All My Children

The majority of children settle happily into the early years setting — some take a bit longer than others and may go through a shy or tearful phase while others bounce into the room with confidence from day one. A lot depends on their experiences prior to joining your nursery or playschool. If they have already experienced playing with other children, have visited other people’s houses, been to the park and discovered the excitement and pitfalls of

Swings and slides and have learnt how to cope with sharing toys and games with brothers and sisters they will probably cope with most early years situations. Continue Reading »

A persistent sad or negative mood

Most parents may at some point, if not frequently, complain that their teenager has a “lousy attitude.” It isn’t at all unusual for adolescents to experience emotions and mood swings that seem out of proportion to the circumstances. But the depressed child or teenager seems to be in a perpetual slump.

Unfortunately, you won’t hear a young person say, “In case you haven’t noticed, I’ve been depressed for the past several weeks.” Instead, you may see any of a number of the following signals that would appear disconnected: Continue Reading »

Alcohol—the most dangerous gateway drug

In all fifty states, it is illegal to sell alcoholic beverages to anyone under age twenty-one. This is no accident, because for teenagers alcohol is a gateway to a lot more than other drugs.

Alcohol causes more deaths among adolescents than any other substance. About 40 percent of all deaths in sixteen- to twenty-year-olds result from motor- vehicle crashes, and half of these are alcohol related. Overall, driving under the influence is the leading cause of death for people between the ages of fifteen and twenty-four. Alcohol also frequently plays a role in adolescent deaths from other causes: homicides, suicides, drownings, and motorcycle and bicycle accidents. Continue Reading »

The task of discovering personal gifts, interests, and passions

One of the most important and life-enhancing aspects of adolescence is the process of looking at a variety of activities and interests. If her childhood interests in Scouts and piano lessons don’t continue into the teen years, don’t count your time spent in those activities as wasted. She may want to explore drama or gymnastics for a while, and they may become her new passions—or she may discover that the piano really is her true love after all. Your encouragement for her to find and develop her strengths and perhaps to overcome what she (and you) might have considered her weaknesses will pay off in many ways. Not only might she find a niche of true excellence and accomplishment, but all of these activities— even the ones that don’t pan out as permanent interests—will broaden her fund of knowledge and experience. Furthermore, your support during these efforts will repeatedly affirm her value. Continue Reading »

From a physical standpoint, the main event of adolescence is puberty, which serves as the physiological bridge between childhood and adulthood.

Puberty: The stage of maturation in which an individual becomes physiologically capable of sexual reproduction. (From the Latin puber: “adult.”)

Rapid growth and body changes during these years are to a large degree brought about by interactions between several hormones, biochemical compounds that are created in one part of the body and sent via the bloodstream to have a specific effect somewhere else. These chemical messages provoke an impressive number and variety of responses throughout the body. All of the hormones and the glands that secrete them are collectively known as the endocrine system. Continue Reading »

Under normal circumstances, each month a woman’s body performs a three-act play entitled Preparing for a Baby. What you are about to read is a summary of the essential characters and plot. (As with many other aspects of human physiology, there are thousands of other details that will not be spelled out here and thousands more yet to be discovered. The design of this process is indeed exquisite.)

The main characters in the play are:

• The hypothalamus: a multifaceted structure at the base of the brain that regulates basic bodily functions such as temperature and appetite. It also serves as the prime mover in the reproductive cycle.

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The words menstrual and menses are derived from the Latin word for “month,” which refers to the approximate frequency of this event. A typical cycle lasts from twenty-seven to thirty-five days, although for some women normal menses occur as frequently as every twenty-one days or as infrequently as every forty-five days. Most of the variability arises during the first (follicular) phase leading up to ovulation. Assuming that a pregnancy does not begin, the luteal phase (from ovulation to menses) is nearly always fourteen days, with little variation. Continue Reading »

Menstrual cramps (also called dysmenorrhea) most often are a by-product of the normal breakdown of the lining of the uterus (endometrium) at the end of a cycle.

Chemicals called prostaglandins are released into the bloodstream by the endometrium, often with unpleasant effects. The most obvious response is a series of contractions of the muscles of the uterus, which may actually be as forceful as contractions during labor. During a strong contraction, blood may be inhibited from circulating through all of the uterine muscle and, like any other muscle temporarily deprived of oxygen, will sound off with genuine pain. Prostaglandins may affect other parts of the body during a menstrual period, causing diarrhea, nausea, headaches, and difficulty with concentration. One bit of good news in connection with menstrual cramps is that they do not predict what level of pain a woman will feel later in life during childbirth. In other words, a teenager with severe menstrual cramps is not necessarily going to have equally severe labor pains. Continue Reading »

Needless to say, no adolescent (or any older woman) is excited about having a pelvic exam, especially if there is discomfort in this area to start with. It is important that whoever does the exam explain step-by-step what is going to happen and then talk her through it while it is being done. She should be reassured that it is normal to feel nervous and awkward and that while the exam is not particularly comfortable, it shouldn’t be extremely painful either. Both patient and parent should understand that a pelvic exam does not terminate a girl’s virginity. Sexual morality is not violated by a medical procedure whose purpose is to help assess, diagnose, and treat a physical problem. Continue Reading »

During the next few years, your teenager will probably need medical input on a number of occasions. Screening exams for sports, camp, and general health assessment will need to be done. Injuries arising from sports or other vigorous activities may need attention. Problems related to menstruation may require medical evaluation and intervention. In addition, a variety of symptoms and emotional concerns may arise during these years.

Adolescent health-care guidelines recommend yearly visits to the doctor for assessment, screening, and guidance, even if there have been evaluations during the year for other medical problems. Quick exams for camp or sports, especially those done assembly-line style on large groups of adolescents, should not substitute for more comprehensive physicals by your regular health-care provider. Continue Reading »