More children and teens are overweight or obese now than ever before. It is important for your child to be active. This is a lesson you should teach your children at a young age. Remember that you’re a role model for your child and they will follow your example.

Physical activity helps prevent or reduce health problems. It also helps manage your child’s weight. Other benefits of keeping your child active include:

• Burning calories instead of storing them as body fat
• Maintaining blood sugar levels (this is vital for children who have or are at risk for diabetes)
• Lowering blood pressure and cholesterol levels
• Increasing bone and muscle strength
• Building strength and endurance
• Relieving stress and helping with focus
• Improving sleep and mental health
• Boosting self-esteem by helping children feel confident about their bodies and appearance

Path to improved health

Children 6 years of age and older should be active 60 minutes or more each day. This doesn’t have to be done all at one time. They can be active several times throughout the day. Just like adults, children need 3 kinds of exercise. They should do a mix of aerobics, muscle strengthening, and bone strengthening. Some activities count as more than one type of exercise.

Aerobic (cardio) exercise increases your heart rate and strengthens your heart and lungs. Types of aerobic activities include:

• Skateboarding
• Skating
• Running
• Hiking
• Dancing
• Bicycling
• Swimming
• Basketball

Muscle strengthening builds and maintains muscles. It also improves balance. Examples include:

• Climbing
• Gymnastics
• Push-ups, pull-ups, and sit-ups

Bone strengthening helps your bones grow and stay strong. Examples include:

• Running
• Skipping
• Dancing
• Jumping rope
• Basketball, soccer, tennis, or volleyball

When it comes to being active, there is something for everyone. Try different activities to see what your child likes. Find things that are fun to do together.

Encourage your child to try physical team or group activities. These could be soccer, tee-ball, gymnastics, or dancing. Being on a team helps your child develop social skills. Keep in mind that some kids enjoy sports, while others don’t like competition. They may prefer group games instead, such as tag or hide-and-seek. Figure out what works best for your child’s personality. It is okay for your child to play alone sometimes, too. This helps them develop independence.

Be a healthy role model for your child. Plan active family outings. Let them see you enjoying exercise. When your child is young, you can push them in a stroller while you run. Another way you can build exercise into your family’s lifestyle is to celebrate with action. Instead of rewarding your child with food, let them pick an activity.

Things to consider

Each day, 8- to 18-year-olds should limit their non-school screen time to between 1 or 2 hours of watching TV and movies, playing on the computer, or playing video games. Screen time limits should include time on their phones as well.

Two out of every 3 kids have a TV in their bedroom. They watch TV about 1½ hours more than kids who don’t have a TV in their bedroom. Health professionals recommend that kids do not have a TV in their bedroom.

You usually sit when you are engaged in screen time. Set a good example by also limiting your own screen time.

There are ways to make screen time more active. Have your child do jumping jacks during commercials. Or they can stand up or jog in place when playing video games. Some video games even include low levels of physical activity. They may mimic the motions of dancing, bowling, tennis, and other sports. Although playing these games is better than sitting, they still count as screen time. Instead, have your child do the motions in real life. Have a dance party, go bowling, or play tennis.

Questions to ask your doctor

• How active should my child be each day if they are overweight or obese?
• What kinds of activity can a child who has a physical handicap do?
• How can I keep my child active and prevent injury?

Resources

Centers for Disease Control and Prevention: Physical Activity, Children

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Children need a certain number of calories to grow and develop. But if a child takes in more calories than he or she uses, the body stores these extra calories as fat. In children who are otherwise healthy, weight gain most often happens because a child takes in more calories than he or she uses.

Why is it important for my child to learn good eating and exercise habits?

Good nutrition and regular physical activity can help your child achieve and maintain a healthy weight. Teach your child good eating and exercise habits when he or she is young. Those good habits will continue to benefit your child as he or she grows into an adult. According to the USDA’s MyPlate program, staying fit helps prevent the health problems that being overweight or having obesity can cause later in life, including:

• Heart disease
• Diabetes
• High blood pressure
• High cholesterol
• Asthma
• Sleep apnea
• Some types of cancer
• Liver problems and arthritis (with severe obesity)

A child who is overweight or has obesity also may be teased or bullied about their weight. They may feel bad about their body or feel isolated and alone. These feelings can interfere with a child’s ability to learn, make friends, and interact with others.

It is important for parents to role model healthy behavior for their children. Be supportive as your child works to achieve a healthy weight. Use language that describes being healthy and strong. Avoid language that focuses on weight loss, dieting, and achieving a certain size. Most of all, be positive and encouraging.

Path to improved health

By teaching and encouraging healthy eating habits, you are giving your child important tools for a lifetime of healthy living. You can shape your child’s views on healthy eating by setting a good example.

Help your child make healthy food choices 

• Be a good role model. Choose healthy foods and snacks for yourself.
• Have healthy snacks (for example, fruits like apples and bananas, and raw vegetables like carrots and celery) readily available in your home.
• Include plenty of low-fat proteins, vegetables, and whole grains in the meals you make.
• Be persistent in your efforts to introduce healthy food options. Children are not always open to new things right away. If you continue to offer healthy choices, you will improve the chances that your child will develop healthy eating habits.
• Teach your child how to make healthy choices for school lunches.
• Avoid fast-food dining. If you do eat at a fast-food or sit-down restaurant, choose the healthiest options available.
• Forget the “clean plate rule.” Let your child stop eating when he or she feels full.
• Meet nutritional needs primarily from foods and beverages.
• Choose a variety of options from each food group.
• Pay attention to portion size.

How can I encourage my child to be more physically active?

As a parent or primary caregiver, you have a lot of influence on your child. Although you may not realize it, what you do affects the choices they make. If your child sees you being physically active on a regular basis, they will be more likely to be active, too.

Make physical activity part of your family’s normal routine. For example, you might take the dog for a walk together each morning or play basketball before dinner every evening. Find physical activities that you enjoy doing together as a family.

The American Academy of Family Physicians (AAFP) recommends that all children participate in physical activity for at least an average of 30-60 minutes a day. The AAFP encourages parents and schools to make physical activity a priority. Prolonged periods of physical inactivity should be discouraged in both the home and school.

Limit screen time

Limit your child’s screen time to no more than 1 to 2 hours a day. Screen time includes playing video or computer games, surfing the Internet, texting, and watching TV. Set a good example by limiting your own screen time, too.

Things to consider

Watch for any changes in your child’s usual eating or exercise habits. For example, does your child seem to be eating out of boredom, for comfort, or in response to other emotions? This is called emotional eating. Emotional eating can lead to weight gain. It may also be a sign that your child is struggling to deal with feelings like depression or stress.

Pay attention to the warning signs of an eating disorder. These include:

• Being overly concerned about calories
• Having anxiety about body weight
• Not eating at all
• Binge eating
• Exercising excessively

Eating disorders such as anorexia and bulimia are unusual in children, but they can occur. The risk increases as a child grows into a teen and young adult.

If you have any concerns about your child’s behavior, be sure to talk to your family doctor.

Questions for your doctor 

• How much should my child be eating?
• How often should my child be eating?
• What are the correct portion sizes for my child?
• How often should my child exercise?
• My child is a picky eater. How can I get him or her to eat more?
• My teen says he or she is always hungry. Can that be true?

Resources

The U.S. Department of Agriculture: MyPlate

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Virginity is the state of not having had sex. A virgin is a person who has not yet had sex or chooses to abstain from sex. Our culture often defines sex as vaginal intercourse between a woman and a man. But sex also occurs between other genders when vaginal or anal penetration takes place.

Talking to your kids about virginity goes hand in hand with talks about sex. It is best to have an ongoing dialogue with your kids on these topics. You should start at a young age with basics about sexuality and respect for our bodies. Add details and advice as your children get older. Be sure to have conversations about virginity and sex both before and after your kids begin to date.

Path to improved health

Kids are influenced by sex in a lot of ways. The media often portrays sex as common and casual. Pressure to have sex also can come from those around them. It could be from friends, boyfriends/girlfriends, peers, or siblings.

Children react better to this topic when parents are open and honest. You can explain that sex is a special act. It should be done with someone they love and fully trust. It can take time to find that person. This is why some people choose to stay a virgin until marriage. You should let your kids know that people might pressure them to have sex before they are ready. People who do this don’t really care about them. When people care about you, they respect your choices. It is important to talk about and model what a healthy relationship looks like. Let them know that having sex requires consent between two people.

Making the choice to stay a virgin or to lose your virginity is a big commitment. It affects your physical, emotional, spiritual, and social well-being. Kids often need help to process these thoughts and feelings. They also need to understand the risks associated with having sex. Two of the biggest risks are pregnancy and sexually transmitted infections (STIs). You can get STIs from vaginal, anal, and oral sex. In addition to using a method of birth control to prevent pregnancy, anyone who is sexually active should use condoms to also prevent STIs. Talk to your children about the types of STIs. Make sure they know how to access and use birth control and condoms if they need them.

Things to consider

It is normal for kids to struggle with deciding when they are ready to have sex. Certain factors can affect this.

• Teens who go through puberty earlier might be more interested in sex. Also, girls often mature before boys.
• A lot of kids want to follow their friends’ actions. Remind them to be friends with people they like and respect. You should get to know their friends well and make them feel comfortable talking to you about problems.
• Self-esteem. If they are not ready to have sex, it is easier to resist peer pressure if they have high self-esteem.
• Kids might think it’s okay to have sex if their parents, or other family members, had kids at a young age. If they see people close to them in unhealthy or unstable relationships, it could make sex seem like a casual act.
• Gender identity can be confusing for kids to understand and talk about. Some children identify as the sex they were born with, and others don’t. This can make life and virginity or sex difficult to process. People also have various gender preferences when it comes to attraction. They may be interested in opposite-sex relationships, same-sex, both, or neither. Don’t assume anything and be open to what they want to share with you.

It is best to talk to your kids early and often about knowing when they are ready to have sex. Tell them it’s normal to have sexual feelings or urges. Let them know they can come to you with any questions or problems. Below are some suggestions on how to prepare:

• Always listen, even when you don’t understand or agree, and be ready to answer questions.
• Try to remain open, honest, and calm. In the end, the choice to have sex and practice virginity is up to them. Let them know you love them and support them either way.
• Provide your children with helpful resources or tools. Make connections to the world around them, such as TV, books, or social media, to make the conversation more approachable.
• Help your children set expectations and create boundaries that will help them make good decisions. Remind them that actions can progress quickly. If your child is dating but not ready to have sex, urge them to set limits ahead of time.

As your child’s parent, or caregiver, it is up to you to provide important information and take action when needed.

• Help your child with self-esteem and teach them skills to handle social pressures and emotional issues.
• Teach them about the danger of substance abuse. Alcohol and drugs can affect your judgment and lead to bad choices.
• Be clear that they should not take any abuse. This includes verbal, physical, and sexual. If this happens, they need to alert a trusted adult right away.

Sex can be an addiction and lead to unsafe behavior and practices. Your child should know that sex is not a game. They should not compete to have sex. They should never have sex if they don’t want to or don’t say yes. If this occurs, they need to tell a trusted adult right away.

When to see a doctor

It is very important to include your child’s doctor in the conversation about sexual health. They can provide additional information, resources, and support. Encourage your kids to ask questions and give them privacy with their doctor, if they wish. Contact their doctor if your child has sex and thinks they are pregnant or have symptoms of a STI.

Children will experience many emotions on the topics of having sex or waiting. These may include anxiety, depression, sadness, confusion, regret, or guilt. If your child is rejected after sex or for choosing not to have sex, they may become isolated or angry. If this happens, seek medical and psychological care.

Questions to ask your doctor

• At what age should I start talking to my kids about having sex?
• What if my child is already sexually active?
• How should I talk to my kids about preventing pregnancy and STIs?

Resources

U.S. Department of Health and Human Services: Talk to Your Kids About Sex

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Healthy teeth are important to your child’s overall health. They help your child eat and talk. Strong oral care helps set good dental habits as your child grows. Poor oral care can lead to infection, disease, or other teeth problems.

Cavities (tooth decay) are common in childhood. However, cavities are preventable with proper brushing, flossing, reduced sugar, and regular dental care. Start young to teach your child good dental health and hygiene with these fun tips:

• Let children help choose their own toothbrush. They can pick one that has a favorite color or character.
• Let children help choose toothpaste. They can pick their favorite flavor.
• Read books or watch videos that talk about dental hygiene.
• Use a timer to make sure kids brush their teeth for 2 minutes. Or play their favorite song to help keep track of time.
• Reward children for good oral care. Do not give them food or sugary treats. Offer something healthy or simple instead, like apple slices or a gold star.
• Plan a fun activity following your child’s dentist visit.

Path to improved health

The role of fluoride

Fluoride is important to your child’s dental health. It is known to reduce cavities in baby (primary) teeth and adult (permanent) teeth. It also helps make teeth strong by hardening the tooth enamel. Most children get fluoride in drinking water. Many cities are required to add fluoride to tap water. Water filters, such as Brita, do not remove fluoride and are okay to use. You should not use “reverse osmosis” water filters.

If your water does not contain fluoride, your child may need to take an oral fluoride supplement. Talk to your doctor to see if your child needs this. Once your child starts going to the dentist, they will get a fluoride varnish or cleaning on their teeth.

Too much fluoride can cause tooth stains and be harmful to your child’s health. Be sure your child does not swallow fluoride toothpaste or mouthwash. Follow all instructions for fluoride supplements.

Brushing and flossing

Dental hygiene should begin when your child is a baby. Start using a soft child-size toothbrush around the age of 1 or 2. You should brush your child’s teeth with water at least twice a day. You also can add a small dab of toothpaste that doesn’t have fluoride in it. This type of toothpaste is safe for your child to swallow. Once your child is old enough to spit out the toothpaste, you can switch to one that has fluoride. Only use a small amount. Teach your child to spread it among their teeth, gums, and tongue. Have your doctor or dentist show you the right way to brush your child’s teeth.

Your child likely will need help brushing their teeth until they are 7 or 8 years old. Around this time, they can start using a larger sized toothbrush. You should switch out toothbrushes every 3 to 6 months, when the bristles look worn, or if your child was sick. Children should brush their teeth for 2 minutes. Flossing is another key part of your child’s oral care routine. Teach your child to floss at least once a day. You can buy floss that comes on a handle to make it easier.

You should also teach your child to brush their tongue. This helps reduce the amount of bacteria in the mouth.

Be sure that your child knows to brush their teeth before bed, after all eating and drinking (except water) is done.

Cavities

Cavities are holes that form in your teeth. These can occur when bacteria (germs) build up in your mouth. Sugar in food and drinks turn into acid, which can eat away at your teeth. Cavities are common in children because their teeth can be harder to brush. Everyone in your family should take good care of their teeth. People who have cavities can pass the cavity-causing bacteria to unborn babies, infants, and children.

Your child may be at risk for cavities if they:

• Have white spots or brown areas on their teeth
• Have ongoing special health care needs
• Do not go to the dentist often
• Were born early (premature) or had a low birth weight

Diet

Kids who eat a lot of sugary foods and drinks also are at high risk for cavities. It is important to make healthy food choices. Avoid too much sugar. Do not let your child have a lot of soda, fruit juice, or sweetened drinks. Limit sweet snacks and drinks between meals. If your child does have sugar, make sure they brush their teeth afterward. Do not let your baby drink a bottle with juice at night or at naps, as the sugar coats their teeth and gums.

Chewing gum is safe for older kids. It can provide benefits, such as:

• Strengthening the jaw
• Helping produce saliva
• Washing away bits of food
• Balancing acid that can cause tooth decay
• Freshening breath

However, gum that contains sugar can cause cavities. Limit the amount of sugar gum your child chews or only give them sugar-free gum.

Mouth safety

Safety is another big part of dental hygiene. If your child plays sports, they should wear a mouth guard. This is a soft, plastic retainer that covers the teeth and sometimes the lips. It helps protect your child’s mouth from injuries. Talk to your dentist if you need a custom-fit mouth guard.

From baby teeth to adult teeth

In general, baby teeth start to appear between 4 and 7 months old. The first teeth to come in are usually the 2 bottom front teeth. Most kids have all 20 baby teeth by about 3 years of age.

Children can lose their baby teeth as early as 6 years old and as late as 12 years old. During this process, your child has a mix of teeth as baby ones fall out and adult ones break through. Around this time, your dentist may talk to you and your child about possible teeth problems. Some kids need orthodontia treatment, such as braces. A full set of adult teeth is 32 teeth. This includes wisdom teeth, which most people do not get until their late teens or early adulthood.

Things to consider

It’s normal for babies to suck their thumbs, their fingers, or a pacifier. Most children give up this habit on their own by age 4. Prolonged use can cause problems with teeth alignment. Talk to your dentist if your child still has a sucking habit after age 4. They can watch for problems as your child’s teeth develop. In most children, there is no reason to worry about a sucking habit until around age 6, when the permanent front teeth come in. 

When to see a dentist

The American Academy of Pediatric Dentistry (AAPD) recommends that children see a dentist around their first birthday. This gives the dentist a chance to look for early problems with your child’s teeth. Pediatric dentists specialize in treating children’s dental health. The dentist will talk to you about proper oral care.

Visiting the dentist from a young age will help your child be more comfortable. It also establishes the good habit of regular dental checkups. Everyone should see the dentist twice a year.

Contact your dentist right away if:

• Your child has tooth pain or a tooth or mouth infection
• Your child loses a permanent tooth. If you find the tooth, put it in milk and take it to the dentist with you. They may be able to reattach it.

Questions to ask your doctor

• Does my child need to take oral fluoride supplements?
• What is the best type of toothbrush for my child?
• Can my child use mouthwash?
• Is my child at high risk for cavities?
• How often should my child visit the dentist?
• Are dental X-rays safe for my child?
• Is it okay for my child to chew gum?

Resources

American Academy of Pediatric Dentistry: Frequently Asked Questions

Centers for Disease Control and Prevention: Children’s Oral Health

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Being a child can be hard. Situations and emotions can be confusing. Children can be affected by situations differently than adults. Moments of anger, or “acting out,” in children are normal. But as parents, it’s important to teach your children how to deal with their anger from a young age. Learning to cope effectively with your anger at a young age is important in a child’s social and emotional learning (SEL).

Path to improved health

A lot of things cause children stress. Stress can lead to anger. Situations that may cause stress include:

• Welcoming a new sibling
• Parents’ divorce
• Going through foster care or adoption
• Starting school
• Struggling in school
• Changes in home or lifestyle
• Processing new feelings
• Bullying, which can start at a young age
• Traumatic events
• Death of a loved one

There are some ways you can help plan ahead to minimize your child’s anger. These include:

• Set rules or limits. Establish boundaries so your child knows what to expect.
• Be consistent and follow through. Tell your child what the consequence is for a unacceptable behavior, then follow through with that consequence. For example, if you don’t want your child to misbehave in a store, tell them before you go to the store that the consequence will be to leave the store immediately. If you don’t act on rules all the time, then your child won’t know when you’re serious. You may confuse your child instead of helping Them. This can lead to anger and stress for both of you. Think before you tell them the consequence. Make sure it’s appropriate for unacceptable behavior.
• Reward good behavior. Praise your child when they follow the rules.
• Practice what you preach. Set a good example and be a role model.

In instances when your child is angry or acting out, try to calm them by following these steps:

• Don’t become angry. Your calmness will help your child relax.
• Pull your child aside if they are around others. Being alone with you may make them more comfortable and willing to share the reason for the anger.
• Talk to your child in a kind tone. Use a level they understand.
• If your child continues to be angry, pause your talking. Hugging or touching your child may help. It lets them know you care.

Help your child with anger issues

Younger children may not understand their emotions. They may not know what anger is or how to recognize it. In these cases, it might be best to ask them to draw their feelings. Ask them to show why they feel the way they do. Also, teach them the common signs of anger, which include:

• The urge to scream or hit
• Clenched fists
• Quickened heartbeat
• Tense (sore) muscles
• Stomachache
• Body shakes

When children are old enough to understand their feelings, it’s important to talk to them in more detail. Doing so can let them know anger is normal. Talk about the situation and their feelings. This can help them, and you, figure out why they’re angry. Plus, talking may lead to a calmer attitude. Ask children questions, such as:

• What are you feeling right now?
• Can you tell me why you’re feeling that way?
• What situation made you feel this way?
• Are you having thoughts of hurting yourself or someone else?
• Have you had these feelings before, and when?
• How can I help you feel better?

Once you identify your child’s anger, help them find ways to control it. For example, suggest they can count to 10 before talking or acting when anger starts.

Things to consider

Anger issues can worsen or become habits if left unnoticed or untreated. Some symptoms of a serious anger issue include:

• Lies repeatedly
• Steals
• Has frequent outbursts that escalate quickly
• Has sudden or extreme mood changes
• Has a hard time sitting still and focusing
• Isn’t doing well or gets in trouble at school
• Is verbally abusive
• Physically hurts oneself or others, such as siblings, pets, or kids at school
• Threatens to harm or kill oneself or others

If you think your child has a serious anger issue, they will need to go to the doctor for diagnosis. Seeing a doctor for your child’s anger doesn’t mean they have a serious issue. Your child may need guidance on how to express and manage their feelings. And as a parent, you may need tips on how to support your child.

Sometimes serious anger issues are a sign of a mental health or behavioral condition. Your doctor can diagnose your child correctly. They will talk with your child, perform a physical exam, and review signs and symptoms. Sometimes an emotional exam, or assessment, may be done as well. Your doctor will want to know about your family history of mental health and behavior problems. The doctor will ask about your family life and your child’s personal life. Your doctor will ask your child’s teacher or school nurse about his or her behavior at school.

Treatment options for these conditions are available. They often include a mix of medicine, therapy, and education. Talk therapy may be offered. This can happen between your child and a specialist. Or it may take place as a family or in a larger group. A counselor can help identify problems and methods to cope.

Your child may benefit from behavioral therapy as well. Meet with your child’s school if special care is needed. They may meet the requirements of the Individuals with Disabilities Education Act (IDEA). This allows children to get customized education plans to help them at school.

Talk to the doctor or specialist about the benefits, risks, and side effects of treatment. Children who have mental health problems should be assessed regularly.

Questions to ask your doctor

• Why does my child get so angry?
• What should I do if I’m concerned about my child’s behavior?
• What can I do to help my child manage their anger?
• What can my child do to manage their own anger?
• Is my child more likely to have a mental health condition if I do or it runs in our family?
• What treatment options are best for my child?
• Should we go to therapy as a family?

Resources

American Psychological Association: Here’s advice from psychologists on how to help kids cope with anger and frustration

Child Mind Institute: Angry Kids: Dealing with Explosive Behavior

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Any sexual activity with a child (by an adult or another child) is sexual abuse. It causes physical and emotional pain. It has long-term effects on the child. And it is a crime. Recognizing childhood sexual abuse isn’t easy. Children are often afraid and embarrassed to tell someone. Many times, the abuser is someone the child knows and trusts. This could be a family member or someone living in the child’s home. It also can be a stranger.

Path to improved health

You do not need to be overly suspicious of sexual abuse. The risk of childhood sexual abuse is low. A stable family home lowers a child’s risk of sexual abuse. However, parents should always keep a watchful eye on any form of childhood abuse. These physical and behavioral signs should raise concern:

• Your child tells you they have been touched inappropriately or sexually.
• Your child is behaving sexually inappropriately around others (this includes touching others inappropriately).
• Your child uses sexually inappropriate language.
• Your child’s knowledge of sex seems to be more than it should be at their age.
• Your child seems withdrawn and doesn’t want to be hugged by some or all of their family members, family friends, teacher, or a particular person.
• Your child is suffering from depression or anxiety.
• Your child has harmed themself.
• Your child is making comments about their low self-worth.
• Your (young) child has blood in their underwear.
• Your (young) child is complaining of pain in their genital area.
• Your child has injuries in their genital area, such as bruising, bleeding, or swelling. The injuries might cause your child pain when walking or sitting.
• Your child shows signs of infection in their urinary or genital area. This would include frequent burning, itching, or discharge.
• Your child becomes pregnant.
• Your child has new academic changes (falling grades, missing assignments, repeated absences).
• Your young child is regressing, such as wetting the bed or thumb sucking.
• Your child is acting overly concerned for a sibling.
• Your child has changes in hygiene, such as refusing to take a bath (in younger children). Older children may shower more (to cleanse themselves of what they perceive as shame and embarrassment).
• Your child is suddenly receiving gifts or money from a person in authority (a teacher, coach, etc.).

If you know your child has been sexually abused, report it to the police. Take your child to the doctor for an exam. Ask your child’s doctor for the name of a counselor or psychologist. Talk to your local police about tracking sex offenders in your neighborhood or city.

Things to consider

Certain situations put children at a higher risk of sexual abuse. Your child may also be at higher risk if they:

• Live in a home where the parents are divorced and/or living with stepparents
• Live in a home without either parent (in foster care)
• Live in a rural or low-income area
• Have been a victim of another type of abuse, such as physical or emotional
• Spend long periods of time alone with people in authority (teachers, clergymen, coaches, babysitters, etc.)

Girls and children with intellectual disabilities face a higher risk. Remember, childhood sexual abuse can occur between a male and female, as well as in same-sex situations.

Questions to ask your doctor

• What other things could explain injuries to my child’s genitals?
• How young can a girl become pregnant?
• What are the signs of sexually transmitted diseases or infections in boys and girls?
• What is the treatment for sexually transmitted disease?
• Can my child eventually overcome the emotional pain of childhood sexual abuse?
• What physical or behavioral signs should I look for if I suspect my child is the one sexually abusing a child?
• How do I raise a concern with my child about possible sexual abuse?

Resources

National Institutes of Health, MedlinePlus: Sexual Abuse in Children – What to Know

Rape, Abuse & Incest National Network: Child Sexual Abuse

The U.S. Department of Justice National Sex Offender Public Website: How to Identify

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It used to be that children were seen and not heard at the doctor’s office. Parents did all the talking, even when the child was the patient. But time and research has shown this isn’t the best way to go. Children should be able to participate in their health care. This will help them make medical decisions for themselves as they get older. There are steps parents can take to help prepare children for the complex world of health care and making informed decisions.

Path to improved health

Preparing your child to make health care decisions can start at a young age. Even children as young as 5 years old can make choices about their care. Here are ways you can help make that happen.

Elementary-aged children

The first thing parents can do is make sure the doctor talks to the child as a patient, instead of speaking only to the parent. The doctor should talk to the child using language that is easy for the child to understand. The doctor should tell them about any illness and treatment that will be needed. Children are more likely to go along with what’s happening if they understand the reasons for a treatment.

You can also let the child make choices along the way. Even a 5-year-old can choose which arm to get an IV in, or what flavor of medicine they want. Being part of the process can help the child feel like they are heard. This can make them more cooperative.

The tween years

Around the age of 11, the child should do most of the talking in the doctor’s office. They need practice asking questions and becoming comfortable talking with a doctor. That way, when the child is old enough to be on their own, going to the doctor alone won’t be unfamiliar or scary.

Children of this age are generally mature enough to see the doctor by themselves for a routine visit, without a parent in the room. This gives them the chance to ask questions without worrying about your reaction. It also allows them to talk about things they might be too embarrassed to talk about in front of you.

Teenagers

As your child gets older, they will take on more responsibility for managing his or her own life. This can include getting up in the morning, driving to school, working a part-time job, and managing time commitments and homework. Your child also has many more opportunities to be responsible for their own health care. The key to this is that you, the parent, shift your role. Step back from running the show and taking care of details. Let your teen start taking over.

Around age 14, kids should be able to:

• Understand and explain any medical conditions they have
• Know what medicines they take and why (If your child has allergies to any medicines, he or she needs to know what those are.)
• Know who to contact for medical equipment or supplies he or she might need if they have a chronic condition, such as diabetes
• Visit with the doctor without a parent in the room
• Answer questions about family history (This could include if cancer runs in the family, or if anyone has diabetes or heart disease.)
• Know their personal history of any major medical conditions, surgeries, or hospitalizations

By the time they are 17 or 18 years old, many teens are preparing to leave home. They are going to need to know how to take care of themselves and their health care. Around this age, they should know:

• How to make their own doctor appointments
• How to fill and refill a prescription and pick it up from the pharmacy
• How to look for a primary care doctor (This could include asking family or friends for referrals or navigating their insurance policy.)
• The information for their health insurance company and how to contact them (They should also have an idea of what their insurance does and does not cover.)
• How to get a referral to a specialist
• What they’re going to do when their coverage under their parents’ health coverage expires

Teaching your children these skills is key to helping them make medical decisions for themselves. So is showing your support by letting them take over responsibilities such as scheduling appointments or talking to doctors. You also can help them by being a good role model. Have a positive attitude about seeing your own doctor. Go to regular check-ups, eat right, and exercise. These good habits are likely to rub off on them.

Things to consider

Children who have chronic conditions or special needs might need more help making medical decisions as they get older. But they can still have independence in adulthood. If your child has special health needs, you may consider contacting:

• A social worker. A social worker can find out if your child qualifies for state or federal programs. These could be health-related benefits, or help with employment, housing, or transportation. Your doctor can direct you to a social worker who can help.
• Your child’s diagnosis-specific group (for example, the Cystic Fibrosis Foundation). Local chapters of these groups can be great resources of information. You can talk to other parents and families about what they’ve gone through. They can give you recommendations on local doctors, services, or programs.
• Family advocacy groups. Some of these groups are dedicated to helping the families of kids with special needs. For example, Family Voices has local chapters that can help you navigate the health care system with your child.

Questions to ask your doctor

• How can my child participate in his or her own health care?
• At what age should my child visit you on his or her own, without me being in the room?
• What should I do if my child can’t remember what was talked about during their doctor appointment?
• What can I do to help my child be more comfortable visiting the doctor by themselves?

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