Annual health care visits (also called well-child visits) allow doctors and other health care practitioners to monitor physical growth Physical Growth During adolescence (usually considered age 10 to the late teens or early 20s), boys and girls reach adult height and weight and undergo sexual maturation ( puberty). The timing and speed with... read more and sexual maturation Sexual Maturation (Puberty) During adolescence (usually considered age 10 to the late teens or early 20s), boys and girls reach adult height and weight and undergo sexual maturation ( puberty). The timing and speed with... read more (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 Childhood Vaccination Schedule Most doctors follow the vaccination schedule recommended by the Centers for Disease Control and Prevention (CDC—see the schedule for infants and children and the schedule for older children... read more ).
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.
(See also Adolescent Development Adolescent Development During adolescence, children become young adults. They undergo striking physical, intellectual, and emotional changes. However, the path to adulthood is not a straight line. Adolescents do not... read more and Problems in Adolescents Introduction to Problems in Adolescents For most children, adolescence is a period of good physical health. The most common problems during adolescence relate to Growth and development School Childhood illnesses that continue into... read more .)
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 Diagnosis Scoliosis is abnormal curvature of the spine. Scoliosis can be present at birth or can develop during adolescence. Mild forms may cause only mild discomfort, but more severe forms can cause... read more are particularly important in adolescence.
Adolescent girls should be offered a pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more and a Pap test Screening for Cervical Cancer Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more (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 Breast examination Breast disorders may be noncancerous (benign) or cancerous (malignant). Most are noncancerous and not life threatening. Often, they do not require treatment. In contrast, breast cancer can mean... read more
.
Older adolescent boys are examined for testicular masses, and boys of all ages are examined for inguinal hernias Diagnosis An inguinal hernia is a protrusion of a piece of intestine or another abdominal organ through an opening in the abdominal wall in the groin. People have a painless bulge in the groin or scrotum... read more . The doctor may educate boys about testicular self-examination Symptoms Testicular cancer occurs in the testes, the two small organs in males that make sperm. Testicular cancer is most common among young men but usually curable. Usually a painless lump is present... read more
to identify masses.
Screening
A blood cholesterol level test Measuring lipid levels The body needs fats for growth and energy. It also uses them to synthesize hormones and other substances needed for the body’s activities. The body may deposit excess fat in blood vessels and... read more 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 Screening Tests for Tuberculosis Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis... read more done.
Sexually active adolescents are screened for common sexually transmitted infections (STIs) Overview of Sexually Transmitted Infections (STIs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted infections may be caused... read more , such as gonorrhea Screening for gonorrhea Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover... read more
and chlamydia Screening Chlamydial infections include sexually transmitted infections of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect... read more
. 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 Intellectual and Behavioral Development During adolescence, children become young adults. They undergo striking physical, intellectual, and emotional changes. However, the path to adulthood is not a straight line. Adolescents do not... read more , mental health Overview of Psychosocial Problems in Adolescents Psychologic and social (psychosocial) problems, particularly involving behavioral and school issues, are more common during adolescence than at any other time during childhood. Adolescents are... read more , and emotional health Emotional Development During adolescence, children become young adults. They undergo striking physical, intellectual, and emotional changes. However, the path to adulthood is not a straight line. Adolescents do not... read more . Counseling usually revolves around physical and psychosocial development Social and Psychologic Development During adolescence, children become young adults. They undergo striking physical, intellectual, and emotional changes. However, the path to adulthood is not a straight line. Adolescents do not... read more , healthy lifestyles, and injury prevention.
Safety
Injury prevention is discussed with adolescents. Counseling typically includes wide-ranging topics such as
The importance of wearing seatbelts
The dangers of drinking and driving and texting and driving
Internet dangers and appropriate cautions
Violence prevention
Nutrition and exercise
Overweight and obesity Obesity in Adolescents Obesity is defined as a body mass index (BMI) equal to or greater than the 95th percentile for age and gender. Although genetics and some disorders cause obesity, most adolescent obesity results... read more 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.