Late Adolescence (Approximate Ages 17-21)

Late adolescence is the last phase of the adolescent’s struggle for identity and separation. If all has proceeded fairly well in early and middle adolescence, the adolescent will be well on his or her way to handling the tasks and responsibilities of adulthood. If the previously mentioned tasks have not been completed, however, then problems may develop with the increasing independence and responsibilities of young adulthood and may lead to anxiety and depression. Although pediatricians can see patients until they are 21 years old, many young adults choose this time to transition to adult care.

Independent-Dependence Struggle

Late adolescence is a time of reduced restlessness and of increased integration. The adolescent has become a separate entity from their family and now may better appreciate the importance of his parent’s values, thus, parental advice may once again be sought and accepted. Your child is ready to enter into the “adult world” and your relationship with your child will look and feel different as they forge into the world on their own.

Body Image Concerns

The late adolescent has completed puberty and is typically unconcerned with this process.  Young adults should be implementing a daily healthy routine that includes good diet habits and regular activity.  Some important issues include:

  1. Continued adherence to healthy eating habits and daily activity and establishing a medical home at college and beyond.
  2. Vigilance with self safety especially in social situations that involve alcohol.
  3. Encouragement of healthy relationships

The following links provide some information on health and safety:

young men’s health: http://youngmenshealthsite.org/

young woman’s health: http://youngwomenshealth.org/

prevention of STD’s: https://www.healthychildren.org/English/health-issues/conditions/sexually-transmitted/Pages/Sexually-Transmitted-Infections-Prevention.aspx

healthy relationships: https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/Expect-Respect-Healthy-Relationships.aspx

transition into young adulthood: https://www.healthychildren.org/English/ages-stages/young-adult/Pages/Mental-Health-Tips-for-Teens-Graduating-from-High-School.aspx

https://www.healthychildren.org/English/ages-stages/young-adult/Pages/Healthy-Tips-for-the-College-Freshman.aspx

Peer Group Involvement

Peer group values become less important to late adolescents as they become more comfortable with their own values and identity. Much time is spent in a relationship with one person. Such relationships involve more of a mutual understanding and enjoyment than on peer acceptance.  Once again, young adults should be encouraged to advocate for what feels right for them and to be in charge of their personal safety. The following links provide some great advice:

drinking and personal responsibility: https://www.healthychildren.org/English/ages-stages/young-adult/Pages/Drinking-Responsibly-at-College.aspx

personal safety: https://kidshealth.org/en/teens/self-defense.html?ref=search#

Immunizations

16-18 years: booster immunizations for meningitis & tetanus and recheck that all vaccines are updated

in males and females: HPV vaccination is strongly encouraged if not already completed

PPD (TB screen – dependent on risk factors)

Laboratory:

In females:

  1. hemoglobin check every 5 years after menstruation
  2. pap smear within 3 years of sexual activity  or by age 21

In males and females:

  1. HIV screening recommended regardless of sexual activity after age 17
  2. urine GC/Chlamydia if sexually active
  3. fasting lipid panel if indicated with patient or family history