Well Child Care, 15- to 17-Year-Old

SCHOOL PERFORMANCE

Your teenager should begin preparing for college or technical school. To keep your teenager on track, help him or her:

  • Prepare for college admissions exams and meet exam deadlines.  

  • Fill out college or technical school applications and meet application deadlines.  

  • Schedule time to study. Teenagers with part-time jobs may have difficulty balancing his or her job and schoolwork.

PHYSICAL, SOCIAL, AND EMOTIONAL DEVELOPMENT

  • Your teenager may depend more upon peers than on you for information and support. As a result, it is important to stay involved in your teenager's life and to encourage him or her to make healthy and safe decisions.

  • Talk to your teenager about body image. Teenagers may be concerned with being overweight and develop eating disorders. Monitor your teenager for weight gain or loss.

  • Encourage your teenager to handle conflict without physical violence.

  • Encourage your teenager to participate in approximately 60 minutes of daily physical activity.  

  • Limit television and computer time to 2 hours each day. Teenagers who watch excessive television are more likely to become overweight.  

  • Talk to your teenager if he or she is moody, depressed, anxious, or has problems paying attention. Teenagers are at risk for developing a mental illness such as depression or anxiety. Be especially mindful of any changes that appear out of character.  

  • Discuss dating and sexuality with your teenager. Teenagers should not put themselves in a situation that makes them uncomfortable. A teenager should tell his or her partner if he or she does not want to engage in sexual activity.  

  • Encourage your teenager to participate in sports or after-school activities.  

  • Encourage your teenager to develop his or her interests.  

  • Encourage your teenager to volunteer or join a community service program.

RECOMMENDED IMMUNIZATIONS

  • Hepatitis B vaccine. (Doses only obtained, if needed, to catch up on missed doses in the past. A preteen or an adolescent aged 11–15 years can however obtain a 2-dose series. The second dose in a 2-dose series should be obtained no earlier than 4 months after the first dose.)

  • Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. ( A preteen or an adolescent aged 11–18 years who is not fully immunized with the diphtheria and tetanus toxoids and acellular pertussis [DTaP] or has not obtained a dose of Tdap should obtain a dose of Tdap vaccine. The dose should be obtained regardless of the length of time since the last dose of tetanus and diphtheria toxoid-containing vaccine. The Tdap dose should be followed with a tetanus diphtheria [Td] vaccine dose every 10 years. Pregnant adolescents should obtain 1 dose during each pregnancy. The dose should be obtained regardless of the length of time since the last dose. Immunization is preferred during the 27th to 36th week of gestation.)

  • Haemophilus influenzae type b (Hib) vaccine. (Individuals older than 5 years of age usually do not receive the vaccine. However, any unvaccinated or partially vaccinated individuals aged 5 years or older who have certain high-risk conditions should obtain doses as recommended.)

  • Pneumococcal conjugate (PCV13) vaccine. (Adolescents who have certain conditions should obtain the vaccine as recommended.)

  • Pneumococcal polysaccharide (PPSV23) vaccine. (Adolescents who have certain high-risk conditions should obtain the vaccine as recommended.)

  • Inactivated poliovirus vaccine. (Doses only obtained, if needed, to catch up on missed doses in the past.)

  • Influenza vaccine. (A dose should be obtained every year.)

  • Measles, mumps, and rubella (MMR) vaccine. (Doses should be obtained, if needed, to catch up on missed doses in the past.)

  • Varicella vaccine. (Doses should be obtained, if needed, to catch up on missed doses in the past.)

  • Hepatitis A virus vaccine. (An adolescent who has not obtained the vaccine before 2 years of age should obtain the vaccine if he or she is at risk for infection or if hepatitis A protection is desired.)

  • Human papillomavirus (HPV) vaccine. (Doses should be obtained if needed to catch up on missed doses in the past.)

  • Meningococcal vaccine. (A booster should be obtained at age 16 years. Doses should be obtained, if needed, to catch up on missed doses in the past. Preteens and adolescents aged 11–18 years who have certain high-risk conditions should obtain 2 doses. Those doses should be obtained at least 8 weeks apart. Adolescents who are present during an outbreak or are traveling to a country with a high rate of meningitis should obtain the vaccine.)

TESTING

Your teenager should be screened for:

  • Vision and hearing problems.  

  • Alcohol and drug use.  

  • High blood pressure.

  • Scoliosis.

  • HIV.

Depending upon risk factors, your teenager may also be screened for:

  • Anemia.  

  • Tuberculosis.  

  • Cholesterol.  

  • Sexually transmitted infection.  

  • Pregnancy.  

  • Cervical cancer. Most females should wait until they turn 21 years old to have their first Pap test. Some adolescent girls have medical problems that increase the chance of getting cervical cancer. In these cases, the caregiver may recommend earlier cervical cancer screening.

NUTRITION AND ORAL HEALTH

  • Encourage your teenager to help with meal planning and preparation.  

  • Model healthy food choices and limit fast food choices and eating out at restaurants.  

  • Eat meals together as a family whenever possible. Encourage conversation at mealtime.  

  • Discourage your teenager from skipping meals, especially breakfast.  

  • Your teenager should:  

  • Eat a variety of vegetables, fruits, and lean meats.  

  • Have 3 servings of low-fat milk and dairy products daily. Adequate calcium intake is important in teenagers. If your teenager does not drink milk or consume dairy products, he or she should eat other foods that contain calcium. Alternate sources of calcium include dark and leafy greens, canned fish, and calcium enriched juices, breads, and cereals.  

  • Drink plenty of water. Fruit juice should be limited to 8–12 ounces (240–360 mL) each day. Sugary beverages and sodas should be avoided.  

  • Avoid foods high in fat, salt, and sugar, such as candy, chips, and cookies.  

  • Brush teeth twice a day and floss daily. Dental examinations should be scheduled twice a year.

SLEEP

Your teenager should get 8.5–9 hours of sleep. Teenagers often stay up late and have trouble getting up in the morning. A consistent lack of sleep can cause a number of problems, including difficulty concentrating in class and staying alert while driving. To make sure your teenager gets enough sleep, he or she should:

  • Avoid watching television at bedtime.  

  • Practice relaxing nighttime habits, such as reading before bedtime.  

  • Avoid caffeine before bedtime.  

  • Avoid exercising within 3 hours of bedtime. However, exercising earlier in the evening can help your teenager sleep well.  

PARENTING TIPS

  • Be consistent and fair in discipline, providing clear boundaries and limits with clear consequences.  

  • Discuss curfew with your teenager.  

  • Monitor television choices. Block channels that are not acceptable for viewing by teenagers.  

  • Make sure you know your teenager's friends and what activities they engage in.  

  • Monitor your teenager's school progress, activities, and social life. Investigate any significant changes.

SAFETY

  • Encourage your teenager not to blast music through headphones. Suggest he or she wear earplugs at concerts or when mowing the lawn. Loud music and noises can cause hearing loss.  

  • Do not keep handguns in the home. If there is a handgun in the home, the gun and ammunition should be locked separately and out of the teenager's access. Recognize that teenagers may imitate violence with guns seen on television or in movies. Teenagers do not always understand the consequences of their behaviors.  

  • Equip your home with smoke detectors and change the batteries regularly. Discuss home fire escape plans with your teen.  

  • Teach your teenager not to swim without adult supervision and not to dive in shallow water. Enroll your teenager in swimming lessons if your teenager has not learned to swim.  

  • Your teenager should be protected from sun exposure. He or she should wear clothing, hats, and other coverings when outdoors. Make sure that your teenager is wearing sunscreen that protects against both A and B ultraviolet rays. 

  • Encourage your teenager to always wear a properly fitted helmet when riding a bicycle, skating, or skateboarding. Set an example by wearing helmets and proper safety equipment.  

  • Talk to your teenager about whether he or she feels safe at school. Monitor gang activity in your neighborhood and local schools.  

  • Encourage abstinence from sexual activity. Talk to your teenager about sex, contraception, and sexually transmitted diseases.  

  • Discuss cellular phone safety. Discuss texting, texting while driving, and sexting.  

  • Discuss Internet safety. Remind your teenager not to disclose information to strangers over the Internet.

Tobacco, alcohol, and drugs: 

  • Talk to your teenager about smoking, drinking, and drug use among friends or at friend's homes.  

  • Make sure your teenager knows that tobacco, alcohol, and drugs may affect brain development and have other health consequences. Also consider discussing the use of performance-enhancing drugs and their side effects.  

  • Encourage your teenager to call you if he or she is drinking or using drugs, or if with friends who are.  

  • Tell your teenager never to get in a car or boat when the driver is under the influence of alcohol or drugs. Talk to your teenager about the consequences of drunk or drug-affected driving.  

  • Consider locking alcohol and medicines where your teenager cannot get them.

Driving: 

  • Set limits and establish rules for driving and for riding with friends.  

  • Remind your teenager to wear a seatbelt in cars and a life vest in boats at all times.  

  • Tell your teenager never to ride in the bed or cargo area of a pickup truck.  

  • Discourage your teenager from using all-terrain or motorized vehicles if younger than 16 years.

WHAT'S NEXT?

Your teenager should visit a pediatrician yearly.