“Just wait until she’s a teenager.” It’s a warning often teasingly extended to parents frustrated with their toddlers. Despite its bad rap, adolescence is an exciting and truly remarkable stage of life.
Adolescence, ages 12 to 18, is a unique developmental period that presents both challenges and opportunities for children, parents and healthcare providers.
During adolescence, individuals undergo both physical and psychological changes as they mature from children to adults. The physical changes are evident, but it is the psychological changes that can be more significant.
These changes include increases in exploration, novelty-seeking, emotional intensity and social engagement. Teens also have a naturally increased drive for reward, and their release of dopamine in response to experiences is heightened, which prompts them to seek excitement.
This can result in amazing accomplishments. Teens tackle complicated calculus problems, complete phenomenal athletic plays and achieve stunning levels of musical and theatrical performance. Teens also naturally develop a strong sense of right and wrong. While this can result in harsh criticism of the adults around them, it also leads them to spend hours on meaningful volunteer projects.
Unfortunately, teens’ judgment is not yet fully developed. The brain’s capacity for executive function, including the abilities to weigh long-term consequences and control impulses, does not fully develop until the 20s.
All of this adds up to several key concerns for parents and doctors.
Teens are at their all-time high for physical strength as well as response speed and agility. Meanwhile, they are three times more likely to suffer serious injury or death than are children or adults.
This is due to the development going on in their brains during the teen years. Their increased drive for novel experiences and dopamine response, paired with an immature level of judgment, make accidents account for nearly half of all deaths of adolescents in this country.
Alcohol, Tobacco and Drug Use and Abuse
The dopamine response teens experience also makes them more susceptible to addictive behaviors. Individuals’ heaviest use of alcohol occurs during their late teens and early 20s. Furthermore, nearly 90 percent of smokers report that they had started smoking by age 18.
Currently, teens report that they are more likely to use marijuana than tobacco. In a 2011 study, 15 percent of eighth graders reported using marijuana, compared with 25 percent of tenth graders and 30 percent of high school seniors.
Pregnancy and Sexually Transmitted Diseases
In 2010, the last year for which data are available, 614,000 teen girls became pregnant in the U.S., a rate of 57 pregnancies for every 1,000 girls. Illinois’ teen pregnancy rate was the same. While teen pregnancy rates have been falling, the numbers are still alarming, and the ramifications can be disastrous for the girls and their children.
Teen parents are significantly less likely to graduate high school or earn a GED than are teens who do not become parents, and only 10 percent of teen mothers complete a two- or four-year college program. This leads to significant reliance on public assistance, chronic unemployment and other long-term effects.
Adolescents also are at risk of contracting sexually transmitted diseases. In fact, almost half of all new STD cases each year occur in adolescents and young adults (up to age 24).
What can parents and doctors do?
Parents should do their best to embrace the changes in their children and afford them the increased independence they crave. Open discussions between adults and teens are crucial to helping them understand the risks involved in their current life stage.
During disagreements, stay emotionally neutral. Teens are likely to lose control, but your ability to remain unemotional will model appropriate behavior to them.
Doctors should have discussions with teens outside of the parent’s presence to discuss concerns he or she might not choose to disclose with mom or dad there. While parents may balk at this, it is in the best interest of the child and part of growing up.
By being aware of the unique development going on during adolescence, parents can better understand their children and help them enjoy the benefits of this time of their lives while successfully navigating the pitfalls.
Dr. Gulson is the mother of three boys and has been a pediatrician in Chicago’s northern suburbs for 20 years. While she treats most pediatric issues, she is passionate about the topics of the breast feeding mother, adolescent development and brain injury. She currently treats patients for PediaTrust/Lake Shore Pediatrics, a new private partnership of seven pediatric practices located in the north and northwest suburbs of Chicago. She recently lectured on the topic of adolescent and young adult development at Northwestern Lake Forest Hospital. She is also founder of Helmet, a volunteer-based community initiative located in Chicago's north suburbs and dedicated to reducing brain injury.
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