When you are young, you may not think much about going to the doctor unless you’re sick or hurt. But your doctor is there in sickness and in health. They can provide “preventive services” that can detect disease or help prevent illness or other problems. It’s important to get these services when you are a teenager or young adult.

Many conditions that happen later in life get their start when you are younger. About 65% of all deaths in adults are caused by heart disease, cancer, and stroke. In many cases, these diseases are preventable. Many of the behaviors that cause these diseases begin at a young age. For example, teens who use tobacco are more likely to have heart disease, cancer, or stroke in adulthood.

Path to improved health

The preventive service you need might be a test, a vaccine, or advice from your doctor. Which preventive services you need depends on your age, medical history, and family history. For adolescents and young adults, there are several key areas that your doctor will probably focus on. These include:

• Social and behavioral health
• Immunizations (vaccines)
• Healthy habits
• Reproductive and sexual health
• Confidential care
• Patient and parent information

Social and behavioral health

Adolescents and young adults face many issues every day that affect their social and behavioral health. These could include violence, harassment, school bullying, or drug use. These types of issues can affect you in many ways. You may experience depression, anxiety, or an eating disorder. You may experiment with drugs or have unsafe sex. It is important for you to talk to your family doctor if you are having trouble with any of these things. You should also talk to your doctor if you have any of these warning signs:

• Agitation or restlessness
• Weight loss or gain
• A drop in grades
• Trouble concentrating
• Ongoing feelings of sadness
• Not caring about people or things
• Lack of motivation
• Feeling tired, low energy
• Lack of interest in activities
• Low self-esteem
• Trouble sleeping

Immunizations

Immunizations (also called vaccines) are an important part of preventive services for children, teens, and adults. They are safe and effective, and they save lives. The American Academy of Family Physicians (AAFP) recommends that patients receive all necessary vaccinations from their primary care physician. These can protect against diseases such as measles, chicken pox, meningitis, flu, COVID and the human papillomavirus (HPV).

Vaccinations that you may need as a teenager or young adult include:

• The flu vaccine: This is given every year at the beginning of cold and flu season to protect you from getting the flu.
• The HPV vaccine: It helps prevent spread of the virus, which causes genital warts and several types of cancer (most commonly cervical cancer). The vaccine is given when children are 11-12 years old, but older teens and young adults can still get it.
• The Tdap vaccine: This prevents tetanus, diphtheria, and pertussis (whooping cough). Preteens and teens should get one shot when they are 11 or 12 years old, but older teens and young adults can get the shot as well.
• The meningitis vaccine: The meningococcal conjugate vaccine is recommended for all preteens and teens at 11 to 12 years old with a booster dose at 16 years old.
• The COVID-10 vaccine: This vaccine is safe for everyone age 6 months and older. It helps prevent you from getting COVID-19 and makes your symptoms less severe if you do get the virus.

Healthy habits

Health is more than the absence of disease. It is a state of physical, mental, and social well-being. Health is the key to living a productive and satisfying life. Developing healthy habits when you are an adolescent or young adult may decrease your chance of getting sick or hurt.

When you are talking to your family doctor, you should discuss how you can stay healthy. Talk to your doctor about:

• Your physical health. Get regular exercise, eat a healthy diet, get enough sleep, and maintain a healthy weight. Take care of your teeth, wear sunscreen, and don’t smoke, vape/use e-cigarettes, or use tobacco.
• Your mental and emotional health. Learn how to manage stress, and develop a good balance between school, work, and social life. Pay attention to your moods and feelings, and don’t be afraid to ask for help if you need it.
• Your behavioral health. Keep yourself safe by avoiding substance use or abuse, driving safely, avoiding violence, and practicing safe sex if you are going to be sexually active.

The habits you have now really do make a difference when you’re older.

Reproductive and sexual health

Becoming sexually active is a big decision. Contact your doctor if you are or are thinking of becoming sexually active. They can talk through your options to prevent pregnancy as well as sexually transmitted infections (STIs).

There are many ways to protect your sexual health and care for yourself. Abstinence is the only way to 100% prevent pregnancy and STIs. This means not having vaginal, anal, or oral sex.

If you decide to be sexually active with a member of the opposite sex, you should consider a form of birth control. Different types include a condom, pill, patch, shot, implant, diaphragm, or intrauterine device (IUD). These can help prevent unwanted pregnancy. Condoms are the only method that can prevent both pregnancy and STIs.

Talk to your doctor before you start having sex. They can answer any questions you have about sexual health. They also can prescribe a form of birth control.

Confidential care

The AAFP believes that adolescents and young adults should have access to confidential healthcare. It is important for your health and well-being. You should have the opportunity to see your doctor alone, without a parent or guardian in the room. You should be able to do this whether you’re there for an examination or for counseling. You need to have confidential one-on-one discussions about making healthy decisions.

Patient and Parent Information

It is important that patients and parents have access to information that will guide adolescents and young adults toward healthy decisions. The AAFP encourages parents and patients to talk with their family doctor about the potential risks to adolescent health and how to avoid them.

Things to consider

You may think that because you are young and healthy, you don’t need to see your doctor. But it is important to see your doctor and receive preventive services. Unhealthy decisions when you’re young can lead to consequences later on. Preventive services now will protect you and help you make healthy decisions throughout your life.

Questions to ask your doctor

• What kind of preventive services do I need at my age?
• Do I need any immunizations?
• What kind of birth control is available to me?
• What can I do now to avoid heart disease, cancer, or stroke later in life?
• How often should I see the doctor for preventive care?

Resources

Preventive Service Recommendations for Adolescents and Young Adults

National Institute of Health, Medline Plus: Health Screening

U.S. Department of Health & Human Services: Clinical Preventive Services for Adolescents

This work is provided through a collaboration between AAP and AAFP and is supported by a grant from Merck Sharp & Dohme Corporation.

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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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It’s difficult to watch your child experience emotional pain. It’s even more difficult to see physical signs of their pain. Cutting is the act of purposely cutting yourself with a sharp object, such as a knife or razor blade. It’s an unhealthy way to relieve emotional pain, sadness, intense frustration, and anger.

Cutting commonly occurs on the arms, legs, or torso. These are places that can be hidden by clothing. Cutting affects men and women of all ages. It usually starts in the teenage years and is more common in girls. Except in rare cases, cutting is not a sign that your child has thoughts of suicide. If you are concerned your child is cutting, learn the warning signs and speak with your child’s doctor.

Path to improved emotional well being

Even though cutting causes physical pain, people cut because they believe it brings them emotional relief. It may be in response to problems at home, school, or in other areas of their life. If your child is cutting, they may not be able to cope with their feelings. These can include loneliness, confused sexuality, deep anger, rejection, guilt, self-hatred, or panic.

Cutting is a clear sign of your child’s emotional distress. However, it usually catches most parents by surprise. Teenagers cleverly cover up their cuts. Unless you know what to look for, it may go undetected for a long period of time. Warning signs that your child is cutting include:

• Multiple, fresh cuts across the skin, and usually clustered together in the same area
• Scarring and bruising
• Having sharp objects nearby for no apparent reason
• Wearing long sleeves and pants at odd times, such as when it’s hot outside
• Making excuses about the reason for the cuts you see

Additionally, your child may be experiencing problems with a relationship. They may be making statements about poor self-worth or hopelessness. Your child may be questioning their identity and reason for living. They could be showing signs of behavioral issues, such as impulsivity and unpredictability.

If you suspect or see evidence of your child’s cutting, do not yell or criticize your child. Offer your support, express your concern, and tell them that you will do what it takes to help them with whatever is causing the urge for cutting. Speak with your child’s doctor. Your doctor will want to see your child and can provide you with referrals for treatment with a mental health professional.

Counseling or psychotherapy is commonly used to treat unhealthy coping methods, such as cutting. Counseling can take the form of one-on-one sessions with your child, family sessions, or a combination of the two. There are many different types of psychotherapy treatments, including:

• Cognitive behavioral therapy (CBT), which identifies and replaces unhealthy behaviors and beliefs.
• Dialectical behavior therapy (DBT), which teaches skills to handle, manage, or balance your emotions and improve relationships.
• Psychodynamic therapy, which helps you identify past experiences that may be at the root of your emotional stress.
• Mindfulness-based therapy, which teaches you how to live in the moment with appropriate thoughts and actions.

Your child’s therapy will depend on their emotional health and the seriousness of their cutting. Counseling and psychotherapy are not one-time treatments. It generally takes time, maybe even years, to uncover the reason for your child’s cutting and teach healthy strategies for coping.

Beyond emotional treatment, your doctor may need to treat the physical effects of cutting to reduce infection, permanent scarring, or severe (or potentially fatal) injury. Additionally, your doctor can help determine if there is an underlying medical condition (such as anxiety or depression) that may benefit from medications.

Things to consider

Continue to pay attention to your child’s friends. Research shows that people who cut spend time with friends who cut. Drug and alcohol use also increase your child’s risk of cutting. While thoughts of suicide aren’t common with cutting, your child could accidentally cut deep enough or cut an artery that could result in death if not treated immediately.

Questions to ask your doctor

• What is the best way to raise the issue of cutting with my child?
• If I confront my child about cutting, will this make them want to cut more and hide it more?
• How do I know if what I see is an accident or true cutting behavior?
• Is this behavior an inherited mental health condition?
• Should I talk to my child’s doctor before bringing them to the office?
• What if I’m wrong? Will I put the idea in my child’s head?

Resources

Centers for Disease Control and Prevention: Self-Directed Violence

National Institutes of Health, MedlinePlus: Self-Harm

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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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Underage drinking is a concern for all parents. It can happen in any family, regardless of income, status, or ethnicity. Many parents are surprised to learn that underage drinking can start earlier than the teenage years.

It’s important for parents to understand the reasons their child may experiment with alcohol. You should also know, how it can become an addiction and how to treat that addiction. Even more important is your role in talking with your child about the dangers of underage drinking. Research shows that the earlier a child starts drinking, the greater the likelihood they will abuse alcohol later in life.

Binge drinking also is dangerous. This is when you drink an excessive amount of alcohol at one time. Binge drinking is commonly tied to alcohol poisoning.

The American Academy of Family Physicians (AAFP) recommends that children between 12 and 17 years old avoid alcohol. As a reminder, drinking alcohol while under the age of 21 is not legal and is unsafe.

Path to improved health

It’s important to talk to your child (at every age) about the dangers of alcohol. It’s equally important to understand why they drink. Teens often take their first alcoholic drink because they get pressured by their friends or peers. Peer pressure may take the form of bullying. Peers also will tell your child that alcohol makes them feel good and gives them confidence. They may say that there’s no harm in drinking and that everyone drinks. Tell your child to expect peer pressure and encourage them to talk to you when those times occur.

Another reason your child may drink is because they want to be independent. As your child gains independence, it’s important for you to continue to monitor what’s going on in their lives. Stress (school, social, home) may be another reason your child starts drinking. Teach your child ways to cope with the stress they experience at every stage of their life. Children who have suffered abuse or have behavior or mental health problems are at an increased risk for underage drinking.

Talk to your children

Talking with your child helps reduce underage drinking. Parents can influence their child’s attitudes about alcohol and prepare them for the challenges ahead. Start by being a good role model. Research shows that when parents are actively involved in their child’s life, the child is less likely to drink. Being a poor role model can have negative consequences. Children of a parent who binge drinks, for example, are more likely to binge drink. If you are a parent and you drink, do so in moderation. Don’t drink and drive. Don’t keep an excessive amount of alcohol in your house. Other underage drinking topics you should discuss with your child include:

• The dangers of alcohol. Talk about the dangers of underage drinking and alcohol abuse. These can include blackouts, alcohol poisoning, injuries and accidents, risky behavior, negative effects on the brain, and death.
• Coping with peer pressure. Give your children real-life examples of ways to cope with pressure from friends and classmates. Have them practice their responses with you.
• Managing stress. Tell your child that drinking away their stress is not the answer. Teach them ways to cope, such as physical exercise, listening to music, reading, watching a funny movie, writing about their stress in a diary, volunteering to help people or organizations in need, and talking with you or someone else they trust.
• Legal and academic consequences. Explain the long-term impact of underage drinking and drinking and driving (losing your license, having an arrest record). Underage drinking and drinking and driving can lead to losing a spot on a school team or club. It can also mean losing a college scholarship. Even worse, someone could be injured or even killed by a decision to drink and drive.
• Choosing the right friends. Encourage your child to find friends and classmates who share their same goals and lifestyle choices. If they choose to hang around kids who drink, they are more likely to give in to peer pressure and drink as well.

Take preventive steps

Talking with your child about the dangers of alcohol is important. However, talking is not enough. Take preventive steps, such as networking with other parents who share your same thinking and rules about underage drinking. This can include not serving alcohol at parties, and adult supervision when friends are over.

Keep alcohol out of your own home or under lock and key. Establish strict rules and consequences for underage drinking. Some parents create a written agreement or contract with their children. This can include consequences for underage drinking or drinking and driving. Consequences may be a loss of driving privileges, loss of free time, earlier curfews, or paying fines.

Things to consider

Alcohol abuse doesn’t just affect your child. Negative consequences can cause harm to others as well, such as injuring or even killing another person while driving drunk.

Learn the warning signs of alcohol abuse, which can include:

• Mood changes, including depression, anger, and irritability
• Poor grades
• Behavior problems at work or school
• Suddenly choosing a new group of friends, or not introducing their friends to you
• Low energy
• No interest in the activities or recreation they once enjoyed
• Evidence of alcohol use, such as red eyes, the smell of alcohol on your child’s breath, slurred speech, or inability to concentrate

Treatment is available in several forms. It may require individual or group counseling, or an inpatient or residential treatment program (where your child stays until they have completed treatment). There are also outpatient treatment plans (where your child leaves the house for treatment and returns home each day), hospital programs, medicine to reduce alcohol cravings, ongoing recovery support programs, and peer supports. Ask your doctor which one or combined treatment is right for your child.

Questions to ask your doctor

• If I suspect my child has been drinking, how do I know if my child is abusing alcohol or if it is a one-time thing?
• If my child is under 18, can I authorize treatment? What if he or she is over 18?
• How do I have a conversation with my child about alcohol if my spouse drinks in moderation (but every day) and I don’t?
• Is alcoholism hereditary?

Resources

Centers for Disease Control and Prevention: Underage Drinking

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