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​Age: 15-16 Years​

Middle adolescence is a great time, filled with growth and maturity. Most girls at this age are nearing the end of puberty, while most boys are in the middle of the process. Peers and acceptance is the predominant focus of most 15 and 16 year-olds. This is the age in which most teens are internalizing their moral values and deciding what really matters to them.


  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. If your child is already involved, seek help. Discuss what happens at parties and strategies to avoiding situations where drugs and alcohol are present.
  2. Car: Establish rules for teen drivers. Fact: Accidents are the #1 cause of death in teens
    1. Drivers and passengers must always wear seat belts.
    2. Educate about the dangers of distracted driving, especially texting and driving.
    3. Have a “Call me ANYTIME for a ride” rule, which applies to any situation where your teen is compromised (e.g., they or their friends have been drinking, are in danger, someone is being abusive with them, etc.). Make sure your teen understands that if called, you will remain calm and not get mad. It is most important that they understand they are loved and that you care most of all about their safety.
  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, dirt bikes, 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. Abuse: Teach your teen strategies to protect themselves from abuse of any type (physical, emotional, sexual/rape). Make sure they seek help if they feel they are in danger.
  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/predators from entering your home via your computer.
    2. Continue offering guidance navigating social media. Follow your teen’s accounts.


  1. Eat 3 nutritious meals a day and healthy snacks. Reinforce the importance of breakfast.
  2. Limit high fat and high sugar foods. Limit soft drinks/soda, instead encourage lots of water.
  3. Reinforce the importance of eating a balanced diet, including 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). Watch for any signs of disordered eating.
  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 teen is not eating a balanced diet. Consider a woman’s multivitamin with iron if your daughter has heavy periods and doesn’t eat an iron rich 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.
  3. Don’t smoke or chew tobacco. It ruins teeth and gums (among other harmful effects).


  1. Continue discussions about sex, contraception, STI’s, masturbation, and pornography. 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 sex should be a well thought out decision. Engaging in sex comes with a lot of responsibilities and consequences; one should delay having sex until mature enough to handle it.
  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 teen is already sexually active, you must discuss safe-sex practices (e.g., contraception, condoms).
  6. If teens are concerned or confused about their sexual feelings (for the same or opposite sex), they should talk with their doctor or a trusted adult.
  7. Keep in mind, your physician is a good resource if you are uncomfortable having any of these very important conversations (including the need for birth control) with your teen.


  1. Mental Health: Teach teens to trust their feelings. Listen to the ideas of good friends and trusted adults. Seek help if teens are regularly feeling angry, hopeless, or depressed. Learn constructive ways to deal with stress. Learn to set and achieve goals.
  2. Media Exposure: Set limits. Create media free zones/time (e.g., no media at the dinner table and in bedrooms or after a certain hour). Interesting Fact: The AAP states that the average teen consumes >11 hour of media a day.Yikes! Consider making a family media use plan ( Be selective about what media your teen consumes. Counsel your teen on appropriate engagement in social media, give clear direction on what is appropriate to post, comment on, and follow, and make sure you follow his/her accounts.
  3. Phones: Most teens have their own cell phones at this age. Set clear limits and expectations. Establish that the phone is a privilege that has responsibilities associated with it. Interesting fact: The AAP reports the average teenager sends >100 texts a day and 20% either send or receive sexually explicit images. Now is not the time to be complacent in parenting.
  4. 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. Be available to discuss concerns, feelings, and experiences at school and with friends. Know who your teen is hanging out with and have their cell phone numbers. Make a contingency plan for when your teen is a situation where he/she feels unsafe/uncomfortable that he/she can contact you.
  5. Family life: Respect family members and family rules (e.g., curfew). Spend time with your teen both individually and together with siblings. Expect your teen to make time to participate in at least some family activities. Provide personal space for your child at home.
  6. Exercise: Aim for a minimum of 30-60 mins of physical activity a day. Model and encourage an active lifestyle.
  7. 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. Just because a teen is involved in more activities doesn’t mean he or she shouldn’t contribute to the household.
  8. School: Emphasize the importance of school. Make sure your teen is staying on top of his/her own homework, course selection, attendance, and extracurricular activities. Discuss openly any frustrations he or she may be having at school. Start discussions of life post high school (e.g., college, military, vocational options, etc.).


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 were not given this visit (15), plan next year (16). If a Bexaro shot (for meningitis) was given today, a booster shot should be given in 1+ months. Depending on the time of year, your teen may also need an annual flu shot.

Period Talk

Do you have a daughter and dread having “the talk” about periods? Are you uncertain when to broach the subject? Are you secretly hoping she’ll learn all she needs to know at “maturation day” in school? (If you aren’t from Utah, “maturation day” is a few hours one day in fifth grade where kids are taught about development, puberty, and periods). If you’re like my husband, he’s so uncomfortable with the notion that he refers to periods as “ladies days.” Take heart, this is what you need to know.

The terms

Menarche: The very first period

Menustration: The cycle of blood coming out of the vagina (a.k.a., the period)

Ovulation: When the egg (to be fertilized) is released from the ovary, happens midcycle

Thelarche: Breast development

Andrenarche: Onset of puberty (when the brain secretes androgens), causes pubic hair and body odor

Talk timing

The onset of periods (menarche) is considered normal as early as 9 years-old (and as late as 16). In my opinion, all girls should know about periods before it could happen. On more than one occasion, I’ve seen a horrified young girl who thinks she is dying because she starts bleeding for some unknown reason. Talk with your daughter by 8 years-old (I know this feels young). She should hear it first from a parent (or a doctor).

How to talk about it

First I am not a big believer in huge sit-down talks. Answer your daughter’s questions as they naturally come up throughout childhood. Your young daughter will see pregnant people and ask about where babies come from. Take the opportunity to introduce (at an age appropriate level), the concept of a girl’s body being different and special. Inevitably, your daughter will encounter products of yours (tampons, pads, birth control, etc.). Answer honestly what they are for. Then, when the time is right, you can build on previous small conversations and give your daughter the rest of the explanation. The explanation doesn’t have to be complicated, just accurate.

The verbiage

Are you still wondering what exactly to say? Everyone’s approach is a little different (and tailored to the person), but I’m happy to share my general approach. I usually start by drawing a simple picture (ovaries, fallopian tubes, uterus, vagina). I generally use the “only girls can get pregnant approach.” The period is the body’s way of practicing and preparing to get pregnant. (I usually give a plug for waiting to get pregnant until the girl is much older and married). Every month the body makes an egg (point to appropriate pics), travels down the tube, and waits to get fertilized. I draw a baby in the uterus (describe it as the baby sack) and ask how the body could get a nice, soft, pillow-like environment for a baby? Since the body doesn’t have stuffing (for the pillow), it uses what it has to make a lining-nice, warm blood. When the baby doesn’t happen (i.e., the egg is not fertilized) the body gets rid of the lining out the vagina (a.k.a., the baby shoot). And voila, the period happens. Depending on how mature your daughter is, you can add the hormonal (estrogen and progesterone) element to the discussion.

You can do this. Just start talking. Your daughter is listening.

When Puberty Starts: Girls vs. Boys

Stages of puberty for girls:

Typically girls show signs of puberty 2 years earlier than boys.

  • Thelarche (breast development), adrenarche (pubic hair development), pubarche (growth), menarche (first period/menses)
  • The average age for greatest growth/height velocity in a girl is 12.1 years old (with a range of 10.4-13.9 years).
  • It is normal for a girl to start her period somewhere between the ages of 9 and 16.

Stages of puberty for boys:

  • Enlargement of the testes, lengthening of the penis, appearance of pubic hair, physical growth
  • The average age for greatest growth/height velocity in a boy is 14.1 yrs old (with a range of 12.2-15.9 years).
  • Average age of onset of puberty is 12 (ranges from 9 to 13 for onset)
  • Gynecomastia (swelling of the breast tissue) is very common concern during puberty, occurring in approximately 60% of adolescent males.

What is delayed puberty?

Puberty is delayed if there are no signs of secondary sexual characteristics by the age of 13 in girls and 14 in boys.

What is precocious (early) puberty?

Precocious puberty is the early onset of what are called secondary sexual characteristics (e.g., breast development, pubic hair, or armpit hair) before the age of 8 in girls and 9 in boys.