Adolescent Visit, 15- to 17-Year-Old

SCHOOL PERFORMANCE

Teenagers should begin preparing for college or technical school. Teens often begin working part-time during the middle adolescent years.

SOCIAL AND EMOTIONAL DEVELOPMENT

Teenagers depend more upon their peers than upon their parents for information and support. During this period, teens are at higher risk for development of mental illness, such as depression or anxiety. Interest in sexual relationships increases.

IMMUNIZATIONS

Between ages 15 to 17 years, most teenagers should be fully vaccinated. A booster dose of Tdap (tetanus, diphtheria, and pertussis, or "whooping cough"), a dose of meningococcal vaccine to protect against a certain type of bacterial meningitis, Hepatitis A, chickenpox, or measles may be indicated, if not given at an earlier age. Females may receive a dose of human papillomavirus vaccine (HPV) at this visit. HPV is a three dose series, given over 6 months time. HPV is usually started at age 11 to 12 years, although it may be given as young as 9 years. Annual influenza or "flu" vaccination should be considered during flu season.

TESTING

Annual screening for vision and hearing problems is recommended. Vision should be screened objectively at least once between 15 and 17 years of age. The teen may be screened for anemia, tuberculosis, or cholesterol, depending upon risk factors. Teens should be screened for use of alcohol and drugs. If the teenager is sexually active, screening for sexually transmitted infections, pregnancy, or HIV may be performed.

NUTRITION AND ORAL HEALTH

  • Adequate calcium intake is important in teens. Encourage 3 servings of low fat milk and dairy products daily. For those who do not drink milk or consume dairy products, calcium enriched foods, such as juice, bread, or cereal; dark, green, leafy greens; or canned fish are alternate sources of calcium.

  • Drink plenty of water. Limit fruit juice to 8 to 12 ounces per day. Avoid sugary beverages or sodas.

  • Discourage skipping meals, especially breakfast. Teens should eat a good variety of vegetables and fruits, as well as lean meats.

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

  • Encourage teenagers to help with meal planning and preparation.

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

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

  • Brush teeth twice a day and floss daily.

  • Schedule dental examinations twice a year.

SLEEP

  • Adequate sleep is important for teens. Teenagers often stay up late and have trouble getting up in the morning.

  • Daily reading at bedtime establishes good habits. Avoid television watching at bedtime.

PHYSICAL, SOCIAL AND EMOTIONAL DEVELOPMENT

  • Encourage approximately 60 minutes of regular physical activity daily.

  • Encourage your teen to participate in sports teams or after school activities. Encourage your teen to develop his or her own interests and consider community service or volunteerism.

  • Stay involved with your teen's friends and activities.

  • Teenagers should assume responsibility for completing their own school work. Help your teen make decisions about college and work plans.

  • Discuss your views about dating and sexuality with your teen. Make sure that teens know that they should never be in a situation that makes them uncomfortable, and they should tell partners if they do not want to engage in sexual activity.

  • Talk to your teen about body image. Eating disorders may be noted at this time. Teens may also be concerned about being overweight. Monitor your teen for weight gain or loss.

  • Mood disturbances, depression, anxiety, alcoholism, or attention problems may be noted in teenagers. Talk to your doctor if you or your teenager has concerns about mental illness.

  • Negotiate limit setting and consequences with your teen. Discuss curfew with your teenager.

  • Encourage your teen to handle conflict without physical violence.

  • Talk to your teen about whether the teen feels safe at school. Monitor gang activity in your neighborhood or local schools.

  • Avoid exposure to loud noises.

  • Limit television and computer time to 2 hours per day! Teens who watch excessive television are more likely to become overweight. Monitor television choices. If you have cable, block those channels which are not acceptable for viewing by teenagers.

RISK BEHAVIORS

  • Encourage abstinence from sexual activity. Sexually active teens need to know that they should take precautions against pregnancy and sexually transmitted infections. Talk to teens about contraception.

  • Provide a tobacco-free and drug-free environment for your teen. Talk to your teen about drug, tobacco, and alcohol use among friends or at friends' homes. Make sure your teen knows that smoking tobacco or marijuana and taking drugs have health consequences and may impact brain development.

  • Teach your teens about appropriate use of other-the-counter or prescription medications.

  • Consider locking alcohol and medications where teenagers can not get them.

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

  • Talk to teens about the risks of drinking and driving or boating. Encourage your teen to call you if the teen or their friends have been drinking or using drugs.

  • Remind teenagers to wear seatbelts at all times in cars and life vests in boats.

  • Teens should always wear a properly fitted helmet when they are riding a bicycle.

  • Discourage use of all terrain vehicles (ATV) or other motorized vehicles in teens under age 16.

  • Trampolines are hazardous. If used, they should be surrounded by safety fences. Only 1 teen should be allowed on a trampoline at a time.

  • Do not keep handguns in the home. (If they are, the gun and ammunition should be locked separately and out of the teen's access). Recognize that teens may imitate violence with guns seen on television or in movies. Teens do not always understand the consequences of their behaviors.

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

  • Teach teens not to swim alone and not to dive in shallow water. Enroll your teen in swimming lessons if the teen has not learned to swim.

  • Make sure that your teen is wearing sunscreen which protects against UV-A and UV-B and is at least sun protection factor of 15 (SPF-15) or higher when out in the sun to minimize early sun burning.

WHAT'S NEXT?

Teenagers should visit their pediatrician yearly.