Early Adolescence (Approximate Ages 10-13)

Early adolescence is heralded by rapid physical changes with the onset of puberty. The onset of puberty is earlier by 1-2 years for girls than for boys. Early adolescence is fun, exciting, scary, frustrating and empowering all at the same time. Some basic things to remember during these years include the following:

  1. Continue healthy eating and sleep habits. It is very normal for children this age to gain weight and eat more calories.  Try to keep the focus on mostly healthy choices and daily aerobic activity.  The following links provide some great guidelines:
    1. https://www.healthychildren.org/English/ages-stages/teen/nutrition/Pages/A-Teenagers-Nutritional-Needs.aspx
    2. https://www.healthychildren.org/English/ages-stages/teen/fitness/Pages/Physical-Activities-for-Teens.aspx
  2. Supervise and limit screen time – ensure that your child is getting enough sleep.
  3. Changes related to puberty start at this age
    1. The basics of pubertal changes are listed in the links below:https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Physical-Development-of-School-Age-Children.aspx https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Concerns-Boys-Have-About-Puberty.aspx
    2. https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Concerns-Girls-Have-About-Puberty.aspx

Independence-Dependence Struggle

Early adolescence is characterized by the beginning of the shift from dependence on parents to independent behavior.  Common events at this time include:

  1. Less interest in parental activities and more interest in their peer group – seem more reluctant to accept advice or criticism from parents but hyper-tuned to peer group thoughts, criticisms and actions -especially on social media.
  2. An emotional void created by separation from parents – children this age crave acceptance from their parents – they just don’t act like it
  3. Wide mood and behavior swings associated with hormonal changes related to puberty

Parenting seems very daunting at this age and communication is sometimes difficult. Here are some basic tips:

  1. Praise the positive – children this age need constant reminders of all the things they “do right” since they often hear more about all the things they “do wrong”.  Praise should be genuine and appropriate and will go a long way in establishing a sense of self worth.
  2. Constructive criticismchildren will and need to make mistakes – this is how they will learn some very important life skills like resilience and adjustment.  This is the perfect age to try and fail at things like time management, new hobbies and friendships.  Because they are very sensitive to words and actions of the people they love most, use gentle words to convey what could be done better next time.  Try not to list all the things they “did wrong”.
  3. Let them speak – it is incredible how engaged these youngsters are to the world around them.  Ask their opinions on anything from your family vacation to politics.  You will be amazed at what you learn about your child’s thought patterns and will provide you an incredible opportunity to share some of your own.  Open communication is the most important key to a healthy relationship with your budding teenager.
  4. Support what they love – every child this age needs to feel like they are “good at something”.  Let them explore what they love and let them be the “expert” on that particular interest in your family.  This allows them to feel valued and gives them a sense of worth.  This will help them develop a strong sense of self esteem that will carry them through the trials and tribulations of the teen years.

More information on healthy self esteem is contained in the following link: https://www.healthychildren.org/English/ages-stages/gradeschool/Pages/Helping-Your-Child-Develop-A-Healthy-Sense-of-Self-Esteem.aspx

Body Image Concerns

Rapid physical changed lead the adolescent to be increasingly preoccupied with body image characterized by:

  1. Preoccupation with self.
  2. Uncertainty about appearance and attractiveness.
  3. Frequent comparison of own body with those of other adolescents.
  4. Increased interest in sexual anatomy and physiology.

Unrealistic physical expectations weigh heavily on a child this age.  Focus on “healthy” at home.

Peer Group Involvement

With the beginning of movement away from the family, the adolescent becomes more dependent on friends as a source of comfort.

  1. Solitary friendships with a member of the same sex: This idealized friendship can become intense.
  2. Strongly emotional, tender feelings toward peers.
  3. Peer contact primarily with the same sex.

This is an important time to monitor the health of their peer relationships.  We know that bullying can leave a lasting impact on children so it is important to stress healthy friendships at this age.  Our children also face possible bullying from social media, chat sites and text so remember to monitor all of their communication modalities.  The following are some helpful links on healthy friendships, bullying and cyberbullying:




Identity Development

At the same time that rapid physical changes are occurring, the adolescent’s cognitive abilities are improving markedly. This corresponds to the evolution from concrete thinking to abstract thinking.

  1. Increased ability to reason abstractly.
  2. Frequent daydreaming, which is not only normal but an important component in identity development.
  3. Setting unrealistic or idealistic vocational goals (for example, rock star, airplane pilot, or truck driver).
  4. Testing authority.
  5. A need for greater privacy.
  6. Emergence of sexual feelings
  7. Development of the adolescent’s own value system.
  8. Lack of impulse control.
  9. Tendency to magnify one’s personal situation.

All of the above changes are occurring while your child is trying to keep up with school work, play sports and “fit in” – they are dealing  with alot!

Social media and the internet are quickly becoming a double edged sword in our pre-teen’s lives.  While they are great tools to connect with others when used appropriately, they can become anxiety provoking and tools for bullying.  Stay involved in your child’s social and “cyber” life to help them better understand and navigate the world around them.  Knowing “who they follow” will help you understand issues that are important to them and will provide you with an opportunity to discuss these issues in the context of your family and what you feel is right “for us”.  Always reiterate the importance of “down time” – in our 24/7 cycle of life, it is important to teach them that it is OK to disconnect and create balance.

The following link provides information on internet safety during the teen years:  https://www.healthychildren.org/English/family-life/Media/Pages/Understanding-the-Internet-Rules-of-the-Road.aspx


* 11 yrs : Meningococcal vaccine and TdaP vaccine (Hep A if never given as a child)

* for females and males –  age 9 – 21: HPV is strongly recommended – dosed in a 2 part series if started before the age of 15  (6 months apart) and dosed in 3 part series (#1, then repeat in 2 months and last in 6 month  – information about the HPV vaccine is linked here:  https://www.cdc.gov/vaccines/partners/downloads/teens/vaccine-safety.pdf

*PPD (TB screen – dependent on risk factors)


  • age 9 – lipid screen if not previously completed, Hb if indicated (generally menstruating females)
  • subsequent years – labwork as indicated by history