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Medical Care and Your 13- to 18-year-old

By meeting yearly with your teen, the doctor can keep track of changes in his or her physical, mental, and social development and offer advice against unhealthy behaviors, such as smoking and drinking. The doctor can also help your child understand the importance of choosing a healthy lifestyle that includes good nutrition, proper exercise, and safety measures. The more teens understand about their physical growth and sexual development, the more they will recognize the importance of active involvement in their own health care.

What Happens at the Doctor's Office?
Teens should visit their doctors annually. At least three of these visits should include a complete physical examination: one performed during early adolescence (ages 11 to 14), one during middle adolescence (ages 15 to 17), and one during late adolescence (ages 18 to 21). If your child has a chronic medical condition or if certain clinical signs or symptoms are present, more frequent examinations may be indicated.

Medical care should include screenings for high blood pressure, obesity, and other eating disorders, and, if indicated, hyperlipidemia (an excess of cholesterol and/or other fats in the blood). A tuberculin (PPD) test may be administered if your teen is at risk for tuberculosis.

Your teen's doctor will also check his or her teeth for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, and other problems. Your teen should also continue to have regular checkups with her dentist.

Vision and hearing will be checked.

Teens will also be checked for scoliosis (curvature of the spine).

Teens should receive a diphtheria and tetanus booster (Td) 10 years after their last childhood booster (usually at age 4 to 6 years) and every 10 years thereafter. They should have already completed their other immunizations, including varicella (if they have not had chickenpox); measles, mumps, and rubella (MMR); and the hepatitis B series (Hep B). If your teen will be living in an institutional setting, such as a college dormitory, speak with his or her doctor about receiving the meningococcal meningitis vaccine.

As your child goes through puberty, issues of sexual health will be addressed. Your child's doctor will teach your daughter how to perform a monthly breast exam. The doctor may also perform (or refer her to a gynecologist for) a gynecologic exam and a Pap smear to check for cervical cancer. Males will be checked for hernias and testicular cancer and taught to perform a testicular self-examination.

Teens should be asked about behaviors or emotional problems that may indicate depression or the risk of suicide. The doctor should also provide counseling about risky behaviors and other issues, including:

• sexual activities that may result in unintended pregnancy and sexually transmitted diseases (STDs), including HIV
• emotional, physical, and sexual abuse
• use of alcohol and other substances, including anabolic steroids
• use of tobacco products, including cigarettes and smokeless tobacco
• use of alcohol while driving
• how to resolve conflicts without violence, including how to avoid the use of weapons
• learning problems or difficulties at school
• appropriate warm-ups before exercise and importance of regular physical activity

What Should I Do if I Suspect a Medical Problem?
Parents or other caregivers should receive health guidance at least once during early, middle, and late adolescence from their teen's doctor. During these sessions, the doctor will provide information about normal development, including signs and symptoms of illness or emotional distress and methods to monitor and manage potentially harmful behaviors.

If you suspect that your teen has a physical disorder, a psychological problem, or a problem with drugs or alcohol, contact your child's doctor immediately.

Typical Medical Problems

Issues involving puberty and sexual development are typical concerns for this age group. Doctors who establish a policy of confidentiality can serve as a valuable resource for a teen by answering questions and providing guidance during this period of physical and emotional changes. Teens should be reassured that anything they discuss with their doctor will be kept confidential, unless their health or the health of others is endangered by the situation.

Sports injuries are common concerns. Osgood-Schlatter disease, a painful inflammation of the area just below the front of the knee, is particularly common in the early teen years. Knee pain is also a frequent complaint. Your teen's doctor should evaluate any severe or persistent pain of the joints, muscles, or other areas of the body.