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.

SAFETY

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.

NUTRITION

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.

SLEEP

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.

ORAL HEALTH

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).

SEXUALITY

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.

OTHER

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 (www.healthychildren.org/MediaUsePlan). 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.).

ILLNESS

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 NEXT VISIT

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.