Editor's note: The 2017 AAP National Conference & Exhibition will take place from Sept. 16-19 in Chicago.
You feel confident educating parents on how to use time-outs when their preschoolers misbehave. And you’re a pro at diagnosing attention-deficit/hyperactivity disorder (ADHD) in school-age children.
But when a parent asks how to deal with an unruly teen, you feel like you’re grasping at straws.
Developmental and behavioral problems are among the most common issues pediatricians see in clinic, but it’s the area where they have the least amount of training, said Adiaha Spinks-Franklin, MD, MPH, FAAP, a member of the AAP Section on Developmental and Behavioral Pediatrics.
Frequent well-child visits in the first years of life allow pediatricians to hone their skills in diagnosing and managing such issues in younger children. However, the same is not true for adolescents, who present less often for care.
But don’t despair. Dr. Spinks-Franklin will get you up to speed during a session titled
“Teens Gone Wild: Advising Families on Parenting Adolescents (S2058).” The seminar will be held from 8:30-10:00 am Sunday, Sept. 17.
“We can’t just demonize our teenagers and dismiss them as just being problem children,” she said. “We’ve got to give them a little more credit than what we often give our kids.”
To help attendees understand adolescent behavior, Dr. Spinks-Franklin will give a brief didactic presentation on brain development. The teenage brain matures from back to front, which means the part of the brain responsible for decision-making and problem-solving is the last to develop.
“If a teenager is arguing with you, you’re arguing with the caveman brain,” said Dr. Spinks-Franklin, developmental-behavioral pediatrician and assistant professor at Texas Children's Hospital/Baylor College of Medicine.
She then will describe how to approach common adolescent behavior challenges such as rebellion/challenging authority, defying curfew, school problems, risk-taking behavior, choice of peer group, experimentation with drugs/alcohol, and concern about possible eating disorders. To illustrate her points, she will draw on cases of patients she has seen, situations in the media and examples from TV or movies.
It’s important to take a thorough history that includes questions on how much sleep the teen is getting and what his or her daily schedule looks like, she said. Lack of sleep is one of the biggest problems for adolescents and can lead to symptoms that mimic mental health problems.
“If a teenager is coming to me and the parent is saying, ‘I’m worried my child may have ADHD,’ that is the last thing I’m thinking of in a teenager,” Dr. Spinks-Franklin said. “I’m worried about is this kid sleeping enough? Is this child taking drugs? Is this child doing something else that would interfere with how well the child functions?”
Dr. Spinks-Franklin also will discuss how to differentiate mental health disorders from normal adolescent angst, how to determine what problems can be managed in the pediatric office vs. what should be referred to a mental health professional and the importance of knowing what community resources are available.
Teens’ willingness to get help has a lot to do with their relationship with their doctor and how mental health care is presented.
“They need to know they are having a normal reaction to an abnormal situation. … and that it’s very common. They’re not the only ones,” Dr. Spinks-Franklin said. “For some kids, I just honestly tell them, ‘Honey, you have a right to be depressed. You’ve been through a lot of stress.’”
Follow Dr. Spinks-Franklin on Twitter @af1971.
For more stories on educational sessions and events at the 2017 AAP National Conference & Exhibition in Chicago, visit http://bit.ly/2vm1VUU. To register for the conference, visit http://aapexperience.org/conference-registration/.
