Well-Child Checkup: 14 to 18 Years
During the teen years, it’s important to keep having yearly checkups. Your teen may be embarrassed about having a checkup. Reassure your teen that the exam is normal and necessary. Be aware that the healthcare provider may ask to talk with your child without you in the exam room.
School and social issues
Here are some topics you, your teen, and the healthcare provider may want to discuss during this visit:
School performance. How is your child doing in school? Is homework finished on time? Does your child stay organized? These are skills you can help with. Keep in mind that a drop in school performance can be a sign of other problems.
Friendships. Do you like your child’s friends? Do the friendships seem healthy? Make sure to talk to your teen about who his or her friends are and how they spend time together. Peer pressure can be a problem among teenagers.
Life at home. How is your child’s behavior? Does he or she get along with others in the family? Is he or she respectful of you, other adults, and authority? Does your child participate in family events, or does he or she withdraw from other family members?
Risky behaviors. Many teenagers are curious about drugs, alcohol, smoking, and sex. Talk openly about these issues. Answer your child’s questions, and don’t be afraid to ask questions of your own. If you’re not sure how to approach these topics, talk to the healthcare provider for advice.
Your teen may still be experiencing some of the changes of puberty, such as:
Acne and body odor. Hormones that increase during puberty can cause acne (pimples) on the face and body. Hormones can also increase sweating and cause a stronger body odor.
Body changes. The body grows and matures during puberty. Hair will grow in the pubic area and on other parts of the body. Girls grow breasts and menstruate (have monthly periods). A boy’s voice changes, becoming lower and deeper. As the penis matures, erections and wet dreams will start to happen. Talk to your teen about what to expect, and help him or her deal with these changes when possible.
Emotional changes. Along with these physical changes, you’ll likely notice changes in your teen’s personality. He or she may develop an interest in dating and becoming “more than friends” with other kids. Also, it’s normal for your teen to be moody. Try to be patient and consistent. Encourage conversations, even when he or she doesn’t seem to want to talk. No matter how your teen acts, he or she still needs a parent.
Nutrition and exercise tips
Your teenager likely makes his or her own decisions about what to eat and how to spend free time. You can’t always have the final say, but you can encourage healthy habits. Your teen should:
Get at least 30 to 60 minutes of physical activity every day. This time can be broken up throughout the day. After-school sports, dance or martial arts classes, riding a bike, or even walking to school or a friend’s house counts as activity.
Limit “screen time” to 1 hour each day. This includes time spent watching TV, playing video games, using the computer, and texting. If your teen has a TV, computer, or video game console in the bedroom, consider replacing it with a music player.
Eat healthy. Your child should eat fruits, vegetables, lean meats, and whole grains every day. Less healthy foods—like french fries, candy, and chips—should be eaten rarely. Some teens fall into the trap of snacking on junk food and fast food throughout the day. Make sure the kitchen is stocked with healthy choices for after-school snacks. If your teen does choose to eat junk food, consider making him or her buy it with his or her own money.
Eat 3 meals a day. Many kids skip breakfast and even lunch. Not only is this unhealthy, it can also hurt school performance. Make sure your teen eats breakfast. If your teen does not like the food served at school for lunch, allow him or her to prepare a bag lunch.
Have at least one family meal with you each day. Busy schedules often limit time for sitting and talking. Sitting and eating together allows for family time. It also lets you see what and how your child eats.
Limit soda and juice drinks. A small soda is OK once in a while. But soda, sports drinks, and juice drinks are no substitute for healthier drinks. Sports and juice drinks are no better. Water and low-fat or nonfat milk are the best choices.
Recommendations for good hygiene include the following:
Teenagers should bathe or shower daily and use deodorant.
Let the healthcare provider know if you or your teen have questions about hygiene or acne.
Bring your teen to the dentist at least twice a year for teeth cleaning and a checkup.
Remind your teen to brush and floss his or her teeth before bed.
During the teen years, sleep patterns may change. Many teenagers have a hard time falling asleep. This can lead to sleeping late the next morning. Here are some tips to help your teen get the rest he or she needs:
Encourage your teen to keep a consistent bedtime, even on weekends. Sleeping is easier when the body follows a routine. Don’t let your teen stay up too late at night or sleep in too long in the morning.
Help your teen wake up, if needed. Go into the bedroom, open the blinds, and get your teen out of bed — even on weekends or during school vacations.
Being active during the day will help your child sleep better at night.
Discourage use of the TV, computer, or video games for at least an hour before your teen goes to bed. (This is good advice for parents, too!)
Make a rule that cell phones must be turned off at night.
Recommendations to keep your teen safe include the following:
Set rules for how your teen can spend time outside of the house. Give your child a nighttime curfew. If your child has a cell phone, check in periodically by calling to ask where he or she is and what he or she is doing.
Make sure cell phones and portable music players are used safely and responsibly. Help your teen understand that it is dangerous to talk on the phone, text, or listen to music with headphones while he or she is riding a bike or walking outdoors, especially when crossing the street.
Constant loud music can cause hearing damage, so monitor your teen’s music volume. Many music players let you set a limit for how loud the volume can be turned up. Check the directions for details.
When your teen is old enough for a driver’s license, encourage safe driving. Teach your teen to always wear a seat belt, drive the speed limit, and follow the rules of the road. Do not allow your teenager to text or talk on a cell phone while driving. (And don’t do this yourself! Remember, you set an example.)
Set rules and limits around driving and use of the car. If your teen gets a ticket or has an accident, there should be consequences. Driving is a privilege that can be taken away if your child doesn’t follow the rules.
Teach your child to make good decisions about drugs, alcohol, sex, and other risky behaviors. Work together to come up with strategies for staying safe and dealing with peer pressure. Make sure your teenager knows he or she can always come to you for help.
Tests and vaccines
If you have a strong family history of high cholesterol, your teen’s blood cholesterol may be tested at this visit. Based on recommendations from the CDC, at this visit your child may receive the following vaccines:
Influenza (flu), annually
Recognizing signs of depression
It’s normal for teenagers to have extreme mood swings as a result of their changing hormones. It’s also just a part of growing up. But sometimes a teenager’s mood swings are signs of a larger problem. If your teen seems depressed for more than 2 weeks, you should be concerned. Signs of depression include:
Use of drugs or alcohol
Problems in school and at home
Frequent episodes of running away
Thoughts or talk of death or suicide
Withdrawal from family and friends
Sudden changes in eating or sleeping habits
Sexual promiscuity or unplanned pregnancy
Hostile behavior or rage
Loss of pleasure in life
Depressed teens can be helped with treatment. Talk to your child’s healthcare provider. Or check with your local mental health center, social service agency, or hospital. Assure your teen that his or her pain can be eased. Offer your love and support. If your teen talks about death or suicide, seek help right away.
Next checkup at: _______________________________
March 28, 2018
Adler, Liora C., MD,Dozier, Tennille, RN, BSN, RDMS,Images Reviewed by Staywell medical art team.