Add 'health checkup' to teens' back-to-school list

Your teen probably has a back-to-school to-do list that is a mile long. But be sure one item moves to the top: a health checkup or "well-teen" visit. Similar to the well-child visits that parents regularly schedule from the time their children are born, well-teen visits are tailored especially for the ages when tweens and teens are undergoing major physical and mental changes and challenges.

Well-teen visits typically start at 11 and older. That’s when most major changes begin, such as puberty, changing schools, forming new relationships and becoming more independent.

A 'temperature check' for overall health

Just as important as when children are younger, well-teen visits assess overall health, development benchmarks and ensure vaccinations are up to date.

By the time they are 11, children should be caught up with all childhood vaccinations, but also receive shots for teenage meningitis, HPV and a tetanus booster.

Typically, during the first part of the visit, parents or guardians and the child will talk with the health care professional together. Then, the provider will spend time one-on-one with the teen.

Beyond vaccinations

That’s often when the visit turns specifically toward the health and wellness issues facing tweens and teens. These include nutrition, exercise, school performance, screen time, social media, safety at home and school, puberty, safe-sex practices, relationships and mental health.

Mental health assessment is a crucial part of the visit. When a parent or guardian is in the room, the health care professional is observing how parents or guardians and children communicate, and how children respond to questions — whether they turn to the adult to answer, engage in their own health care or if they’re shy about talking in front of the adult.

To put children at ease, the health care professional often starts with questions about what makes them happy, what gives them confidence, what their strengths are, who their friends are, if they have a best friend and what they like to do. Then the conversation may turn to what bothers them, makes them sad or gives them stress.

The health care professional also will ask if teens have been or are in a relationship, and if they feel safe in that relationship — whether the relationship is with a male, female or both. Teens, as most parents know, are pretty savvy about what makes them feel safe or unsafe, but the health care professional will still review cyberbullying, what to do if someone talks to the teen inappropriately and who to reach out to for help or support.

No matter a child’s sexual identification, gender identity or orientation, the health care professional aims to express support and empower them to seek support in their community — starting with their parents. The goal is to give them healthy avenues to cope with stress or anxiety due to relationships.

Coming together

Before the health care professional invites the parents or guardians to rejoin the conversation, the provider verifies that it’s OK with the teen to share information with them. While respecting the teen’s privacy, the health care professional's role also can be one of facilitator to promote open communication between teens and their parents or guardians. Laws do protect information about teen health, pregnancy, sexually transmitted diseases and gender. And unless information shared poses direct, immediate harm to the child, it can remain confidential between the health care professional and the teen.

A well-teen visit can have a major impact on a child’s health and well-being. Recommended annually, it’s a time to identify any issues or concerns early and then follow up to monitor improvement or additional problems. The visit also begins laying the groundwork for teens to take charge of their health care as they move into adulthood.

Elizabeth Ojukwu, M.D., is a pediatrician in Pediatric & Adolescent Medicine in Albert Lea, Minnesota.