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Are You Talking With Your Teen?
Open and honest communication between parent and teen is especially important during the teen years. Studies show strong parent / teen communication reduces problems with alcohol, drugs, unwanted pregnancy and sexually transmitted diseases.
Moving through the teen years can be both wonderful and challenging for parents and teens alike. With so many changes taking place physically, socially and emotionally, Advanced Pediatrics pays special attention to teen needs to help make this transition to adulthood a healthy process.
Many families ask how long their children should see a pediatrician. Advanced Pediatrics recommends that adolescents continue to see our providers until they graduate from high school. In fact, college students may continue to be patients at Advanced Pediatrics until they reach 21 years of age to ensure continuity of care. Since many of our adolescent patients have been with Advanced Pediatrics since birth or early childhood, they have had the opportunity to establish a comfortable and trusting relationship with our providers. Studies show that this relationship often makes it easier for teens to discuss sensitive concerns with the pediatric health care providers they know and trust, than with new "adult" health care providers. By continuing care with this established "medical home," our providers help guide our adolescent patients as they pass through this bridge to adulthood.
Our adolescent services include:
Well Care Exams
With so many changes taking place during the teen years, annual well care exams are more important than ever. In addition to a complete physical examination, these important visits give our providers the opportunity to discuss nutrition, family, social and school issues, safety, behavior and puberty. As part of all well care exams beginning at age 13, adolescents will be asked to complete the "RAAPS" risk assessment questionnaire, which helps identify any important concerns regarding adolescent health and safety. In order to foster honest communication, we assure teens that answers to this questionnaire will be confidential between themself and their health care provider, and we request that parents respect this privacy promise. A blank copy of the "RAAPS" questionnaire is available for review in the link below:
As teens mature, it is important for them to begin to take some responsibility for their own health -- providing a "bridge" toward becoming an adult and handling health issues independently. Sometimes, adolescents have questions or concerns that they do not feel comfortable discussing in front of their parents. Consistent with recommendations from the American Academy of Pediatrics, we will ask parents to leave the room for a portion of each well care exam beginning at age 13, so that adolescents may freely discuss confidential health issues and ensure that important adolescent health concerns will not be overlooked due to a teen's concern for privacy.
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What's the Difference Between a Well-Care Exam and a Sports Physical?
Local high schools require athletes to provide proof of an annual physical exam in order to participate in high school sports. Unfortunately, families may not realize that a "sports physical" is not as comprehensive as a "well care exam". A sports physical is simply an exam that helps determine if it is safe for the athlete to participate in a particular sport. An annual well-care exam gives our providers a chance to perform a thorough physical exam and health assessment. It's also a good chance to address important adolescent issues such as drinking, smoking, drugs, sexual activity and anxiety/depression. Since your adolescent already needs an annual "well care exam," there is no need to schedule a separate "sports physical." Just be sure to schedule his or her annual "well care exam" at one of our offices a few weeks prior to the start of the season.
We strongly recommend against seeking sports physicals at retail based health clinics or urgent care facilities, as providers at these clinics have no access to your child's medical record or health history and advertised "sports physicals" are not as comprehensive as a well-care exam by your child's primary care provider. Recent health care reform laws require most insurance plans to cover 100% of well care and immunizations for children. We recommend you check with your insurance company to be aware of coverage for your specific plan.
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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, diphtheria 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:
For more information on adolescent immunizations, please visit AdolescentVaccination.org.
Annual Influenza Vaccine
Wednesday, May 16, 2012 -
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. Even mild cases can cause children / teens to miss a week of school and have a cough for three weeks. 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, Diphtheria, Pertussis Booster)
Wednesday, May 16, 2012 -
Given at age 11 or older to protect against three serious bacterial diseases - Tetanus, Diphtheria and Pertussis (Whooping Cough). Tdap is required for entry into 6th and 10th grades.
Tuesday, May 15, 2012 -
Given at age 11 - 12 years, with a booster at 16 years (or 4 - 5 years after initial dose). Protects 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.
Monday, May 14, 2012 -
A series of three doses given at 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. Because Human Papillomavirus can infect both males AND females (and can cause other cancers), APA recommends that both girls and boys receive this vaccine to prevent the spread of HPV. For more information, see the Gardasil website.
Catch-Up Vaccines (as needed)
Thursday, January 01, 2009 -
During adolescent well-care visits our providers check to be sure that patients are up-to-date on all other vaccines, including Hepatitis A, Varicella (chicken pox) etc.
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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:
- Diagnosis and treatment for painful or irregular menstrual cycles
- Birth control and emergency contraception
- Pregnancy testing
- Testing, treatment and counseling for sexually transmitted diseases
An annual Pap test is recommended beginning at age 21.
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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 adolescent issues. As such, we offer the following additional services for teens:
- Acne evaluation and treatment
- Evaluation, treatment and referral for eating disorders
- Diagnosis, treatment and counseling for sexually transmitted diseases
- ADHD evaluation and treatment
- Evaluation, treatment and referral for anxiety and depression
- Evaluation, treatment and referral for mental health concerns
- Drug and alcohol testing and referral
For more information on some of these services, see the ADHD and Emotional / Mental Health pages of this website.
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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.
The providers at Advanced Pediatrics strongly value 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.
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 teen's 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.
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
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General Adolescent Health & Wellness
Pre-Teens / Tweens
Teens / Young Adults
Female Teens / Young Adults
Male Teens / Young Adults
Topics in Adolescent Health
Behavior / Mental Health
Drugs, Alcohol & Smoking
Healthy Weight / Nutrition / Fitness
Internet / Technology Safety
Sexuality / STDs
Texting While Driving / Teen Driver Safety
Graduating High School and Beyond
back to topRecommended Reading
Caring for Your Teenager. Philip Bashe & Donald Greydanus (ed). The American Academy of Pediatrics, 2003.
Your Adolescent: Emotional, Behavioral, and Cognitive Development from Early Adolescence Through the Teen Years. AACAP, David Pruitt, MD., 2000.
Surviving Your Adolescent: How to Manage and Let Go of your 13 - 18 Year Olds. Thomas W. Phelan, 2005.
A Parent's Guide to Building Resilience in Children and Teens. Kenneth Ginsburg, MD, and Martha Jablow. The American Academy of Pediatrics, 2006.
So Sexy, So Soon. Diane E. Levin, Ph.D. and Jean Kilbourne, Ed.D.,2009.
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, 2002.
Less Stress, More Success. Kenneth R. Ginsburg, MD, and Marilee Jones (former Dean of Admissions, MIT. The American Academy of Pediatrics, 2006.
Your Defiant Teen: 10 Steps to Resolve Conflict and Rebuild Your Relationship. Russell A. Barkley, PhD, ABPP, ABCN and Arthur L. Robin, PhD, 2008.
Nurturing the Shy Child: Practical Help for Raising Confident and Socially Skilled Kids and Teens. Markway, 2006.
Letting Go with Love and Confidence: Raising Responsible, Resilient, Self-Sufficient Teens in the 21st Century. Kenneth Ginsburg M.D. and Susan FitzGerald, 2011.
Grow the Tree You Got: & 99 Other Ideas for Raising Amazing Adolescents and Teenagers. Tom Sturges, 2011.
Odd Girl Out: The Hidden Culture of Aggression in Girls. Rachel Simmons. Harcourt, 2002.
Graduating High School and Beyond:
Launching Your Teen into Adulthood : Parenting through the Transition. Patricia Hoolihan, 2009.
The Launching Years: Strategies for Parenting from Senior Year to College Life. Laura S. Kastner and Jennifer Wyatt, 2002.
The Care & Keeping of YOU2: The Body Book for Older Girls. Dr. Cara Natterson and Josee Masse. American Girl, 2013.
The Care and Keeping of You: The Body Book for Younger Girls, Rev. Ed. Valorie Schaefer and Josee Masse. American Girl, 2013.
The Girls Body Book: Everything You Need to Know for Growing Up YOU. Kelli Dunham & Laura Tallardy, 2008.
Will Puberty Last My Whole Life?: REAL Answers to REAL Questions from Preteens About Body Changes, Sex, and Other Growing-Up Stuff. Julie Metzger RN MN and Robert Lehman MD, 2012.
The Body Book For Boys. Rebecca Paley, Grace Norwich, Jonathan Mar, 2010.
American Medical Association Boy's Guide to Becoming a Teen. American Medical Association, 2006.
The Boys Body Book: Everything You Need to Know for Growing Up YOU. Kelli Dunham, 2007.
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