexual feelings is normal, but having sex should be a well thought out decision. Do not have sex if you do not want to.
- Not having sexual intercourse is the safest way to prevent pregnancy and sexually transmitted diseases, including HIV infection/AIDS.
- Learn about ways to say "no" to sex.
- If you are engaging in sexual activity, including intercourse, ask the health professional for an examination and discuss methods of birth control. Learn about safer sex.
- Practice safer sex. Limit the number of partners, and use latex condoms and other barriers correctly.
- If you are confused or concerned about your sexual feelings (for the same sex or opposite sex), talk to a trusted adult or a health professional.
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Say "No" to Substance Use/Abuse - Do not smoke, use smokeless tobacco, drink alcohol, or use drugs, diet pills or steroids. Do not become involved in selling drugs.
- If you smoke, find out about smoking cessation programs.
- If you use drugs or alcohol, ask for help (e.g., a substance abuse treatment program).
- Avoid situations where drugs or alcohol are easily available.
- Support your friends who choose not to use tobacco, alcohol, drugs, steroids or diet pills.
- Become a peer counselor to prevent substance abuse.
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Safety Advice for the Adolescent - Wear a seat belt while driving or riding in the car. If you are driving, insist that your passengers wear seat belts. Follow the speed limit.
- Learn how to swim.
- Do not drink alcohol, especially while driving, boating or swimming. Plan to have a designated driver if drinking.
- Protect yourself from skin cancer by putting sunscreen on before you go outside for long periods of time. Avoid tanning salons.
- Test smoke detectors in your home to ensure they work properly. Change batteries yearly.
- Always wear a helmet when on a motorcycle, in an all-terrain vehicle or riding a bicycle. Even with a helmet, motorcycles and ATVs are very dangerous.
- Wear protective sports gear such as a mouth guard or a face protector.
- Wear appropriate protective gear at work and follow job safety procedures.
- Avoid high noise levels, especially in music headsets.
- Do not carry or use a weapon of any kind.
- Develop skills in conflict resolution, negotiation and dealing with anger constructively.
- Learn techniques to protect yourself from physical, emotional and sexual abuse, including rape by strangers or acquaintances.
- Seek help if you are physically or sexually abused or fear you are in danger.
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Health Promotion - Get adequate sleep.
- Exercise vigorously at least three times per week. Encourage friends and family members to exercise.
- Discuss with your health professional or coach about athletic conditioning, weight training, fluids and weight gain or loss.
- Limit television viewing to an average of one hour per day.
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Growth Milestones - 18 Years
"Leaving the Nest"
| At the age of 18, adolescents begin to recognize that parents can be their best friends. This is the time when parents can help their son or daughter more by being a good sounding board for them rather than making their decisions. As Mark Twain once noted, "18 year olds are sometimes amazed at how much their parents have grown on so little knowledge and how much they have learned in the past few years!" The peer group becomes less important to the late adolescent and is replaced by a few good friends. The young adult's interests now focuses on education or a vocational future. He or she attempts to answer the question frequently asked when he or she was younger: ".......and what do you want to be when you grow up?" The unrealistic fantasies of early adolescence are now replaced by more realistic educational and vocational plans. The mature adolescent is able to understand his or her strengths and applies them to a potential career. Separation from parents is a necessary part of growing up. We expect children to become independent adults. This independence does not mean there cannot be close family relationships, but this relationship should be based on mutual respect. In other words, parents need to recognize that their child has grown up and has come to terms with their sense of loss as the child "leaves the nest." |
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Parenting and Behavioral - The role of parents during this phase in their child's development should be one of support. Parents will usually find that their teenager has a better relationship with them now than he or she did in the early teen years. The adolescent may even seek out your advice!
- The most common mistake most parents make at this age is being overprotective. Many parents feel their young person will make a serious mistake with career choice or spouse selection. Parents should resist the impulse to make choices for their son or daughter and allow the youngster to come to that conclusion on his or her own. This is mostly true concerning spouse selection when many parents feel their young person has chosen a spouse who would not be right for him or her. In many cases, parents are correct, but it will do no good to impose that feeling upon your adolescent. Your young adult will interpret this as being unjust or unfair, and will push him or her further into the disliked relationship.
- Late adolescence is less of a struggle between parent and child than it was in earlier years. By the end of this period, most parents will find they like and enjoy their offspring as an emerging young adult. As older adolescents become more comfortable with themselves and their emotional independence, their relationships with family members become more accepting and harmonious.
- Most 18 year olds have decided whether they will go on to college, join the work force or enter the military. While late adolescence should be a time of choice it can also bring intense frustration to youth with restricted options. Those who have not concentrated on academic performance now confront severely curtailed choices. High unemployment rates among youth—especially those who are unskilled or belong to minority groups—underscore the fact that vocational options are limited. This harsh reality diminishes the young person’s sense of hope for the future unless some positive intervention is offered.
- Establish realistic expectations for family rules, with increasing autonomy and responsibility given to the adolescent.
- Enhance the adolescent’s self-esteem by providing praise and recognizing positive behavior and achievements.
- Minimize criticism, nagging, derogatory comments, and other belittling or demeaning messages.
- Spend time with your adolescent.
- Respect your adolescent’s need for privacy.
- Teach your young adult techniques for resisting peer pressure.
- Discuss with the adolescent possible contingency plans in the event that a car trip is necessary and the person who is driving is drunk or has taken drugs.
- Parents should learn the signs of adolescent depression:
- Making statements like "I want to die" or "I feel dead inside."
- Previous suicide attempts.
- Abuse of alcohol or drugs.
- Giving away prized possessions, writing a will or making other "final" arrangements.
- Preoccupation with themes of death or expression of suicidal thoughts.
- Changes in sleeping patterns (too much or too little), withdrawal from friends or family, or other major behavioral changes.
- Changes in school performance (lower grades, cutting classes, dropping out of activities).
- Frequent complaints of physical symptoms such as stomachaches, headaches or fatigue.
- Sudden and extreme changes in eating habits, or loss or gain of unusual amounts of weight.
- Sudden cheerfulness after a prolonged period of depression.
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Traits of the Adolescent Who may be Expected to do Well: - Is in good health and has good food habits.SMALL>
- Believes he or she will do well.
- Has self-confidence and a sense of pride and competence.
- Enjoys close interactions with peers of both sexes.
- Takes advantage of recreational outlets.
- Recognizes the need for rules and fair play.
- Is energetic, enthusiastic and idealistic.
- Has plans for the future and has identified some life goals.
- Recognizes the consequences of his or her actions.
- Feels responsible for his or her health.
- Generally cooperative, understanding and considerate of parents.
- Has dramatic, artistic or musical talents.
- Does well in school and/or work.
- Takes appropriate responsibility for homework with little prodding.
- Is comfortable in asking parents questions.
- Generally cooperative and considerate, although at times is inconsistent and unpredictable.
- Has experienced an intimate relationship and has a firm self-identity.
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Traits of an Adolescent to be Concerned About: - Has a low self-esteem or lack of friends.
- Does not communicate well with parents.
- Does poorly in school or has dropped out of school.
- Extremely worried to the point of panic concerning what he or she is going to do with his or her life.
- Delinquent behavior and has been in trouble with the law.
- Physically inactive.
- Anxious or fearful; displays aggressive or acting out behavior (lying, defiance, stealing, temper, vandalism, animal cruelty).
- Compulsive behaviors, fears, depression and without initiative.
- Has no marketable skills and cannot find or keep a job.
- Has no life goals.
- Is overly dependent on parents.
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Life Style Issues - Youth 18–24 years of age are the most infrequent users of health care services. They are also the age group most likely to be uninsured. Many are no longer covered by their parents’ insurance plan, and those who work often have entry-level jobs that offer no health insurance benefits.
- Emphasize to your adolescent the importance of exercise. On the other hand, the dangers of overexercise should also be explained.
- The older adolescent is usually more receptive to information regarding good nutrition. Preaching to adolescence is generally ineffective, but supplying him or her with good factual information about nutrition and being a good role model are worthwhile.
- Maintains an appropriate weight.
- Brushes and flosses teeth regularly. Practices routine dental care.
- Is familiar and does self-examination of breasts and testes.
- Drives responsibly by always wearing a seat belt and shoulder harness, drives defensively, never drives when drinking or under the influence of drugs or when angry. Never rides in a car whose driver (including parent) has been drinking.
- Alcohol and Smoking- Older adolescents who live away from home may need to be reminded about the dangers of smoking and drinking. Those adolescents who have chosen not to begin smoking should be constantly commended for their decision and reminded that being in a room with others who smoke is harmful to their lungs.
- Mental Health: Take on new challenges that will increase your self-confidence. Continue to develop your sense of identity, clarifying your values and beliefs. Accept who you are and enjoy both the adult and the child. Trust your own feelings as well as feedback from friends and adults. Seek help if you often feel angry, depressed or hopeless. Learn how to deal with stress. Set reasonable but challenging goals. Understand the importance of your spiritual and religious needs and try to fulfill them.
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Nutrition for the Adolescent - Eat three meals per day. Breakfast is especially important. Eat meals with your family or residential group on a regular basis.
- Choose and prepare a variety of healthy foods.
- Choose nutritious snacks rich in complex carbohydrates. Limit high-fat or low-nutrient foods and beverages such as candy, chips or soft drinks.
- Choose plenty of fruits and vegetables; breads, cereals, and other grain products; low-fat dairy products; lean meats; and foods prepared with little or no fat. Include foods rich in calcium and iron in your diet.
- Select a nutritious meal from the school cafeteria or pack a balanced lunch.
- Achieve and maintain a healthy weight. Manage weight through appropriate eating habits and regular exercise.
- Many girls develop anemia during this time. They need sufficient iron in their diet to replace menstrual loss.
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Sleep - You may think that your 18-year- old "sleeps" his or her life away (especially on weekends), but many youngsters this age are actually sleep-deprived. Adolescents this age
need 9-10 hours of sleep per night. Lost sleep can not be made up later.
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Immunizations
Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to
seek the advice of your child's health care provider concerning your child's vaccine schedule. - Most adolescents at age 18 have received the following vaccines and no immunizations are usually given at this age:
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5 doses of DtaP
1 dose of TdaP, to be followed with tetanus boosters every 10 years
4 doses of IPV (polio)
4 doses of HiB
2 doses of Chickenpox vaccine
4 doses of pneumonia vaccine (if born after 1999)
3 doses of Hepatitis B vaccine
2 doses of MMR vaccine
The HPV (humanpapilomavirus) vaccine series (girls)
Meningococcal vaccine
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- A Td (tetanus-diphtheria) booster is recommended every 10 years and is usually given at the 14 or 16 year checkup.
- Annual flu vaccines for children with chronic illnesses like asthma and heart defects. Check with your doctor.
- Measure and plot on a standard chart the adolescent’s height and weight. Determine the body mass index (BMI) If an adolescent has a BMI greater than the 95th percentile for age and gender, or less than the 5th percentile, refer for dietary assessment and counseling. Adolescents with a BMI between the 85th and 95th percentile need initial evaluation and counseling for obesity.
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Sexuality for the Late Adolescent - Educate yourself about birth control, sexually transmitted diseases, gay and lesbian issues, celibacy and other issues related to sexuality.
- Having sexual intercourse should be a well thought out decision. Do not have sex if you do not want to.
- Not having sexual intercourse is the safest way to prevent pregnancy and sexually transmitted diseases, including HIV infection/AIDS.
- Learn about ways to say "no" to sex.
- If you are engaging in sexual activity, including intercourse, ask the health professional for an examination and discuss methods of birth control. Learn about ways to negotiate safer sex and to share your feelings about sexuality with your partner.
- Practice safer sex. Limit the number of partners and use latex condoms and other barriers correctly.
- If you are confused or concerned about your sexual feelings (for the same sex or opposite sex), talk to a trusted adult or the health professional.
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Say "No" to Substance Use/Abuse - Do not smoke, use smokeless tobacco, drink alcohol, or use drugs, diet pills or steroids. Do not become involved in selling drugs.
- If you smoke, find out about smoking cessation programs.
- If you use drugs or alcohol, ask for help (e.g., a substance abuse treatment program).
- Avoid situations where drugs or alcohol are easily available.
- Support your friends who choose not to use tobacco, alcohol, drugs, steroids or diet pills.
- Become a peer counselor to prevent substance abuse.
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Safety Advice for the Late Adolescent - Wear a seat belt while driving or riding in the car. If you are driving, insist that your passengers wear seat belts. Follow the speed limit.
- Learn how to swim.
- Do not drink alcohol, especially while driving, boating or swimming. Plan to have a designated driver if drinking.
- Protect yourself from skin cancer by putting sunscreen on before you go outside for long periods of time. Avoid tanning salons.
- Test smoke detectors in your home to ensure they work properly. Change batteries yearly.
- Always wear a helmet when on a motorcycle, in an all-terrain vehicle, or riding a bicycle. Even with a helmet, motorcycles and ATVs are very dangerous.
- Wear protective sports gear such as a mouth guard or a face protector.
- Wear appropriate protective gear at work and follow job safety procedures.
- Avoid high noise levels, especially in music headsets.
- Do not carry or use a weapon of any kind.
- Develop skills in conflict resolution, negotiation and dealing with anger constructively.
- Learn techniques to protect yourself from physical, emotional and sexual abuse, including rape by strangers or acquaintances.
- Seek help if you are physically or sexually abused or fear that you are in danger.
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