Eleven year-olds are often referred to as ‘tweeners’, because they are between childhood and teens. I always find it an interesting age in my well child exam. Some 11 year-olds are completely prepubescent and some are well into puberty. Some have great relationships with their parents and some are well on their way to strife and struggles with parents. I find the visit a fabulous opportunity to educate preteens about their bodies and good healthy behaviors.


  • Substance use and abuse: This topic must be addressed. It is not unreasonable to have the expectation that your child should NOT use tobacco, drugs, alcohol, inhalants, diet pills, etc. However, children see through double standards. Do not tell your child not to smoke if you smoke. Show him or her a good example, stop. Discuss peer pressure openly. Opening the conversation with, “Do your friends do…” rather than “Do you do…” makes it more likely to get an honest answer, and it can open the door of communication. If your child is already involved, seek help.
  • Car: Wear seat belts when riding in vehicles. Still ride in the back seat until 12 years old (it’s the safest place). Fact: Accidents are the #1 cause of death in this age group. Guess where most of them happen?
  • Smoking: Make sure your home and cars are smoke free zones. Also, check smoke alarms to ensure that they work properly, and change batteries annually.
  • Wear a helmet on all things a kid can ride (e.g., bicycles, scooters, ATVs).
  • Guns need to be unloaded and locked in a safe. (Disturbing Fact: More children are killed from guns every year than are intruders).


Try to get at least 8 hours of sleep a night. Some need closer to 10 hours. Continue with bedtimes and bedtime routines, especially important with kids who have trouble sleeping.


  • Eat 3 nutritious meals a day, and healthy snacks.
  • Limit high-fat and high-sugar foods.
  • Limit soda and other high-calorie drinks.
  • Eat fruits, vegetables, whole grain breads, lean meats, chicken, fish, and low fat dairy products.
  • Ensure your child gets 3 servings of dairy a day for adequate calcium. If not, your child may need to take a calcium and Vit. D supplement.
  • Eat meals as a family (around a table with the television off). Not only does eating together as a family develop good nutritional habits, it has multiple lasting effects on the social support of a family.
  • Model good eating habits.
  • Keep in mind is it very difficult to eat healthy when eating out (especially at fast food restaurants).
  • Supplements: Unless your child eats a perfectly balanced diet, he or she likely needs a multivitamin once a day. Otherwise, other supplements are not necessary unless specifically directed by your physician.

Oral Health

  • Continue to brush and floss teeth twice a day.
  • Schedule appointment to see a dentist every 6 months.
  • Fluoride supplementation, this depends on the level of fluoride in the drinking water in the city where you live. (Your pediatrician or dentist can prescribe it if needed.)


  • Identify an appropriate adult to give accurate information.
  • Have discussions (if not already done so) about sex, puberty, development, contraception, and STIs. It is a common misconception that discussing it is condoning it. Quite the contrary, education is empowerment. Educate your child, tell him or her what your beliefs and expectations are.
  • Recognize that sexual feelings are normal, but delay having sex.
  • Learn how to say no to sex.
  • Practice abstinence, it is the only 100% effective STI and pregnancy prevention method.
  • If your child is already sexually active, you must discuss safe-sex practices (e.g., contraception, condoms).
  • Keep in mind, your physician is a good resource if you are uncomfortable having any of these very important conversations with your child.


  • Media Exposure: Limit total media time (e.g., TV, movies, video games, computer time) to no more than 2 hours a day, ideally less than 1 hour. Set up safeguards on home computers to prevent inappropriate material/child predators from entering your home via your computer.
  • Exercise: Engage in 30-60 minutes of physical activity 3 or more times a week.
  • Establish realistic expectations at home, set clear limits with consequences. Share in household chores.
  • Emphasize the importance of school. Make sure your child is learning to be responsible for his or her own homework, course selection, attendance.