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What to expect in the tween, teen years

Most new parents devour the book “What to Expect When You’re Expecting” early on as they await the arrival of their newborn. With lots of comforting advice and suggestions for health care and parenting survival, it becomes indispensable before their child arrives. After the arrival of their child, they consume the rest of the books, “What to Expect in the First Year” and “What to Expect in the Toddler Years,” just as earnestly.

But what should parents do during the tween and teen years for health care?

Without a clear, defined list for children ages 8-18, how do parents guard their children’s health and ensure their continued growth? Parents use their instincts and personal experience, but there are a variety of health and medical guidelines to consider during this important period as well.

Dr. Lance Chilton and Dr. Gary Giblin recently shared their thoughts on this age range and the unique health issues of various stages. Chilton, located in Albuquerque, has been a pediatrician in New Mexico for more than 40 years, is on the faculty at the University of New Mexico, and writes a biweekly health column for the Journal. He will be on hand to answer questions at the Journal’s Spring Wellness Fair on Saturday. Giblin, located in Santa Fe, is a family physician at La Familia Medical Center. He has practiced for 19 years in Santa Fe.

School life

For the younger ages (8-12), Chilton suggests that parents and doctors focus on how school is going. He says that while academic progress is important, he talks to young patients about their relationships with other kids and how they feel at school. This is a prime time for bullying issues to arise and by taking the time to discuss this with this age group, a lot of problems can be addressed. Parents also need to be vigilant and dig deeper in their discussions as some children really try to stay under the radar, even if they are experiencing problems.

Chilton notes that “there are not too many surprises with this age group (8-12) when we do physical exams because most anomalies are detected before age 8.” Giblin agrees, saying that “most congenital problems and developmental delays are picked up by age 6.”

Because of this, Chilton tends to focus on school life and relationships with those in the 8-12 age range.

Giblin notes childhood obesity as an area of concern for the 8-12 age range. He focuses on discussing healthy lifestyles with his patients and their parents to combat obesity.

Using the list for well checks (age 11-18) at Bright Futures, a resource for pediatric providers, Chilton assesses the following areas: home, education, eating, activities, drugs, safety, sex and mental health. Similar to the checklists most parents are familiar with from those early well-checks, the lists cover issues more pertinent to older children.

In Chilton’s practice, the areas that are of concern to him for the 11-18 age group are eating disorders, electronic usage and depression.

Both doctors agree on the seriousness of depression for the children in these age groups. Chilton explains, “The major concern is the safety of depressed children. If necessary, I refer the patients to psychiatrists but I ask the parents about any knives or guns in the home.”

Frequently overlooked is the fact that if children start using alcohol or drugs or causing problems at home or school, they may actually be dealing with depression.

Vaccines

Another important area for this age group: vaccinations and well-checks. Since most required vaccinations are completed, many doctors don’t see their patients again until age 11 when the next required vaccinations occur. At age 11, Chilton advises that children should receive their Tdap (tetanus-diphtheria-pertussis), HPV (human papillomavirus) and meningococcal conjugate vaccines. An explanation of these vaccines can be found on a CDC chart at cdc.gov/vaccines/who/teens/downloads/parent-version-schedule-7-18yrs.pdf.

Chilton also suggests a yearly flu shot because more than 22,000 deaths are linked to influenza. He calls it one of the most preventable diseases. In addition, he recommends that Tdap booster shots be given every 10 years. As for well-checks, Giblin recommends every 1-2 years for this age range.

So while a parent should make sure their child has the appropriate vaccinations, schedule well-checks every 1-2 years, look out for eating disorders, electronics obsession, drug/alcohol abuse and depression, they have another health-related task to think about: teaching their children to advocate for their own health and how to navigate the health-care system.

As children reach the late teens, most doctors recommend that at least a portion of the doctor’s visit be alone so that teenagers can ask questions and work on their ability to communicate with a health-care professional.

Other issues that should be reviewed are medications, insurance information and drug allergies. If a child has a disability or long-term health issue, a parent may want to contact an organization specializing in that area.

Like most lessons taught by parents, the most powerful ones are those taught by example. Take a look at your health habits and self-advocacy skills and resolve to strengthen those so that you can pass good habits on to your children.

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