For Health Care Providers

Adolescents have healthcare needs that are specific to their age and developmental progress. Many causes of injury and death link to risk behaviors that start during adolescence. The major causes of mortality (motor vehicle accidents, homicide, and suicide) are preventable. Pregnancy, sexually transmitted infections, and substance abuse are preventable too. At the same time, youth will only seek care if it’s confidential. Addressing an adolescent’s health concerns requires knowing their developmental characteristics and complex needs.

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There are 3 recognized developmental stages. A teen’s physical, intellectual, and social maturity may not match up at all stages. General indicators of each stage are below:

EARLY ADOLESCENCE
• Growth spurt
• Signs of physical growth
• Concrete thinking but without the skills to process consequences of actions
• Initial development of abstract thought

MID-ADOLESCENCE
• Physical changes stabilizing
• Growing sense of identity
• Progress in developing reflective thought
• Peer relationships and risk-taking more frequent

LATE ADOLESCENCE
• Adult physical form
• Set sense of identity
• More mature relationships
• Transition to living away from family

In the change from being a child to being an adult, adolescents develop new health needs and concerns. At the same time, they are gaining independence from their parents. They should start becoming the key partner in medical decisions. Building a strong bond with young people can help them take control of health decisions. Parents are an important part of the transition process. Parents may need help to give control of medical decisions to their children. The process must be set up within current consent and confidentiality laws. 

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DECISION-MAKING / TRANSITION

Decision making may change during the transition from childhood to adulthood.

  • Parent and Doctor make decisions in the early adolescence stage.
  • Parent, Patient, and Doctor make decisions in the mid-adolescence stage.
  • Patient and Doctor make decisions in the late adolescence stage.  

Texas Health Steps’ Adolescent Health: A Guide for Providers has more information. The guide will help:

  • medical providers,
  • social workers,
  • counselors,
  • teachers, and
  • other professionals.

Adults who provide services and support to young people can use the guide. It offers tips on health and related legal issues in the adolescent years. Ask for legal guidance if you have concerns or questions on laws. Visit the Texas Health Steps webpage for a current version of the Guide for Providers.   

Transition to adult services maximizes lifelong functioning and well-being for all youth. The American Academy of Pediatricians provides an algorithm to assist with transition at the appropriate ages. Got Transition has tools and resources for providers, parents, and youth.     

Delivering good health care to young people is in the best interest of all involved:

  • the healthcare provider,
  • the family,
  • the insurance company,
  • the policy makers, and
  • most important, the adolescent.
For more information on working with adolescents, see the Texas Health Steps Online Provider Education modules:
  • Promoting Adolescent Health
  • Teen Consent and Confidentiality
  • Culturally Effective Health Care  
  • Motivational Interviewing
  • Building a Comprehensive and Effective Medical Home
  • Overcoming Barriers to medical Home Implementation
  • Interpersonal Youth Violence
  • High-Risk Behaviors in Young People: Screening and Intervention
  • Preventing Unintentional Injury
  • Adolescent Substance Use
  • Transition Services for Children and Youth with Special Health Care Needs
  • Behavioral Health: Screening and Intervention
  • Childhood and Adolescent Depression
Each module has CEs available. There are case studies and quick courses also available.
 

Healthy People 2020 lists 3 emerging issues in Adolescent and Young Adult (AYA) Health in the coming decade:

  1. The AYA population is becoming more diverse. There are rapid increases in the numbers of Latino and Asian American youth. This diversity needs cultural awareness to health needs. Pay attention to disparate health, academic, and economic outcomes.
  2. Mental health of AYAs impacts their physical health, academic achievement, and well-being. About 50 percent of lifelong mental disorders begin by age 14 and 75 percent begin by age 24. Suicide is a leading cause of death among AYAs. Suicide rates climbed for these age groups between 1999 and 2014. Trauma associated with Adverse Childhood Experiences (ACEs) contributes to mental and behavioral health issues for youth. This leads to negative adult outcomes. Some ACEs are preventable and their effects improved.
  3. Positive youth development (PYD) is a method to provide youth with: support,relationships,experiences,resources, and opportunities.
    • support,
    • relationships,
    • experiences,
    • resources,
    • and opportunities. 

 PYD helps young people become competent, thriving adults. Evidence shows that PYD can lead to positive outcomes. It can help prevent AYA health risk behaviors.    

Helpful Web Sites for Preventive Services Guidelines for Adolescents:

American Academy of Pediatrics

Society for Adolescent Health & Medicine

Bright Futures
Centers for Disease Control and Prevention  

For more information, please contact us at:

Texas Department of State Health Services
Maternal & Child Health
PO Box 149347, Mail Code 1922
Austin, TX 78714-9347
Phone: (512) 776-7373
Fax: (512) 458-7658
TitleV@dshs.texas.gov

 

External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These external links may not be accessible to persons with disabilities. For more information about Maternal and Child Health or information regarding adolescent health in Texas, please email TitleV@dshs.texas.gov or call (512) 776-7373.

       
Last updated January 18, 2019