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Age: 13-14 Years

Early adolescence is filled with drama. There are dramatic physical changes of puberty and dramatic mood swings. Young adolescents are egocentric and intensely focused on the question, “how do I look?” They have bright minds and great ideas. The difficulty lies in balancing guidance and open communication with their increasing need for privacy.


  1. Substance use/abuse: This topic must be addressed. Clearly educate about the dangers and the misconceptions (e.g., many teens believe marijuana is not addictive or vape is a safe alternative to smoking). It is not unreasonable to have the expectation that your child should NOT use tobacco, drugs, alcohol, inhalants, diet pills, etc. However, kids 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.
  2. Car: Wear seat belts when riding in vehicles. Educate about the dangers of texting and driving (so he/she can help police whoever may be driving whenever he/she is a passenger). Fact: Accidents are the #1 cause of death in this age group.
  3. Smoking: Make sure your home and cars are smoke-free zones. Discuss the dangers of nicotine, both smoking and vaping. Also, check smoke alarms to ensure that they work properly, and change batteries annually.
  4. Helmets: Wear a helmet on all things a kid can ride (e.g., bicycles, scooters, go carts, skateboards, ATVs, etc.).
  5. Guns: Lock guns with ammunition separate and in a gun safe. (Disturbing Fact: More children are killed from guns every year than are intruders.)
  6. Sports: Teach safety in sports, including using protective gear (e.g., mouth guards, helmets, knee pads).
  7. Media: Family computers and laptops should be in an easily seen place in the home.
    1. Install safety filters/safeguards to prevent inappropriate material/child predators from entering your home via your computer.
    2. Teach children how to navigate the internet and social media safely (e.g., do not give out personal information, what to do when you encounter inappropriate content, etc.)


  1. Eat 3 nutritious meals a day and healthy snacks.
  2. Limit high fat and high sugar foods. Limit soft drinks/soda, instead encourage lots of water.
  3. Teach the importance of eating a balanced diet. Help your child choose lots of fruits, vegetables, whole grains, and good sources of protein.
  4. Milk should be low fat. Aim for 3 servings of dairy/day (or calcium rich foods like almond milk, dark leafy greens, etc.). If not, you may need a separate calcium and vitamin D supplement.
  5. Eat meals as a family (around a table with no media). Not only does eating together as a family develop good nutritional habits, it has multiple lasting effects on the social support of a family.
  6. Model good eating habits. Teach the concept of listening to our body’s hunger cues (e.g., eat when you are hungry, stop when you are satisfied).
  7. Keep in mind it is very difficult to eat healthy when eating out (especially at fast food restaurants).
  8. Give a multivitamin daily only if your child is not eating a balanced diet. Other supplements are not necessary unless specifically directed by your physician.


Most teens need 8-10 hours of sleep a night (unfortunately few are getting it). Help make adjustments where possible to accommodate this sleep need. Getting enough sleep has dramatic improvements in academic performance and mood, as well as decreasing risk of obesity.


  1. Continue to brush twice daily and floss once a day.
  2. Should continue to see a dentist every 6 months.


    1. Have discussions (if not already done so) about sex, puberty, masturbation, pornography, development, contraception, and STI’s. 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.
    2. Recognize that sexual feelings are normal, but encourage your child to delay having sex.
    3. Learn how to “say no” to sex. Warn against feeling pressured.
    4. Educate that abstinence, it is the only 100% effective STI and pregnancy prevention method.
    5. If your child is already sexually active, you must discuss safe-sex practices (e.g., contraception, condoms).
    6. Keep in mind, your physician is a good resource if you are uncomfortable having any of these very important conversations with your child.


  1. Media Exposure: Set limits (e.g., total time, content, etc.). Make a family media use plan ( Be selective about what media your teen consumes. If your teen is engaging in social media, make sure you follow his/her accounts and give clear direction on what is appropriate to post, comment on, and follow.
  1. Phones: Carefully consider what is the right age for your teen to get a cell phone. At this age, many are starting to get their own phones. Set clear limits and expectations. Establish that the phone belongs to mom/dad who maintain ownership/control over it.
  2. Social Interactions: Praise your teen for accomplishments. When correcting, make the clear distinction that the choices the teen is making, not the teen him/herself is bad. Encourage your teen to talk about feelings and experiences at school and with friends, but don’t be surprised if they are reluctant to do so. Know who your teen is hanging out with. Make a contingency plan for when your teen is a situation where he/she feels unsafe/uncomfortable that he/she can contact you.
  3. Family life: Spend time with your child both individually and together with siblings. Acknowledge conflicts between siblings. Come to a resolution without taking sides. Do not tolerate violence. Provide personal space for your child at home.
  4. Exercise: Aim for a minimum of 60 mins of physical activity a day. Model and encourage an active lifestyle.
  5. Chores: Give your teen chores and household responsibilities (e.g., do the dishes, wash and put away own laundry, mow the lawn, etc.). Having predictable, set jobs every day/week help with consistency and setting expectations.
  6. School: Emphasize the importance of school. Make sure your child is staying on top of his/her own homework, course selection, attendance.


Treat fever and minor illnesses at home as long as your teen looks and acts ok. Bring your teen to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your teen reports specific symptoms (e.g., sore throat, painful urination, etc.), or you are concerned.


Your teen’s next well check is in 1 year. If shots are up to date, your teen’s next vaccines aren’t until 16 years-old. Depending on the time of year, your teen may also need an annual flu shot.

Is Your House Safe? The Top Five Home Hazards

A colleague recently told me that he thought there was no such thing as an accident, that everything is preventable in some way or another (e.g., the drunk could have been prevented from driving, the pool could have been covered, the rough housing game stopped before someone got hurt). While I’m not sure I entirely agree with his stance, I can certainly see his point that many accidents can be prevented. Short of putting your kids in a bubble suit, there are a many hazards that are easily addressed.

Here are the top five causes of accidental home injuries.

Water hazards:

Anything deep enough to cover a small child’s nose; typically 1-2 inches, is a drowning hazard.

  1. Bathtubs: Never leave a child unattended in the bathtub (even for a minute), make sure the tub is completely drained after use.
  2. Buckets, pails, ice chests (with melted ice): Any amount of standing water. Kids bend over to play and fall head first (because they are top heavy) and then get stuck. Make sure these items are emptied after use.
  3. Swimming pools, hot tubs, and spas: Keep covered and locked when not in use. A four-sided, lockable fence also adds a layer of protection.
  4. Water features/fountains: While pretty, they are huge drowning risks. Don’t have them on or exposed unless an adult is directly supervising.
  5. Other waters (irrigation ditches, lakes, rivers, wells, etc.): These are particularly difficult for you to control. Sometimes the best way is to fence the child in rather than attempt to fence the area off.


  1. Stairs: For the early crawler/walker, stair gates are a good place to start. When a child is just learning to navigate the stairs, directly supervise the child going up and down. Also ensure that there are handrails on all stairs and that the stairs are well lit. Lastly, keep the stairs clear of clutter (a trip hazard).
  2. Walkers: Baby walkers are a huge hazard (especially falling down stairs) and shouldn’t be used.
  3. Windows: Kids like to climb onto window ledges and push on/lean on screens. The screens give way and kids fall out windows. Either keep windows shut/locked or install window guards.
  4. Play equipment: Kids can easily lose their grip/balance on slides, swings, monkey bars, etc. Ensure the material under the equipment allows for a soft landing. See article on trampoline safety: IS YOUR TRAMPOLINE A SUPER FUN DEATH TRAP?
  5. Hard floors: Pose a slipping risk for stocking feet. Your young child may be better off in bare feet.
  6. Large furniture: Unattended children transform into monkeys in minutes. Kids can climb bookshelves, tables, etc. Secure any large furniture to the walls (e.g., big dressers, book shelves).


Make sure the number to poison control is programmed in your phone (1-800-222-1222) see article POISON CONTROL AND PREVENTION.

  1. Cleaners and chemicals should be kept well out of reach of children. I thought I was doing great in this area (all the cleaners are on a top shelf in a closet) until I found my 2 year old unwrapping the dishwasher tablets under my kitchen sink the other day. I was lucky she didn’t attempt to eat them. They now reside on the top shelf of my pantry.
  2. Medicines and vitamins. Most medicines are not safe/intended for children. Keep them well out of reach of children (and preferably locked). Never leave a bottle of medication open and unattended (even if for only a second). Also keep kids vitamins out of children’s reach (while eating one is safe, eating a whole bottle is another story).
  3. Products in the wrong bottle. Never relocate cleaners/chemicals into bottles that served another use (like a drink bottle).
  4. Plants. Many household plants are poisonous if eaten. Keep them out of reach or forego them for this stage of life with young children.


  1. Water heaters: Should be set to 120 degrees or lower to prevent scalding water burns.
  2. Don’t have candles (even if they smell good) burning within reach of a child.
  3. Pots/pans: Don’t walk away from a pot in use. Kids can reach and pull anything on them in a second.
  4. Cooking with a baby: A surprising number of burns happen when mom is holding a baby and cooking at the same time. A child will reach out at just the wrong time or a foot will drop against a hot pot, etc.
  5. Irons/curling irons/flat irons: Don’t let them heat up or cool down with dangling cords. Don’t leave them unattended.
  6. Whenever possible use back burners. Take care to keep small children away from hot surfaces.
  7. Hot foods. Parents don’t usually give children food or drinks that are too hot. The accident happens when the parent is holding a child, eating the hot food/drink and spills it on the child. So, don’t hold the child while eating hot food.

Choking /suffocation:

  1. Bedding: Extra blankets and pillows cause a suffocation hazard to small children. Don’t let a child under 2 years of age sleep with a pillow.
  2. Choke foods are smooth and round: Foods like grapes and hotdogs are common offenders. Cut up food into small pieces while your child is young (younger than 2 years) and not completely reliable about chewing well.
  3. Plastic bags: A seemingly harmless item can easily cause suffocation. Keep them out of reach of kids.
  4. Airtight spaces: Kids love to climb into anything and everything. If the item has a limited amount of air (e.g., like a freezer), then consider putting a lock on it to prevent suffocation.
  5. Little toys. Any “bite-sized” toy or item poses a choking risk for the small child who likes to put everything in his/her mouth. It is another reason to get after older children for leaving out the Legos.
  6. Items that can cause strangulation:
    1. Window blind cords: Tie them up, ensure they don’t end in a loop, or replace them with a cordless design.
    2. Pacifier strings: Don’t use them. I know the pacifier may drop, but better to clean it than have your child strangulated.
    3. Drawstrings on clothing (e.g., hoodies)
    4. Ribbons
    5. Necklaces: Don’t put them on your infant (or only for the 1-minute, supervised picture).
    6. Headbands: Don’t put them on your infant (or only for the 1-minute, supervised picture). Headbands can slip down around your infant’s neck.
    7. Anything a child can get his/her head stuck in (e.g., furniture, playground equipment, etc.).
    8. Electrical cords: Extra cords are a huge potential disaster for young children (from pulling appliances on top of the child, to electrical burns, to strangulation). Keep them out of reach.

One last plug…while it may not be in the top 5 causes of accidents, no article on home safety would be complete without a nod to gun safety. I am not making commentary on whether an individual should or shouldn’t have a gun, but guns and children don’t mix. Make sure all guns are locked in a safe (preferably with a biometric lock).

Ben Franklin’s famous quote: “An ounce of prevention is worth a pound of cure,” is as true today as was nearly 300 years ago. Stay vigilant and keep your child safe.