When our children are babies, we look forward to the first smile, laugh, and word. We encourage them to take each new step. As children approach the teen years, we often worry about their new skills. It’s one thing to see a toddler start to walk. It’s another to drop a teen at the mall with friends or to hand over the car keys. It may be especially hard for parents of teens with special health care needs to “let go,”—allowing their teens to set their own limits and have “teen” experiences.
Teens also develop at different rates. It’s important to let them figure out how to handle new skills and responsibilities, yet still be there to provide help and advice. Youth with special health care needs may need unique supports. Your health care provider can refer you to helpful services. Parents can also learn about services, resources, and supports from each other, school, and community sources. Share these resources and supports with your teen’s health care provider as part of your parent/provider partnership.
In many cultures, families celebrate coming of age with special rites and traditions. Help your health care provider learn about your culture, values, and preferences. You may prefer that you, or another adult in your family or community, be the one to talk to your teen about body changes, intimate relationships, sexuality, and responsibility for choices about health and wellness. By sharing this information and your preferences with your child’s health care provider, together you can partner in preparing your child for all of the changes during the adolescent years.
When you and your teen’s health care provider work together to ensure that your teen receives health services and needed supports, you are modeling the skills they will use to make health decisions as an adult. To prepare for this responsibility, it is important for teens to learn their medical history, making them informed partners in their own health care.
Then, teens can “test drive” these skills. Let them take on more responsibility. Let your teen take the lead during the health care visit. Ask your teen to think about questions to ask or specific topics to address with the provider. This is also the time to begin planning for health care transition—the move from pediatric to adult health systems. Families, teens, and current health care providers should partner and work together to ensure that teens are ready to manage their own health needs. Goals should include choosing adult providers and developing new health partnerships. This is especially important for teens with special health care needs. Some specialty providers continue with their patients. Others will work with you and your teen to transfer care to adult health care providers, hospitals, and health systems for adults.
Many teens with special health care needs have teams of doctors, but your teen still needs a yearly well-visit with a primary health care provider. These health visits help ensure and support your teen’s overall health. This yearly exam is also a time to screen for secondary health conditions that can occur in all teens. Well-visits are a time to discuss puberty, healthy eating, physical activity, mental and emotional health, risky behaviors, friends, and school. This is also the time to talk about other services and supports that your teen has now or may need in the future.
Teens with special health care needs may have more transitions than their typical peers between ages 11 and 21. In addition to moving to adult health care systems, some teens will receive full or partial guardianship. This involves an adult with the legal authority to make some or all decisions for a person making choices about health care, finances, or other parts of adult life. Whether or not to pursue guardianship can be difficult for families. Know that there are other options available that can help your teen keep their rights while still allowing to provide support for their decision-making. Supported decision-making can be an effective way for a teen to make decisions with guidance from a trusted adult. You can find more information by visiting the Got Transition website at https://www.gottransition.org/ or the National Resource Center for Supported Decision-Making website at http://www.supporteddecisionmaking.org/. For additional assistance with this process, you can contact your Family-to-Family Health Information Center (F2F). Visit https://familyvoices.org/affiliates/ to find a local F2F chapter.
Some teens with IEPs may need more than 4 years to complete high school. Part B of IDEA allows them to stay in school through age 21. Transition planning should begin no later than age 16 in most states and by age 14 in other states. Transition planning should include goals for post-high school employment and independent living. Discuss this transition plan with your school team and share it with your health care provider in order to help the school and health care providers work together to meet the needs of your teen. You can contact the Parent Training and Information Center (PTI) in your state to get assistance on this transition process. Visit https://www.parentcenterhub.org/find-your-center/ to find your local PTI.
If your teen gets support from a state agency, find out if eligibility changes at age 18. You can contact your local F2F to discuss your child’s current services and determine what services may be available to your youth as they move into adulthood.
With the passage of the Patient Protection and Affordable Care Act (ACA) in March 2010, parents are currently able to keep any adult child on their health plan until age 26. The ACA also stops health insurers from denying coverage to children and adults with preexisting conditions. This means that your health insurer cannot deny coverage for your teen because of their disability. Some health plans cover dependents with disabilities of any age who are unable to work. Check with your health insurance plan to determine if coverage is available for dependent adults with disabilities. However, your teen may also be eligible for Medicaid through your state if they meet the Social Security Administration’s disability criteria.
In some states, a teen with special health care needs may meet the Social Security Administration’s disability criteria, which allows a teen to access SSI and Medicaid benefits; however, if family income is too high, the teen may not be eligible to get these benefits. When a teen turns 18 years old, even if still living at home, family income no longer counts towards the teen’s eligibility. Depending on the teen’s income and assets, they may now be able to receive SSI and Medicaid.
Applying for SSI and Medicaid can be a difficult process, and some individuals who meet the criteria as children do not always qualify as adults. This is because the definition of disability is stricter for adults. Sometimes your young adult with a disability may receive a denial-of-benefits letter from Social Security initially. However, many individuals receive approvals after 1 to 2 appeals of the decision. Contact the F2F Health Information Center in your state in order to get more information on eligibility, the appeal process, and other health financing options by visiting https://familyvoices.org/affiliates/.
- Try to talk with your teen every day. Sometimes it’s easier to talk while doing other activities, such as eating meals or driving in the car.
- Show an interest in your teen’s life without sounding nosy. Ask about friends, school, work, and other interests. Be a good listener. Praise your teen’s efforts and successes. When your teens come to you with problems, try not to fix them. Instead, listen to them and ask how they would like you to help. This allows them to think about how they can receive support in addressing the many issues they will face in their lives. It also helps them build confidence and competence in handling difficult situations.
- Model the positive behaviors you want your teen to engage in.
- Talk with your teen about relationships, dating, sex, marriage, parenting, and family planning as issues arise. Use topics and media that are interesting to your teen to start conversations. Share your views in a nonjudgmental way and listen to your teen’s point of view.
Share with your teen about what it means to be a “good friend.” When you can, get to know your teen’s friends. Be there to listen if problems arise in friendships that your teen would like help resolving.- If your teen has a disability, talk with your teen directly about the disability, including the strengths, challenges, and weaknesses involved. Discuss practical supports, so they can pursue a successful path forward.
- If financial or other types of support would be helpful to your family, including access to food, medical care, or general aspects of living, talk to your health care provider.
- Emphasize the importance of school and the importance of learning—as well as the difference between the two. Help your teen find subjects they enjoy and can succeed in, as well as some that are interesting but challenging.
Monitor and guide your teen as they assume more responsibility for schoolwork. Many teens need help organizing and setting priorities as they transition to high school and college. - Be ready to help with organizational skills or new activities, such as applying for jobs and college.
- Help your teen find activities outside of school that interest them, especially if your teen has challenges with academic subjects.
- Encourage reading by helping your teen find books, magazines, and websites about subjects of interest. Help them learn about current events and watch or read the news every day.
Help your teen learn how to use the internet safely and appropriately. Teach them how to evaluate websites to identify informative sites from less reputable ones. Also, help them learn about appropriate social media use and what is considered cyber bullying or inappropriate behavior. - Teach your teen about online phishing and scams, as well as inappropriate content.
- Involve youth in family decision-making, as appropriate. This can provide experience with the ups and downs of “real life” and the many ways families choose to address situations. Praise their efforts and thank them for their help.
- Discuss family responsibilities, expectations, and how these change with age.
- Encourage problem-solving skills rather than providing all the answers.
- The legal age of consent varies by state. Your teen’s health care provider needs your teen’s permission to share information with you once they reach legal age. Depending on your teen’s medical and cognitive needs, you may want to ask your teen to sign a Health Insurance Portability and Accountability Act (HIPAA) release form so that the health care provider can still talk to you about your teen’s overall health and well-being.
- Teens with special health needs usually want to be like everybody else. Some may try not taking medications or following medical advice because it makes them feel different. Develop a partnership between you, your teen, and the health care provider to focus on helping your teen understand their medical condition. Together, discuss the need for self-care to help address these challenges. It is important for your teen to build confidence in who they are and understand what they need to be their best self. This will promote lifelong health, so take advantage of community resources and supportive adults.
If your teen has special health care needs, discuss the support services and benefits they currently receive or could receive in the future and learn the ways these may be changing. This could include financial supports (eg, SSI, Medicaid, community waivers), public transportation, school supports, and employment services. - Ask your teen’s school to facilitate connections to community supports as a part of your teen’s transition plan.
- Contact your state F2F Health Information Center to determine what community supports are available in your area for teens and young adults.
- This is critical: Model nonviolent conflict resolution.
- Teens today think about different types of violence (such as school shootings and suicide bombers) and their impact on them. Most parents didn’t face these issues when they were young. Talk about these events as you hear about them in the news.
- Ask your teen what their concerns are about different types of violence, like bullying and dating violence. Help your teen develop ways to cope non-violently, to address the situations they face, and to learn about available resources (eg, a guidance counselor, trusted adult at school) for assistance.
- Be on the alert for possible bullying. Talk to your teen’s teacher, guidance counselor, or program leader right away if your teen is anxious about going to school or if you think your teen is being bullied. Help your teen learn to tell the bully to stop and then to leave. Also, teachers and health care providers can help if your teen is bullying others.
- Encourage your teen to get involved in your community by volunteering, serving on a committee, or doing another activity to contribute to community well-being.
- Support safe activities at school, in community- and faith-based organizations, and with volunteer groups to encourage personal and social development.
- Join with other parents in your community to keep all teens safe and active.
- Encourage your teen not to smoke, use e-cigarettes, or vape and to avoid places where others do.
- Ask for help if you or your teen is worried about any family member’s alcohol or drug use.
Talk to your teen about alcohol and drug use and what their friends are doing. Discuss the dangers and consequences of alcohol and drug use. Share the importance of staying away from these substances. - Give your teen the tools to get out of uncomfortable or unsafe situations such as being with a drunk driver. For example, provide money for bus fare, ride shares, or honor a no-questions-asked call to parents.
- Support good nutrition and eating habits by keeping a variety of healthy foods at home and by encouraging healthful food choices.
- Encourage your teen to eat a balanced plate of food consisting of ¼ protein, ¼ starch, and ½ fruits and vegetables. Visit https://www.choosemyplate.gov for additional tools to help your teen develop lifelong healthy eating habits.
- Limit high-fat or low-nutrient foods and drinks (eg, candy, chips, soft drinks).
- Provide 3 or more daily servings of low-fat (1%) or non-fat milk and other low-fat dairy products.
- Provide lots of fruits and vegetables, especially colorful ones.
Serve lean meats, chicken, fish, and other sources of protein and iron.- Serve whole-grain breads, cereals, and other grain products.
- Use community nutrition programs and food resources as needed. Check with your health insurance provider to determine if nutritionists or dietitians are considered preventive services that may be covered by your health insurance provider.
- Eat together as a family as often as possible. Make meals pleasant family times.
- Teach your teen to cook healthy meals to increase independence and develop healthy eating habits.
- Support your teen’s healthy weight. Help them balance eating healthy foods and being physically active. Help your teen understand that fad diets don’t work long term.
- As teens have more exposure to media and society’s opinions about weight, it’s important to talk about what a healthy body looks and feels like. These conversations may help teens feel good about their bodies and make better choices about food and exercise.
- If your teen asks about diets to lose weight or dietary supplements, discuss this with your health care provider to make sure they are appropriate and safe.
- Help your teen limit screen time on TVs, phone calls, texting, emails, chats, social networking, videos, video gaming, DVDs, and computer, not counting homework. Work together to set guidelines and discuss a balance of active and inactive pastimes.
- Help your youth be physically active. Walk around the mall before shopping, go on a hike, ride bikes, garden, or vacuum!
- Encourage your teen to explore interests and find activities they enjoy—especially ones that can be done lifelong.
- Some teens like to play organized sports. As teens get older, sports often become more competitive. If your teen doesn’t enjoy the pressure, look beyond the competitive sports. Other types of physical activities welcome all including community leagues or sports like swimming, tennis, hiking, and running clubs.
- Provide a properly fitting helmet and safety gear for biking, skating, in-line skating, skiing, snowmobiling, and horseback riding.
- Your teen should be in charge of daily oral health care.
- Help create a daily routine for flossing and brushing with fluoridated toothpaste. Teach by example: floss, brush, and go for regular dental visits.
- If your teen has braces, follow your dentist’s or orthodontist’s advice for managing and cleaning the teeth and braces.
- Follow the recommended schedule for dental visits for your teen, usually twice a year. Ask your dentist if your teen needs more frequent exams or fluoride supplements.
Your teen’s dentist will be looking at their gums to make sure they are healthy. Follow any suggestions for their care as well.- Work with your family dentist to develop an emergency plan before it is needed. This way, you and your teen will know who to call and what to do in case of an accident.
- Limit sugary drinks and snacks.
- Let your teen know that smoking and chewing tobacco are bad for teeth and overall health.
- Mouth guards protect the teeth and mouth when playing contact sports.
- Remember: Seat belts protect the mouth when riding in a car.
- Praise your teen’s efforts. Compliment successes.
- Show affection. Teens may act like they don’t want your attention, but they really do! Remember that affection can be demonstrated physically or with words. Get to know how your teen receives affection best.
- Recognize failures. Don’t be afraid to let your teen fail sometimes. Failure teaches coping skills, such as how to deal with anxiety and stress—emotions all teens must learn to handle as difficult situations arise in the future.
- Support your teen’s evolving self-image. Comment on the positive things that your teen does or has learned. Don’t just correct things they have done wrong.
- Encourage your teen to strive to reach their goals and be the best version of themselves. Talk to your teen about the importance of not comparing themselves to other people, as every person’s needs, desires, strengths, and weaknesses are different.
- Help your teen see things from others’ points of view. Help them learn that not everyone thinks and feels the same way.
- Talk to your teen’s health care provider if you are concerned about their behaviors, moods, mental health, or substance use.
- Model healthy emotions with your child by expressing your feelings and emotions at appropriate times. Allowing your teen to see your emotions lets them know that it is okay to express emotions and discuss your feelings.
Inform your teen that hard times come and go. Encourage your teen to talk to you if they are feeling bored, sad, or irritable much of the time and/or if they have thoughts of harming themselves.- Give your teen language to identify and express emotions. Help them think about how emotions feel in their body. For example, anxiety might feel like a sick stomach.
- Check in with your teen about feelings of extreme sadness or hopelessness. Ask them whether or not they are having thoughts of harming themselves. If they report feelings of extreme sadness, hopelessness, or thoughts of harming themselves—or you suspect that these feelings are present—contact your health care provider for immediate assistance.
- Teens go through the physical changes of puberty at different times. Talk with your teen about their physical changes that occur during puberty, including menstruation for girls. Ask your daughter what language/terms she uses for her menstruation. Does she use terms such as her flow, her moon, her cycle, or something else? If you or your teen has questions about development, talk with your health care provider.
- Help your teen make a plan to resist pressure to have sex. This can be an issue for both boys and girls. Be there for your teen and provide support or assistance.
- You may feel uncomfortable talking with your teen about development, gender identity, sexual orientation, sexual pressures, teen pregnancy, or sexually transmitted infections (STIs). Ask your health care provider to help you begin the discussion or to take a role in handling these topics with your teen.
- Teach them about consent. Let your teen know that anything other than a sober, definite “Yes” is not consent. “No” means NO, and saying no is okay.
- Develop a plan with your child about what to do if they feel as though they are in an unsafe situation, including whom they can contact and the corresponding phone numbers.
- Talk with your teen about relationships, dating, sex, marriage, parenting, and family. You might use a TV show, news article, or other current event to start a conversation. Don’t judge, but be honest about your own views.
- Encourage your teen to wait to have sex (abstinence) and explain about safe sex. Help your teen make a plan to resist pressure to have sex. Let your teen know that the safest way to prevent pregnancy and STIs is to not have sex, including oral sex. However, if they are having sex, teach your teen about how to engage in safe sex.
- Your teen is more likely to wear seat belts and sports helmets if you do. Know the laws in your state.
- Set expectations and limits when your teen is ready to drive. There are many sample “teen-parent driving contracts” available. Guides may discuss limiting the number of passengers, the amount of night driving, and how to avoid high-risk situations. Some states have added restrictions for teen drivers.
- Talk openly about the risks of driving under the influence of alcohol, marijuana, pills, or other mind-altering substances.
- Remind your teen about the dangers of talking on cell phones or texting while driving. This is illegal in many states.
- Help your teen make an action plan in case they feel unsafe riding in a car where the driver has been drinking, using drugs, or is driving unsafely.
If your teen is in a crash or witnesses one, tell them not to leave the scene. Your teen should call 911 and wait for the police or ambulance to arrive.- Teens younger than age 16 should not drive an all-terrain vehicle (ATV). They do not yet have the physical coordination or judgment to handle these vehicles safely. Everyone should wear helmets while riding on ATVs.
- The best way to keep your teen safe from injury or death from guns or firearms is not to have them in the home. If you do keep a firearm, it should be stored unloaded and locked. Lock the ammunition separate from the firearm. Then, hide the key.
- Make sure your teen understands gun and firearm safety and the risks from firearms owned by friends and their families.
- Establish an age for your teen to start using social media based on your cultural beliefs and family values. Most social media sites require that a teen be at least age 13 to sign up for a social media account without a parent’s permission.
- Encourage your teen to keep social media profiles private to decrease the likelihood of personal information being used or stolen.
- Encourage your teen not to post their personal information, including phone number, address, email address, photographs, or location.
Talk to your teen about the importance of posting pictures and comments that would pass the “grandma” test: If you wouldn’t want your grandma to see the picture or comment, it does not belong on social media. Remind them that employers frequently check social media presence. - Encourage your teen not to accept friend requests from people they would not be able to identify while walking down the street.
- Consider establishing a social media contract with your teen in order to ensure that guidelines and expectations are understood.
- Help your youth be a partner in their health. Give your youth a “heads up” about physical and emotional changes that may be occurring at this age.
- Ask your youth to write down questions about health and development, like signs of puberty, that they may want to discuss with the health care provider.
- Ask the health care provider for information on their transition policy. At this age, the visit often includes time for you and your youth together and some time with just your youth.
- Discuss how the transition from elementary to middle school is going or has gone socially, academically, and in terms of special education supports and other services.
- Encourage your youth to start and participate in the transition discussion. This is a perfect time for them to feel independent, involved, and heard. They can begin to advocate for themselves.
Spend time in the well-visit asking your youth what they want; they won’t hesitate to tell you and your health care provider! - Bring copies of any relevant education, health, or transition plans for your provider.
- Discuss recent visits with specialists, procedures, and/or medication changes. Review support services you use or may need.
- Develop caring relationships with family, friends, and other adults.
- Take part in community life.
- Engage in activities that promote health and wellness, like choosing healthy eating, physical activity, and safety behaviors.
- Show social and emotional skills and a sense of right and wrong.
- Show compassion and caring for others.
- Cope with stress in constructive ways (eg, yoga, being in nature, art therapy)
- Take increasing responsibility and desire to make their own decisions.
- Show self-confidence, hopefulness, and well-being.
Youth and families’ questions and concerns are the #1 priority. The health care provider may also discuss
- Promoting lifelong health: Family, friends, and community relationships; school performance; coping with stress and making decisions; fighting and bullying; concerns about living situation and having enough money for food to eat; family use of tobacco, alcohol, and drugs.
- Physical growth and development: Your youth’s physical, mental, and oral health; body image; healthy eating and physical activity; getting enough sleep.
- Emotional well-being: Your youth’s moods; concerns about mental health; concerns about substance use; how they feel about their changing body and sexuality.
- Risk reduction: Protection against pregnancy and STIs; tobacco, e-cigarette, drug, or alcohol use; sharing or misusing prescription medications; preventing hearing damage.
- Safety: Use of seat belts and helmets; sun protection; use of alcohol or drugs and riding in a vehicle; firearm safety; social media use.
Your health care provider will
- Measure your youth’s height and weight.
- Calculate body mass index and measure blood pressure.
- Do a physical exam, covering your youth with a drape for privacy and paying special attention to skin and spine.
- May examine genitals and breast development.
- May carry out screening tests for anemia, depression, cholesterol, hearing, HIV, oral health, tobacco/alcohol/drugs, STIs, tuberculosis, and vision.
- Immunizations: See the CDC chart at https://www.cdc.gov/vaccines for any needed at this age.
- It is important to remember that during this time your youth is growing and changing rapidly. They are trying to figure out who they are in relation to the rest of the world. Talk to your emerging teen about their interests and get to know their friends. Help them begin to set goals and take on increased responsibility for their health, education, and behaviors.
- Difficult topics take center stage during early adolescence. The youth’s focus begins to shift from family to peers and friend groups. With this shift comes exposure to topics that may be difficult to discuss with your youth such as sexual health, drugs and alcohol, and safety concerns.
- Talk to your emerging teen about the impact of the physical changes they are experiencing, including sexual development, sexual orientation, and gender identity. Also, talk to your youth about drugs, alcohol, and tobacco.
- Ask questions about whether or not their friends are using drugs, alcohol, and tobacco. By asking about friends, you may help your youth open up about the world around them. It can be a gateway to conversation about drug, alcohol, and tobacco use.
- Develop social media rules as a family—and stick to them. This may include things like making all bedrooms in your home device-free zones or having device-free mornings on the weekend in order to encourage increased family engagement. During this time it is important to model healthy social media and device use for your emerging teen and reinforce the importance of continued interaction with the family.
- Reminder: Review the Adolescence section (beginning on page 126) for recommendations for this age. Most important, what happens at home every day matters and will affect your teen’s lifelong health and well-being.
- Help your teen be a partner in their health.
- Encourage your teen to write down health questions. Note anything new, like how they handle stress, a different set of friends, or changes at school.
- Your teen may speak with the health care provider alone about physical and emotional changes.
- Discuss finding an adult health care provider.
- Ask your health care provider to help you and your teen develop a transition plan that includes education about the differences between their current care plan and an adult care model.
- Discuss finding an adult provider in your community. Transitions in health care take time and relationship-building. It can be emotional for you and your teen.
- Be gentle and kind to yourselves and trust your gut! Discuss with your teen and health care provider how best to involve your teen in this process.
- Encourage your teen to form their own partnerships with new providers.
- Make sure that your health care provider has accurate records of all of the people and things involved in supporting your teen’s life, such as specialists, therapies, medications, and adaptive activities and share any updates or concerns.
- Develop caring relationships with family, friends, and other adults.
- Take part in community life.
- Engage in activities that promote health and wellness, like choosing healthy eating, physical activity, and safety behaviors.
- Show social and emotional skills and a sense of right and wrong.
- Show compassion and caring for others.
- Cope with stress in constructive ways.
- Take increasing responsibility and make their own decisions.
- Show self-confidence, hopefulness, and well-being.
- Have an increased desire for independence and social interaction with peers and friends.
Questions and concerns from teens and families are the #1 priority. The health care provider may also discuss
- Promoting lifelong health: Family, friends, and community relationships; school performance; coping with stress and making decisions; fighting and bullying; concerns about living situation and having enough money for food; family use of tobacco, alcohol, and drugs.
- Physical growth and development: Your teen’s physical and oral health; body image; healthy eating and physical activity; getting enough sleep.
- Emotional well-being: Your teen’s moods; concerns about mental health; how they feels about their changing body and sexuality.
- Risk reduction: Protection against pregnancy and STIs; tobacco, e-cigarette, drug, or alcohol use; not sharing, misusing, or using someone else’s prescription medications; preventing hearing damage.
- Safety: Use of seat belts and helmets; safe driving; sun protection; gun and firearm safety; social media use.
Your health care provider will
- Measure your teen’s height and weight.
- Calculate body mass index and measure blood pressure.
- Do a physical exam, covering your teen with a drape for privacy, and paying special attention to skin and spine.
- May examine genitals and breast development.
- May carry out screening tests for anemia, depression, cholesterol, hearing, HIV, STIs, tobacco/alcohol/drugs, tuberculosis, and vision.
- Immunizations: See the CDC chart at https://www.cdc.gov/vaccines for any needed at this age.
- Your teen’s independence is continuing to develop during this time. Your teen has many of their own ideas and ways of doing things. These may be similar or different from the choices that you would make. It is important for your teen to feel that they have a voice and that open dialogue is encouraged. Have conversations with your teen that help them identify their own beliefs and values. Then discuss how to remain true to those beliefs in the face of peer pressure. When your teen comes to you with a problem, help them talk through it and make a decision that matches their beliefs and values.
- It is important to talk about staying safe as your teen spends more and more time with peers instead of family. Have conversations with your teen about maintaining safe friendships and romantic relationships.
Encourage them to talk to you if they are considering becoming sexually active. While it is important to share your beliefs and values, it is also important to listen to your teen. Hear their perspective in order to keep the lines of communication open. These can be difficult conversations, but knowing that you are there for them—and that you are listening—helps to further your teen’s social and emotional development. - Teens are under a lot of pressure to figure out who they are and how they fit in this world. They question sexuality (sex at birth versus gender) and cope with the pressure of determining the next steps in their lives. It is important to lead from behind; meaning let your teen make decisions for their future while providing tools and guidance to help them make the best decisions for themselves. Try not to pressure or stress your teen without providing them with the tools to handle these big decisions.
- Reminder: Review the Adolescence section (beginning on page 126) for recommendations for this age. Most important, what happens at home every day matters and will affect your teen’s lifelong health and well-being.
- Help your young adult be a partner in their health.
- Ask your young adult to write down any questions and news to share, like career plans or moving away from home.
- Young adults will speak with the health care provider alone.
- Unless alternative supported decision-making or guardianship arrangements are in place, your young adult should also discuss health care transition.
- You may want to set up a health care proxy so you can continue to help manage health care needs, if needed.
- If your young adult cannot manage their health or decision-making, you may need to discuss other supported decision-making options or guardianship.
- Develop caring relationships with family, friends, and other adults.
- Take part in community life.
- Engage in activities that promote health and wellness, like choosing healthy eating, physical activity, and safety behaviors.
- Show social and emotional skills and a sense of right and wrong.
- Show compassion and caring for others.
- Cope with stress in constructive ways.
- Take increasing responsibility and make their own decisions.
- Show self-confidence, hopefulness, and well-being.
Your young adult’s concerns and questions are the #1 priority. The health care provider may also discuss
Promoting lifelong health: Family, friend, and community relationships; school performance; coping with stress and making decisions; feeling safe from violence at home or in the neighborhood; concerns about the living situation and having enough to eat; family use of tobacco, e-cigarettes, alcohol, and drugs.- Physical health and health promotion: Oral health; body image; healthy eating, physical activity; managing special health care needs and secondary conditions; transition to adult health care.
- Emotional well-being: Moods; coping with stress; concerns about mental health; how your young adult feels about their sexuality.
- Risk reduction: Protection against pregnancy and STIs; tobacco, e-cigarette, drug, or alcohol use; sharing prescription medications or using someone else’s medications; preventing hearing damage.
- Safety: Seatbelts; helmets; sun protection; driving and substance use; gun and firearm safety.
Your health care provider will
- Measure your young adult’s height and weight.
- Calculate body mass index and measure blood pressure.
- Do a physical exam, using a drape for privacy and paying special attention to skin.
- May examine genitals and do a breast exam.
- May carry out screening tests for anemia; cholesterol; hearing; HIV; STIs; tobacco, alcohol, and drugs use; tuberculosis; and vision.
- For women at the 21 year visit, perform a cervical dysplasia screening test.
- Immunizations: See the CDC chart at https://www.cdc.gov/vaccines for any needed at this age.
Your young adult has moved into adulthood but will continue to need your guidance throughout these important years. Whether your young adult goes on to college, career, or community-based activities, it is important for them to know that you are still in their corner. Offer encouragement for their progress and provide advice as needed. When your young adult comes to you with a problem, help them talk through it and make a decision that matches their beliefs and values. - Continue to have conversations with your young adult about maintaining safe friendships and romantic relationships. Encourage them to continue to talk to you if they are considering becoming sexually active. Discuss ways to engage in safe, consensual sexual activity. Also, ensure that they have a plan that includes contacting you if they find themselves in an unsafe or dangerous situation.
- Young adults are under a lot of pressure to figure out who they are and how they fit into the world. They question sexuality and cope with the pressure of determining the next steps in their lives. It is important to lead from behind; meaning let your young adult make decisions for their future while providing tools and guidance to help them make the best decisions for themselves. Try not to pressure or stress your young adult without providing them with the tools to handle these big decisions.
Resist the urge to pass judgment on your young adult’s decisions. Instead, use each success and failure as a conversation starter and learning opportunity. Help your young adult reflect on their choices including what worked and did not work. This will help them continue to build problem-solving skills for future situations. - Reminder: Review the Adolescence section (beginning on page 126) for recommendations for this age. Most important, what happens at home every day matters and will affect your young adult’s lifelong health and well-being.