Late Adolescence Well-Child Visits (ages 17-19y)

We will look at ages 17-19y, known as middle adolescence, as a group rather than individually. It is still important that your child come to see the Pediatrician once per year during this time. There are important milestones and plans for the future to discuss. What can you expect at these visit with the Pediatrician?

Vitals – Heart rate and respiratory rate will be counted, temperature and blood pressure are taken.

Growth measurements – Height, weight, and BMI (Body Mass Index) continue to be measured and plotted on growth curves for age and gender.  You may start to see slowed growth in height during this time if your child has already had a growth spurt. The BMI is s a person’s weight in kilograms (kg) divided by the square of height in meters. Higher BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the health of an individual by itself. It is another marker we use to help determine the health of your child. 

Vision and Hearing – Most offices will check your child’s vision and/or hearing at these visits, unless you are certain they have been screened at school within the last year. Any abnormalities noted, including poor eyesight, hearing loss, etc, will result in a referral to a vision or hearing specialist for further, more detailed evaluations. 

Development –

• They continue to form caring relationships with others in a positive way, and begin to engage with their community.
• They are better able to self-regulate their emotional, social, and cognitive abilities. They are becoming more self-confident and use independent problem solving skills. 
• They exhibit compassion and empathy towards others and demonstrate resiliency. 

Questions from the Pediatrician – your adolescent’s doctor will ask questions about nutrition and meals, sleeping, screen time, interactions with family members and peers. The doctor may ask to speak with your teen alone, if he or she is comfortable with this. It is important to know that teens have the privilege of doctor-patient confidentiality. Anxiety and depression screenings are done every year in this age group. 

Nutrition – Continue to offer your teen a variety of fruits, vegetables, proteins, dairy, fats, and carbohydrates. Promote family meal times with snacks in between as needed. Allow your child to decide how much to eat at once.  Avoid fruit juices or other sweetened beverages, but always have water available to drink. 

Healthy Teeth – brushing teeth twice daily should be an important part of the daily routine. Your teen should be seen by the dentist every 6 months for check ups and cleanings. 

Exam – your adolescent will have a head-to-toe exam at every well-child visit. A sports physical may be done at this visit as well. 

Vaccinations – If you have followed the CDC vaccination schedule, there are no scheduled vaccinations during this age range. The HPV series (Human Papilloma Virus) is also recommended if it has not yet been received. Your Pediatrician will discuss these in detail with you at your visit. Depending on the time of year, your child’s doctor may recommend the Influenza vaccine as well. I discuss adolescent vaccines in depth in another post if you would like more detailed information. 

Questions from you – you will likely have questions about proper nutrition, sleep habits, behavior, and schooling. Bring your questions to the visit and never hesitate to ask your child’s Pediatrician about your concerns. Encourage your adolescent to ask questions as well. 

School – This age group will finish high school. It is vital for them to determine the next step, whether it is progressing on to college, trade school, apprenticeship, taking a “break year,” or entering the work force. 

Safety information – part of every well-child visit is discussion of safety that is appropriate for age. For adolescents, this includes:

• car safety – ensure your teen wears a seat belt each time he or she is in the car.  Have clear rules for driving safely, including number of friends allowed in the car as passengers, no cell phone use, no driving while under the influence of drugs or alcohol. 
• water safety – ensure your teen knows how to swim but do not assume this will prevent drowning accidents. There should always be a responsible adult present when your child is in the water. 
• bike safety – ensure your adolescent has a well-fitting helmet to use with bicycles, scooters, skateboards, hover boards, etc. Make sure your adolescent actually wears them. 
• social safety – talk about relationships with peers and other adults. Know your child’s friends. Discuss the risks of tobacco/alcohol/drugs with your child, as well as how to avoid risky situations. Discuss dating and sexual activity with your adolescent, including the risks of infections, pregnancy, and unwanted contact.  Discuss online safety and be sure to monitor your teen’s screen time activities closely.
• sun exposure – avoid direct exposure during the middle of the day as much as possible. Use hats and long sleeves. Use sunscreen with a high SPF. 
• firearms – remove all firearms from the home, if possible. Otherwise, ensure they are locked in a safe and stored unloaded. 

Well-child visits should occur yearly. Teens should transition to an adult provider between the ages of 18 and 20. 

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