Subscribe to the free KidsGrowth weekly email newsletter by entering your email address below.
Advertising links will direct you off of the KidsGrowth Web site. KidsGrowth is neither responsible for nor does it necessarily endorse the privacy practices, content or products of these sites.
|Quick reference medical handouts used
by Pediatric offices
Growth Milestones - 14 Years
"The Age of Rapid Changes"
|During middle adolescence, puberty is well underway, and is complete in many teenagers. There is a decreased preoccupation with the body and an
increased involvement with peers.
Parental conflicts develop over
independence, since the peer group often serves as the adolescent's reference
for their standards of behavior.
This age is often called the neglected age of pediatrics, according
to pediatrician William Crook, M.D. "It is 'no man's land' between childhood
and adulthood." The maturing teen does not want to be treated like a child,
and often balks at having to go to the "baby doctor" for checkups. Yet, at
the same time, the adolescent does not want to go to a new adult physician
who may be unfamiliar with issues important to this age group. The result
is that often the youngster ends up going to neither. This is unfortunate
since middle adolescence is a period of rapid development during which time
checkups are important.
This can be a difficult time for parents, who must cope with their
adolescent while trying to keep the channel of communication open. Love your
teen with no strings attached.
Parents do best when they understand the normal characteristics of
the middle teen years, otherwise known as the five "I"'s and six "M"'s
(courtesy of the Parent and Child Guidance Center, Pittsburg,
The five "I's"
Immediate (wanting everything now)
Industructable (thinking nothing can hurt them, they can not get pregnant,
they will not get into an auto accident, etc.)
The six "M's":
|Parenting and Behavioral
Basic survival strategies for parents of adolescents are
(courtesy of the Parent and Child Guidance Center, Pittsburg,
1. Choose your battles carefully. Settle for something less
than perfection on issues that don't really matter. Remain calm, and don't
match his/her level of emotional intensity.
2. Be available to your adolescent
without directing or controlling him/her. The time when they want you is
often at teen's choosing, not yours. Be there if possible.
3. Help him/her regulate his/her lifeand consider alternatives.
4. Establish networks with parents of your teen's friends, even if
they are new to you.
5. Let teens know they can always call you when in trouble, without
fear of recrimination.
Parents should remember that adolescents can be especially worried
about their bodies, diets and sexual abilities. Will they be normal? Can
they perform? How will others perceive them? Parents need to remember that
the adolescent's interest in body changes and sexual topics is a natural,
normal development and does not necessarily indicate movement into sexual
activity. One must take care not to label emerging instinct/behaviors as
"wrong," "sick" or "immoral." ." Nor should parents jump
to conclusions about behaviors based soley on hunches or feelings.
Increased emotionality is a hallmark of the period. Teens can be
excessively modest, insecure and feel isolated and alone, as they discover
the tenuousness of their peer relationships.
Adolescents usually require privacy in which to contemplate changes
taking place within their own bodies. Ideally the youth should be allowed
to have his/her own room, but if this is not possible some private space
needs to be made available so the teen can go and not be bothered by older
or younger siblings or parents!
Teasing an adolescent child about physical changes is inappropriate,
because it may cause self-consciousness and embarrassment.
The teenager's quest for independence is normal development and need
not be looked upon by the parent as rejection or a loss of control. Examples
include (1) young teenagers may not want to join the family on all family
outings; (2) Young teens may not want their parents around the school at
social functions as chaperones; (3) Young teens may begin to confide in an
adult outside the family rather than in mothers or fathers as in previous
To be of most benefit to the growing adolescent, parents need to remain
a constant and consistent figure, available as a sounding board for the youth's
ideas without dominating and overtaking the emerging, independent identity
of the young person.
Most 14-year olds focus on social life, friends and school. They
have chosen friendships with members of the same sex. Sometimes, a teenager's
best friends becomes a parent substitute and confidante. These friendships,
however, may change abruptly, causing hurt feelings.
Teens need to learn to respect the rights and needs of others, follow
family rules, such as those for curfews, television viewing, and chores. Share
in household chores.
Parents need to serve as a positive ethical and behavioral role
Teach the adolescent techniques for resisting peer pressure.
Parents should learn the signs of adolescent depression and drug
|Characteristics of the "teen friendly"
Praises, approves, supports and shows interest in their adolescent.
Attends events in which their son or daughter is a participant.
Encourages reasonable independence, friendships and interests outside
of the home.
Finds time to be with and listen to the adolescent.
Is a good ethical and behavorial model.
Establishes realistic expectations for family rules, with increasing
responsibility given to the adolescent.
Establish and communicate clear limits and consequences for breaking
rules. Does not repeatedly warn or threaten. Simply follows the protocol
already agreed upon and is consistent.
Is present at home or makes arrangements for the adolescent's supervision
in their absence.
Assigns chores around the home and provides an allowance.
Demonstrate interest in the adolescent's school activities and emphasize
the importance of school.
Takes pleasure in their son's or daughter's abilities and
Respects the adolescent's privacy - bedroom, bathroom,
mail, phone calls.
Enhances the teens self-esteem by providing praise and recognizing
positive behavior and achievements.
Minimizes criticism, nagging, derogatory comments, and other belittling
or demeaning messages.
Is not necessarily the teens best friend. Remembers that their role
is to teach and parent
Shows respect for their teen. Listens to their side without interrupting
Gets to know their teen's friends, and avoids making quick judgments
based on appearance only. Whenever possible, avoids downgrading
Encourages their son or daughter to invite peers home.
Allows their son or daughter to make age-appropriate decisions and
selections (for example, choosing clothes).
Involves their teen in decision making regarding their role in family
chores, supervision of younger sibling, etc.
Assumes a role in the teen's sex education, perhaps with the
help of books recommended by the physician
|Traits of the adolescent who is doing
Is in good health or functions up to capacity if has
a chronic condition; has good food habits.
Believes he/she will do well.
Has self-confidence and a sense of pride and competence.
Enjoys close interactions with peers (especially same-sex
Enjoys recreational activities.
Recognizes the need for rules and fair play.
Is energetic, enthusiastic and vital.
Has reasonable athletic ability.
Has dramatic, artistic or musical talents.
Does well in school.
Takes appropriate responsibility for homework with little
Assumes responsibility for his/her own health.
Is comfortable in asking parents questions.
Generally cooperative and considerate, although at times is inconsistent
to talk so your teen will listen
- getting what you give
for raising teenagers
Oral Health for the Adolescent
Brushes teeth twice a day with a fluoridated
toothpaste and flosses daily.
Knows what to do in the cause of a dental emergency,
especially the loss or fracture of a tooth.
Has seen a dentist within the last six months unless your dentist
determines otherwise based on his/her individual needs/susceptibility to
Does not smoke or use chewing tobacco.
|Nutrition for the Adolescent
14-year olds seem to eat continuously and appetite rarely is a problem.
Unfortunately, many 14 and 15 year olds consume fast foods daily. They eat
snacks that are high in calories and fat.
Eat three meals per day. Breakfast is especially important. Do your
best to make sure your 14-year old has a nutritious breakfast daily.
Choose a variety of healthy foods.
Choose nutritious snacks rich in complex carbohydrates. Limit high-fat
or low-nutrient foods and beverages such as candy, chips or soft
Choose plenty of fruits and vegetables; breads, cereals and other
grain products; low-fat dairy products; lean meats; and foods prepared with
little or no fat. Include foods rich in calcium and iron in your
diet. Girls may suffer anemia at this time so make sure they
are receiving sufficient iron in their diet to replace menstrual losses.
Select a nutritious meal from the school cafeteria or pack a balanced
At this age it is especially important to evaluate your 14-year old's
food consumption in relation to the amount of exercise they do. Obesity can
be a problem in 14 and 15 year olds. Studies have shown that children who
are overweight at this age group have a great chance of being overweight
as an adult. Achieve and maintain a healthy weight. Manage
weight through appropriate eating habits and regular exercise.
*Annual flu vaccines for children with
chronic illnesses like asthma, diabetes and
heart defects. Check with your
*Vision and hearing, as well as blood
and urine and blood pressure are usually checked at this visit. Other
screening done at this age may include a tuberculin test (if indicated). If
there is a family history of elevated cholesterol, some physicians will also
obtain a screening blood test.
*Measure and plot on a standard chart
the adolescent’s height and weight. Determine the body mass index. (BMI)
If an adolescent has a BMI >95th
percentile for age and gender, or < 5th percentile, refer for dietary
and counseling. Adolescents with a BMI between the 85th and 95th percentile
need initial evaluation and counseling the prevention of obesity.
*Special referrals should be considered
at this age for;
(1) adolescent girls who have not begun breast development or boys who have
not experienced testicular enlargement,
(2) Boys or girls who do not follow
the normal pattern of pubertal development (for example, menstruation before
(3) Families that are in prolong conflict - some turbulence is expected
in all families, but a decline in the families ability to communicate or
prolonged conflict should not be expected.
(4) The adolescent who is a loner
|Sexuality for the Adolescent
to teens about sexuality
Find a supportive adult who can give you accurate information about
Ask your doctor about any questions you have about body changes during
puberty, including variations from individual to individual.
Ask any questions you have about
birth control or sexually transmitted diseases.
Having sexual feelings is normal, but you should wait to have sex.
Not having sexual intercourse is the safest way to prevent pregnancy.
and sexually transmitted diseases,
including HIV infection/AIDS.
Learn about ways to say no to sex. If you have already said "yes,"
talk with your doctor about ways to prevent pregnancy and STDs.
Pay attention to personal safety
from physical or sexual assault (that is, do not accept rides from or hitchhike
you an askable parent?
time for the big talk - now what?
Say "No" to substance use/abuse
- Do not smoke, use
smokeless tobacco, drink
alcohol, or use drugs, diet
pills, or steroids. Do not
become involved in selling
- If you smoke, discuss
smoking cessation with the
- Avoid situations
where drugs or alcohol are
- Support friends who
choose not to use tobacco,
steroids or diet pills.
- Become a peer
prevent substance abuse.
riding in Pickup Trucks
Get adequate sleep.
Exercise vigorously at least three times per week. Encourage friends
and family members to exercise.
Discuss with the health professional
or your coach athletic conditioning, weight training, fluids and weight
gain or loss.
Limit television viewing to an average of one hour per day.
your neighbor if there is a gun in the house
steer kids away from alcohol
to choose a safe car for your teen
your ears: Turn the radio down
Check your child's progress with our
The information presented in Growth Milestones was obtained with the
help of our pediatric experts and with material from The American
Academy of Pediatrics' Guidelines for Health Supervision and Bright
Futures' Guidelines for Health Supervision of Infants, Children, and
Adolescents. Bright Futures is supported by the Maternal and Child
Health Bureau, U.S. Department of Health and Human Services..
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
Please read our full disclaimer.