Well and Preventative Pediatric Care
from Ten to Twentyone Years Old
Ten Year Visit
We will measure height, weight, and blood pressure. We will discuss diet and food choices, digestive issues, sleep, safety and family life. Vision and hearing screens are performed. Developmental issues are school performance, organization, emerging independence and increasing responsibility, home and school behavior, including mood changes, friendships, and out of school activities. We continue to discuss puberty and hygiene. Most children desire modesty and privacy during the physical exam at this age, and parents should plan on not including siblings, both older and younger in the exam room.
Immunization: The TdaP (tetanus, diphtheria, and pertussis) booster is given.
Special Consideration for Adolescents
Please see our Adolescents page for helpful information about caring for adolescents.
Eleven Year Visit
We will measure height, weight, and blood pressure. We will discuss healthy eating habits, digestive issues, sleep and self-care, safety and family life. A vision screen is performed. Developmental issues are school performance, organization, responsibility, self-control, and managing changes in friendships. We will review any changes in behavior or moods. We will discuss puberty. After a girl has had her first menstrual period, we will do a hemoglobin check for anemia each year. For boys and for girls who have not yet had their first period, we will check the hemoglobin every other year. As stated in the Ten Year exam, children by age eleven should expect privacy both during the interview and the physical exam, and siblings should not be included in the exam room.
Immunizations: Menactra (Neisseria Bacterial Meningitis) vaccine is given; the Gardasil (HPV) is offered, and strongly recommended to be completed ( a three dose series) before age 14 years.
Twelve Year Visit
We will measure height, weight, and blood pressure. We will discuss healthy eating habits, physical activity, sleep and self-care, safety and family life. A vision screen is performed. Developmental issues are school performance, organization, independence, responsibility, self-control and managing peer relationships. We will discuss any changes in behavior or moods. We will review the changes of puberty, and discuss menstrual periods. We will discuss whether the child would like privacy from the parents during the physical exam. Chaperones are always available if the child desires privacy.
Immunization: Gardasil (HPV) is offered and strongly recommended to be completed before age 14 years.
Thirteen Year Visit
We will measure height, weight, and blood pressure. We will discuss healthy, and increasingly independent, eating habits, physical activity, sleep, responsibility for taking care of oneself, safe behavior, and family life. A vision screen is performed. Issues in early teenage development are school performance, peer relationships, out of school activities, and managing changing moods and feelings.
As puberty progresses, teenagers start to desire more independence with peers and have sexual/romantic feelings. We encourage parents to talk openly with teenagers about their own values and expectations. At age thirteen, the physician will encourage a private conversation with the teenager. This is an opportunity for the teenager to begin to work with a health care provider in explaining their own body and feelings. The teenager can express concerns about their body, their emotions, their peer and family relationships that they may not be comfortable expressing in front of parents or guardians. We let patients know that we will not report the conversation back to the parents, unless there is a serious health or safety issue.
Immunization: Gardasil (HPV) is offered and strongly recommended to be completed before age 14 years.
Fourteen Year Visit
We will measure height, weight, and blood pressure. With parents, we will discuss healthy eating, physical activity, sleep, independence, safety, and family life. A vision screen is performed. Teenage developmental issues are school performance, peer relationships, discovery of personal interests, managing emotions, managing exposure to alcohol and drugs, managing romantic feelings and relationships, and balancing independence and family responsibility.
We will speak to the adolescent privately to discuss any physical concerns and to discuss family and peer relationships. These discussions are confidential with the teenager, unless a serious health or legal issue requires communication with the parent. The law in Connecticut provides that information on sexuality, diagnosis and treatment of sexually transmitted diseases, pregnancy, birth control, and initial mental health and substance abuse treatment can be provided confidentially to adolescents between the ages of 13 and 17. We encourage parents to ask us any questions regarding these confidentiality issues. The best medical care takes place when adolescents can speak to providers confidentially and then share important decisions and information with their parents on their own.
Immunization: Gardasil (HPV) is strongly recommended if not already completed.
Fifteen Year Visit
We will measure height, weight, and blood pressure. With parents, we will discuss healthy eating, especially as teenagers are reaching adult height and need to maintain a healthy weight. We will also discuss sleep, independence, safety, and family life. A vision screen is performed. We will also order a blood test for cholesterol, if it has not already been performed. The issues in mid-adolescence are school performance, peer and romantic relationships, family relationships, identifying personal interests and goals, and managing safe behaviors, including alcohol and drugs, car and bike safety, and potentially violent situations. We will speak to the adolescent privately to discuss physical concerns, emotional issues, family relationships, substance use, and sexual concerns. As above, these discussions are confidential with the adolescent. We encourage adolescents and parents to be open with each other about all important aspects of health care.
Immunization: Gardasil (HPV) is strongly recommended if not already completed.
Sixteen Year Visit
We will measure height, weight, and blood pressure. With parents, we will discuss healthy eating and healthy weight as well as sleep, independence, safety, and family life. A vision screen is performed. School performance and relationships remain a main concern, along with increasing independence in interests, educational goals, and work. Safe behaviors, especially regarding use of substances and safe driving are reviewed. We will speak to the adolescent privately to discuss physical concerns, emotional issues, family relationships and sexual concerns and behaviors. These discussions are confidential with the adolescent. We encourage adolescents and parents to be open with each other about all important aspects of health care.
Immunizations: Gardasil (HPV) is strongly recommended if not already completed. A booster for Menactra (Neisseria meningitis) may be indicated.
Seventeen Year Visit
We will measure height, weight, and blood pressure. With parents, we will discuss diet, sleep, independence, safety, and family life. A vision screen is performed. Education, and goals past high school, are discussed. Family, peer, and romantic relationships are discussed. Substance use, driving safety, violence are also discussed. We will speak to the adolescent privately to discuss physical concerns, emotional issues, family relationships and sexual concerns and behaviors. These discussions are confidential with the adolescent, and are extremely important steps in preparing the adolescent to seek and participate in health care in young adulthood.
Immunizations: Gardasil (HPV) is strongly recommended if not already completed. A booster for Menactra (Neisseria meningitis) may be indicated.
Eighteen to Twentyone Year Visit
As specialists in pediatric and adolescent medicine, we are available to care for young adults until age 21 years. At any point during this age range, young people may choose to transition their care to an adult primary care provider. We will work with families in this transition process, including any needed changes in chronic condition or sub specialist care.
During these visits, we expect to primarily work with the adolescent or young adult. At age eighteen, young people have the full legal ability to consent for medical care and receive fully confidential care.
Issues discuss include diet, exercise, education, work, relationships, substance use, independence, and sexuality.
Immunizations: Gardasil (HPV) is strongly recommended if not already completed. A booster for Menactra (Neisseria meningitis) may be indicated.