Middle Adolescence (Approximate Ages 14-16)

Middle Adolescence is an exciting time of growth and change for your child.  These changes can  signal some internal conflict as well as conflicts with those around them as they try to assert more independence.  While their peer group starts to take up most of their time, the support, positive encouragement and moral compass still comes from their family.  It may not seem like it but children this age need the structure and guidance to help them navigate towards healthy good choices and telling “right from wrong”.

Independence –Dependence Struggle

Children this age are actively working toward becoming more independent.   It is imperative that children this age “fail” within a supportive framework to be able to learn from their mistakes.  Some guiding principles are listed below:

  1. Teach organizational skills and let consequences happen – This is a great age to teach them how to organize their day and allow them to “feel the pain” of when they forget. (for example – not having any clean clothes for the sleepover because the laundry never got into the dryer, forgetting lunch at home).  Just like the toddler days, you have to fall sometimes to learn how to balance better.
  2. Consider a regular allowance without any extras – This serves as a great way to learn to budget (for example – they will learn to spend less on food at the mall if they really want that pair of jeans).
  3. Do less as time goes on so they learn how to do more for themselves – this concept is just like a toddler learning to walk – we hold with both hands until eventually, we let go so they can take steps on their own.

Body Image Concerns

Most middle adolescents, now having had pubertal changes, are less preoccupied with these changes. Much time is spent trying to make themselves more attractive and “in”.  With social media becoming a  bigger part of our teens’ lives, it is very important for parents to keep track of positive and negative influences that are not coming from home.  Many times, looks depicted on the internet are not attainable and it is very important to keep the focus on healthy at home. Body image issues are becoming more prominent in both males and females and can lead to health issue like eating disorders, anxiety and depression.  Some ways to help keep the focus on health at home include:

  1. Limit screen time – create family ground rules that encourage no more than 2 hours of “fun use” of the internet/social media – this helps your teen avoid being “over” connected.
  2. Try to have at least one meal together weekly – this encourages a positive relationship with food and provides a great opportunity to connect and talk.
  3. Focus on health instead of “fat” or “skinny”, avoid “fad” diets like gluten free or high protein – encourage moderation in diet and exercise.
  4. encourage opportunities to “look outside themselves” – family volunteer opportunities are a wonderful way to give back to others and find a focus that is not based on self

The following links provide guidelines on healthy eating and exercise in this age group:

general nutrition guidelines for teens: https://www.healthychildren.org/English/ages-stages/teen/nutrition/Pages/A-Teenagers-Nutritional-Needs.aspx


exercise information in teens: https://www.healthychildren.org/English/ages-stages/teen/fitness/Pages/How-Teens-Can-Stay-Fit.aspx

Peer Group Involvement

At no other time than middle adolescence is the powerful role of peer groups more evident.

  1. Intense involvement by the adolescent in his or her peer subculture.
  2. Conformity by the adolescent with peer values, codes, and dress, in an attempt to further separate from family.
  3. Increased involvement in relationships.
  4. Involvement with clubs, team sports, gangs, and other groups.

Adolescents’ reactions to peer pressure are extremely varied, and peer pressures can also involve a desire to excel academically, in sports, or in other positive activities.  Of course, it can lead down a path of negative behaviors like substance abuse or bullying.  Stay connected with your teen – know who their friends are, have time available to talk through their concerns and be there to help set guidelines for problem solution. The following links discuss some common issues teens this age deal with:

bullying: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Bullying-Its-Not-Ok.aspx:

signs of possible mental health issues: https://www.healthychildren.org/English/ages-stages/teen/Pages/Mental-Health-and-Teens-Watch-for-Danger-Signs.aspx

substance abuse: https://www.healthychildren.org/English/ages-stages/teen/substance-abuse/Pages/Drug-Abuse-Prevention-Starts-with-Parents.aspx


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



*10 yrs: TdaP (Hep A if never given as child)

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

* for females and males –  age 9 – 21: HPV is strongly recommended (dosed in 3 part series (#1, then repeat in 2 months and last in 6 month) – goal to give all 3 doses males and females before age 15 yr

PPD (TB screen – dependent on risk factors)


  • age 10 – lipid screen if not previously completed, Hb if indicated (generally menstruating females)
  • subsequent years – lab work as indicated by history