Adolescent Health
Moving through the teen years can be both wonderful and challenging for parents and teens alike. Advanced Pediatrics pays special attention to teen needs to help make this transition to adulthood a healthy process. Our adolescent services include:
Well Care Exams
Advanced Pediatrics recommends annual well care exams for all adolescents. Many changes take place over the teen years physically, emotionally and socially. In addition to a complete physical examination, these important visits give our providers the opportunity to discuss nutrition, puberty, behavior, safety (including substance abuse and sexuality), family, social and school issues. During these visits, parents will be asked to leave the room for a portion of the exam, so that adolescents may freely discuss confidential health issues with their provider. This practice is consistent with recommendations from the American Academy of Pediatrics, helps to ensure that important adolescent health concerns will not be overlooked due to a teen's concern for privacy, and provides a "bridge" toward becoming an adult and handling health issues independently.
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Immunizations
Adolescent vaccines are key to preventing serious, sometimes life-threatening diseases. Because immunity from some childhood vaccines can decrease over time, adolescents need to get another dose of the tetanus, diptheria and pertussis vaccine during their pre-teen years. Also, as children move into adolescence, they are at greater risk of catching certain diseases, like meningitis and human papillomavirus (the leading cause of cervical cancer). Consistent with recommendations from the AAP and CDC, Advanced Pediatrics recommends the following immunizations for adolescents:
Annual Influenza Vaccine
Given annually beginning in September. Influenza is a serious disease, causing (on average) 36,000 deaths and more than 200,000 hospitalizations annually in the United States. Getting the annual flu vaccine is the best way to reduce the chances of getting the flu or transmitting it to others.
Tdap/Adacel (Tetanus, Diptheria, Pertussis Booster)
Given at age 11 or older for children who have completed the DTaP series and who have not received a Td booster. (Children who received a Td booster should wait at least 2 years before receiving Tdap.) Protects against three serious bacterial diseases - Tetanus, Diptheria and Pertussis (Whooping Cough).
Meningococcal/Menactra (Menengitis)
Given at age 11 or older for protection against meningitis, a serious bacterial infection of the fluid surrounding the brain and spinal cord. College freshman living in dormitories and teenagers age 15 - 19 have an increased risk of getting meningococcal disease.
Gardisil (HPV)
Given to girls age 11 or older to protect against HPV (Human Papillomavirus), the leading cause of cervical cancer. Every year, about 6.2 million people are infected with HPV in the U.S. Cervical cancer is the 2nd leading cause of cancer deaths among women in the world.
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Gynecological Services
The providers at Advanced Pediatrics feel it is important to offer gynecological health care to meet the needs of female teens as they pass through puberty and approach adulthood. Many adolescents have been patients at Advanced Pediatrics since birth or early childhood and have established a comfortable relationship with our providers. We feel that this relationship will make it easier for teenage girls to discuss gynecological concerns in our office than at a more "adult" gynecological practice. Our gynecological services include:
- Annual gynecological/pelvic exams (including pap if appropriate)
- Diagnosis and treatment for delayed onset of, irregular or painful menstrual cycles
- Birth control and emergency contraception
- Pregnancy testing
- Testing and treatment for sexually transmitted diseases
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Additional Teen Services
The providers at Advanced Pediatrics want to be there to provide quality health care and guidance for teens facing difficult adolescent issues. As such, we offer the following additional services for teens:
- Counseling, testing and treatment for sexually transmitted diseases (male and female patients)
- Drug and alcohol testing and referral
- Evaluation, treatment and referral for mental health issues
- Evaluation and referral for eating disorders
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Advanced Pediatrics Philosophy: Sensitive Adolescent Issues
During this important period of transition between childhood and adulthood, the providers at Advanced Pediatrics recognize the concerns of both teens and their parents regarding sensitive health issues, and follow recommendations from the American Academy of Pediatrics and requirements of state and local laws in providing health care for adolescents. Our philosophy in dealing with sensitive adolescent health issues centers around the following principles.
Education
Advanced Pediatrics values the importance of providing education for both adolescents and their parents regarding sensitive health and safety concerns. We believe that by educating teens and parents regarding the risks of substance abuse, sexually transmitted diseases, unwanted pregnancy and other adolescent health concerns, we can open the door for communication and help teens make safer and healthier choices as they grow and mature. Our providers strive to provide helpful educational materials and discussion during well care visits, and encourage teens and parents to visit our website or call our nurse advice line whenever they have questions regarding adolescent issues.
Privacy
The providers at Advanced Pediatrics strongly encourage ongoing communication between teens and parents. We respect the special relationship between teens and their parents and encourage teens to be open and honest with their parents regarding health, emotional, sexual and social issues. As health professionals, however, we are bound by state and federal laws governing a teens right to confidentiality regarding sexuality, substance abuse and mental health issues (see below for details). While we encourage teens to discuss concerns with their parents, there are certain situations where a teen can legally decide to protect his or her privacy.
Sexuality
The providers at Advanced Pediatrics strongly support the practice of abstinence as the best way to promote healthy adolescent physical and emotional growth, as well as prevent sexually transmitted diseases and unwanted pregnancy. However, we live in a world where many adolescents are making adult choices at an earlier age than in generations past. Our goal is to provide education and guidance when possible, while providing access to quality health care for our adolescent patients.
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State and Federal Laws Regarding Confidentiality
According to Colorado state law, a person is deemed to be "of full age" once he or she has attained the age of eighteen years (CRS 13-22-101). Every competent person eighteen years and older may "make decisions in regard to his or her own body." Before the age of eighteen, a minor is generally presumed to be incompetent to make his or her own medical decisions without parental consent (CRS 13-122-103). However, there are a few exceptions. Minors can consent to medical care for themselves without parental consent in the following instances:
- If the minor is financially independent and living separate and apart from his or her parents
- If the minor is legally married
- If the minor requests birth control or family planning services
- If the minor requests testing and treatment for sexually transmitted disease
- If the minor requests testing and treatment for drug addiction
- If the minor requests treatment for certain mental health issues
Federal HIPAA regulations are clear that if a minor has requested confidential treatment in one of the above instances, the minor is the owner of that portion of the medical record. That portion of the medical record can only be released or shared with the permission of the minor. Advanced Pediatrics complies with state laws and federal HIPAA regulations regarding confidentiality and privacy rights of adolescents. The rights, well-being, safety and best medical interests of the adolescent patient will be the primary factors in determining confidentiality of patient information.
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Advanced Pediatrics Teen Health Articles
Pediatric Web Teen Health Links
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Recommended Resources
Helpful Websites
Recommended Reading
Caring for Your Teenager. Philip Bashe & Donald Greydanus (ed). The American Academy of Pediatrics.
Your Adolescent: Emotional, Behavioral, and Cognitive Development from Early Adolescence Through the Teen Years. AACAP, David Pruitt, MD.
Surviving Your Adolescent: How to Manage and Let Go of your 13 - 18 Year Olds. Thomas W. Phelan.
A Parent's Guide to Building Resilience in Children and Teens. Kenneth Ginsburg, MD, and Martha Jablow. The American Academy of Pediatrics.
So Sexy, So Soon. Diane E. Levin, Ph.D. and Jean Kilbourne, Ed.D.
Get Out of My Life, but First Could You Drive Me and Cheryl to the Mall: A Parent's Guide to the New Teenager. Anthony E. Olf.
Less Stress, More Success. Kenneth R. Ginsburg, MD, and Marilee Jones (former Dean of Admissions, MIT. The American Academy of Pediatrics.
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