Your Child’s Checkup: 14 Years

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your teen’s weight and height, calculate body mass index (BMI), and plot the measurements on growth charts.

2. Check your teen’s blood pressure using standard testing equipment. Examine spine for curvature. Examine your teen to determine sexual maturity and screen for sexually transmitted diseases (STDs) if warranted.

3. Ask questions, address concerns, and offer advice about your teen’s:

Eating. At this age, teens should begin making healthy food choices on their own. Explain that eating five servings of fruits and vegetables per day and avoiding sweet, salty, and fatty foods not only is better nutritionally, but also will support a healthy weight. Calcium and iron are important for supporting the growth spurts of adolescence. Aim for three daily servings of low-fat dairy products to provide 1,300 milligrams of calcium. One cup of low-fat milk has 300 milligrams of calcium. Include enough lean meats, poultry, and seafood in the diet to reach 8 milligrams of iron per day. One serving of beef has 2–3 milligrams of iron.

Sleeping. Teens generally need about 9 hours of sleep per night. Inadequate sleep is common during the teen years and can have negative effects on school and athletic performance. Changes to the circadian clock make teens want to stay up later, but early school start times can make it hard for them to get enough sleep. Establish a bedtime that allows for adequate sleep and encourage your teen to follow a relaxing bedtime routine.

Physical activity. Aim for 60 minutes of physical activity per day. Experts recommend limiting screen time, including TV, DVDs, video games, smartphones, tablets, and computers, to no more than 2 hours per day.

Growth and development. By age 14, it’s common for teens to:

• show signs of puberty:
  • In boys, testicular enlargement is followed by penile lengthening and the growth of pubic hair. Most boys start puberty between 9 and 15 years of age.
  • Girls continue breast development, grow pubic hair, and possibly begin menstruation. The first menstrual period usually occurs by age 13, but can come as late as age 15.
• have oily skin and/or acne
• yearn for peer acceptance, independence, and time to be alone
• focus on personal appearance and behavior (because they think all eyes are on them)

4. Update immunizations. Immunizations can protect kids from serious childhood illnesses, so it’s important that your teen receive them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

5. Order tests. The doctor may assess your teen’s risk for anemia, high cholesterol, and tuberculosis and order tests, if needed.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 15 years:

School

1. Encourage your teen to participate in a variety of activities, music, arts, sports, after-school clubs, and other activities of interest.
2. Praise accomplishments and provide support in areas where your teen is struggling.
3. Provide a quiet place to do homework. Minimize distractions, such as TV and cell phones.
4. As school becomes more challenging, poor school performance may be a sign of attention or learning problems, bullying, or depression. Get to the root of the problem.
5. Peer pressure can lead to dangerous activities, such as drinking or smoking. Know who your kids are spending time with and make sure that an adult is monitoring them.

Self

1. Talk openly about sex and encourage your teen to wait until older to engage in sexual activity with others. Explain the risk of STDs and unwanted pregnancy.
2. Talk to your daughter about menstruation before menarche occurs and encourage her to come to you once it does.
3. Assure your son that erections and “wet dreams” are normal.
4. A growing need for independence means teens may test the boundaries of established rules. Decide which rules can be eased and which must remain in place.
5. Encourage your teen to bathe or shower daily and use deodorant.
6. Your teen should brush his or her teeth twice daily, floss once a day, and see a dentist once every 6 months.
7. Look for signs of depression, which can include irritability, sadness, loss of interest in activities, poor academic performance, and talk of suicide.
8. Your daughter can visit the gynecologist between 13 and 15 years of age. This first visit typically does not involve a pelvic exam unless she is having problems.

Safety

1. Talk to your teen about the dangers of smoking, alcohol, and drugs.
2. Teens should always wear a seatbelt while in a vehicle. Talk to your teen about dangers of drinking and driving and tell your child to never get in a car with someone who has been drinking. Instead, let your teen know to always call you for help.
3. Your teen should always wear a helmet while riding a bike, skateboard, or scooter.
4. Your teen should apply sunscreen of SPF 30 or higher at least 15 minutes before going outside and reapply about every 2 hours.
5. Protect against exposure to secondhand smoke, which increases the risk of heart and lung disease.
6. Monitor your teen’s Internet usage. Keep the family computer in a place where you can watch what your teen is doing. Install safety filters and check the browser history to see what websites your child has visited.
7. Prevent gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids cannot access the keys.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.