Visualise this, it’s a warm Saturday afternoon and you’re all out shopping as a family at one of Shanghai’s many malls. Your daughter goes to try on some outfits and you can’t wait to see her in the latest ‘Dora The Explorer’ fashions... but then reality bites, the jeans are tight and riding low. The top is way too short and, yes, that’s her belly button out for the world to see. Your three-year-old is suddenly thirteen and has no interest in Dora... and you’re the stunned parents of an adolescent! Congratulations – welcome to the club.
Adolescence
In contrast to puberty (a biological process universal to all children), adolescence is a period of ‘growing up’ (a cultural phenomenon), unique to each civilisation or society. According to ‘Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents’ (2008), adolescence is the period from 11 to 21 years of age and is divided into three sections: Early Adolescence (11 to 14 years), Middle Adolescence (15 to 17 years), and Late Adolescence (18 to 21 years). These are very dynamic periods and often flow smoothly (but some- times not) from one to the next. There are significant changes that occur during these periods which can be quite puzzling to both the adolescent and their guardians. Amongst them are physical, cognitive, and psychological changes; development of social and sexual identity; formulation of educational and other long-range goals and plans; and development of an ideology and set of values.
Aetiology of Adolescent Behaviours
Observing adolescent behaviours is easy, however, the more common and challenging question, posed by both caretakers and teens, of “WHY?” is not. There is no simple answer to this question because all human behaviour is based on multiple factors including biology (gender, hormones), environment (cultural norms, media), social context (parents, peers), and personality (self-esteem, values). When there are disruptions in the sequence of normal adolescent growth and development, significant problems can arise and are often closely related. Delayed pubertal development in a boy, for example, can cause increased peer pressure leading to issues with self-esteem and ultimately depression. Severe acne or other common medical conditions associated with adolescence can similarly cause problems with peers and school performance.
Social expectations, family or personal issues, and poverty can all lead to unhealthy behaviours, especially during early adolescence when impulse control is still developing. The important concept for us to understand is that situations can trigger many different responses in adolescents. This is not excusing adolescent behaviour but rather a recognition that we can try to understand the roots of that behaviour whilst holding them accountable for the consequences of their actions.
Common Adolescent Issues
In addition to acne, asthma, delayed puberty, musculoskeletal concerns, and weight problems (both over and under), adolescence is a period during which many psychosocial, psychological, and psychiatric issues emerge. Peer and personal relationships are tested, concerns about sexual identity seem suddenly present, and more worrisome issues like mood and eating disorders, impulse
control, and oppositional behaviours become more challenging to manage. Unhealthy, risky behaviours such as sexual activity, substance abuse, and violence test the limits of adolescent relationships with family, peers, and teachers alike. New issues confronting adolescents are related to excess or inappropriate use of the internet, social media, and social networking websites. Sometimes when we try to engage an adolescent in meaningful dialogue about these issues, we are met with the blanket statement, “you just don’t understand me...”, leaving us feeling frustrated and helpless.
Prevention
Anticipating and avoiding all potential adolescent issues is impossible, but there are steps we can take to make this transition period less traumatic. In addition to a complete his- tory and physical, a paediatrician will conduct recommended screenings, make sure immunisations are up to date, and help families understand some of “what’s ahead” as their child becomes an adolescent. Adolescents should see their family doctor or paediatrician annually.
It is common for your adolescent’s doctor to spend a few minutes alone with her/him. Don’t be alarmed! This allows them time to discuss sensitive topics that often make caregivers and adolescents uncomfortable but are essential to providing the best possible care to this age group. While confidentiality is sacred to the doctor-patient relationship, be assured that doctors inform caregivers of issues affecting adolescents that can cause harm to themselves or others. These visits are also a time for your adolescent’s doctor to offer you tips on dealing with your adolescent, including discussing what is “normal” adolescent growth and development, and areas for concern based on information gathered during the check-up. Treatment for any medical conditions discovered will be offered and the necessary referral to specialists will be done.
Key Points to Remember
Some factors associated with helping to protect youth from engaging in unhealthy behaviours include close connection to home, extracurricular activities, school, and spirituality. In addition to counsellors and teachers, your family doctor or paediatrician is an excellent source of information about many issues that confront you and your adolescent.
Before you know it, your adolescent will have moved on from arguing about being responsible and skilled enough to drive (in China) and to please get off their case, to planning a medical internship in Costa Rica. Tada! You’re now the proud parents of a young adult...
United Family Healthcare
Phone: 400 639 3900
Website: shanghai.ufh.com.cn
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