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Preventive Health Care Visits in Adolescents

By

Deborah M. Consolini

, MD, Sidney Kimmel Medical College of Thomas Jefferson University

Last full review/revision Jul 2021| Content last modified Jul 2021
Click here for the Professional Version

Annual health care visits (also called well-child visits) allow doctors and other health care practitioners to monitor physical growth and sexual maturation (puberty) and provide advice and counseling. The yearly health care visits for adolescents begin at age 11 and continue until about age 21.

Routine health care also includes a review of the immunization record and administration of recommended vaccines (see Childhood Vaccination Schedule).

Doctors also may encourage activities such as participation in sports, the arts, and community service. Most doctors interview and examine adolescents privately, although parents may be invited to participate and share concerns and receive their own counseling and guidance at the beginning or end of the visit.

Examination

The adolescent's height, weight, and blood pressure are measured at every yearly health care visit. The doctor then does a complete physical examination. Once children become adolescents, certain areas of the body require a more detailed examination. For example, examination of the skin for acne, evaluation of the degree of sexual maturation, and examination of the back for scoliosis are particularly important in adolescence.

Adolescent girls should be offered a pelvic examination and a Pap test (Papanicolaou test) when they become sexually active. If girls are not sexually active, these tests are done beginning at age 21. The doctor may educate girls about breast self-examination.

Older adolescent boys are examined for testicular masses, and boys of all ages are examined for inguinal hernias. The doctor may educate boys about testicular self-examination to identify masses.

Screening

A blood cholesterol level test should be done for all children between 9 and 11 years of age and at least once for all adolescents between 17 and 21 years of age. More frequent testing may be recommended for obese adolescents or those with a family history of high cholesterol.

Adolescents are screened for tuberculosis (TB) risk factors at all well-child visits. Risk factors include exposure to TB, being born in or having traveled to areas of the world where TB is common (countries other than the United States, Canada, Australia, and New Zealand and Western and North European countries), having a family member who has TB, and having parents or close contacts who are recent immigrants from an area where TB is common or who have recently been in jail. Those with risk factors then usually have tuberculosis screening tests done.

Sexually active adolescents are screened for common sexually transmitted diseases (STDs), such as gonorrhea and chlamydia. Screening for human immunodeficiency virus (HIV) infection may be discussed with all adolescents and is encouraged for adolescents who are sexually active and for those who use injection drugs. The doctor screens sexually active female adolescents for precancerous changes of the cervix (cervical dysplasia) as well as for pregnancy.

All people should be routinely screened for hepatitis C virus (HCV) infection at least once between the ages of 18 and 79. People at increased risk of HCV infection, including those who have used or who currently use injection drugs, should be tested for HCV infection and reassessed every year.

Most of a routine health care visit involves a psychosocial screening interview and counseling. The screening interview includes questions regarding the home environment, academic achievement and goals, activities and hobbies, engagement in risk-taking behaviors, mental health, and emotional health. Counseling usually revolves around physical and psychosocial development, healthy lifestyles, and injury prevention.

Safety

Injury prevention is discussed with adolescents. Counseling typically includes wide-ranging topics such as

Nutrition and exercise

Overweight and obesity are common in the United States and are associated with heart disease and type 2 diabetes (formerly called non– insulin-dependent diabetes). To combat the risk of obesity, parents should continue to provide adolescents with healthy food choices and limit their intake of unhealthy foods. Soda and excessive fruit juice drinking have been implicated as major contributors to obesity.

Inactivity is directly linked to obesity. Parents should try to limit the amount of time their adolescent spends watching television, playing video games, or participating in noneducational computer time. Participation in sports and physical activity should continue to be encouraged as adolescents age.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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