Medical Care and Your 13- to 18-Year-Old

By meeting yearly with your teen, the doctor can keep track of changes in physical, mental, and social development and offer advice against unhealthy behaviors, such as smoking and drinking.

The doctor also can 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 to Expect 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 exams may be needed.

Medical care should include screenings for high blood pressure, obesity, 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 your dentist.

Vision and hearing will be checked. Teens are also checked for scoliosis (curvature of the spine).

Immunizations

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 a group setting, such as a college dormitory, ask the doctor if the meningococcal meningitis vaccine also is required.

As kids go through puberty, issues of sexual health will be addressed. Your doctor will teach your daughter how to perform a monthly breast exam. The doctor also might 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-exam.

Teens should be asked about behaviors or emotional problems that may indicate depression or the risk of suicide. The doctor also should 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
• use of safety devices, including bicycle helmets, seat belts, and protective sports gear
• 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

If You 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.