Four new recommendations for adolescent health

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publications

The yearly “check-up” is the perfect (perhaps only) time to not only see how kids are growing and give any needed shots, but to see how they are doing more generally — and help be sure that they grow into healthy, happy adults. After all, prevention is really what pediatrics is all about.

That’s why the American Academy of Pediatrics (AAP) has a checklist for pediatricians called “Recommendations for Preventive Pediatric Health Care.” These recommendations, which are updated every few years, are based on the most up-to-date research about the health of children now — and in the future.

While the latest version does include new recommendations for younger children, such as putting fluoride varnish on the teeth of children under 5 and doing a simple test for heart defects on newborns, most of the changes this time around pertain to adolescents. Here’s what the AAP thinks pediatricians should be doing with their pre-teen and teen patients:

  • Lipid screening. Sometimes high cholesterol runs in families — but parents and other relatives may not have had theirs checked, or may not be aware of the test results of other family members. Because high cholesterol can cause real damage to blood vessels over time and lead to heart disease and stroke, it’s recommended that all youth have their cholesterol checked between the ages of 9 and 11. Doctors may do it before or again based on risk, but the AAP wants to be sure that everyone gets checked at least once.
  • Screening for drug and alcohol abuse. As we all know, adolescents commonly experiment with drugs and alcohol. For some youth, this can lead to difficult or even deadly consequences. The AAP recommends asking six simple questions (called the CRAFFT screen) that can bring out really important information — and allow for really important conversations.
  • Depression screening (for example, with a questionnaire). Suicide is a leading cause of death among adolescents — and depression is a treatable condition. But to treat it, we need to know that it’s there.
  • HIV testing between the ages of 16 and 18. This is important because one in four new HIV infections occurs in youth ages 13 to 24, and 60% of all youth with HIV don’t know they are infected. If they don’t know, not only can they not get help, but they can spread the infection to others.

I can imagine some parents saying, “My child doesn’t need these — our family is healthy and my child is a good, happy kid who knows to stay out of trouble.” But the simple truth is that we can never know everything about either our family history or our child — and when it comes to the health and well-being of our children, it’s always better to be safe than sorry.

If you have questions about these recommendations or anything else that does — or doesn’t — happen at your child’s check-up, talk to your doctor.