Chapter 1. Adolescence

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Look Inside

What is going on inside your child’s head as they go through puberty and enter into adolescence? Review adolescent brain development in this video clip.

Are you ready for puberty? These two video clips follow boys and girls as they reach puberty between the ages of 11 and 14.

Should {model.babyName} continue with homeschooling, even though the academic demands may get more challenging?

This may be an opportunity to move things in a more positive direction.

{model.babyName} has been going to {model.MC4_school_choice}. You have been pleased with how things have gone and you are a bit sad to see this school year come to an end.

While {model.babyName}’s years at {model.MC4_school_choice} have been challenging, you are optimistic that maybe sixth grade with bring an opportunity for a fresh start.

While {model.babyName}’s years at {model.MC4_school_choice} have been difficult academically, {model.baby_he_she} has certainly learned a lot. You are nervous about the move to middle school next year.

{model.ADO1_homeschool_paragraph}

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Explain

Schooling for children in early adolescence doesn’t tend to get high marks from researchers or parents in the United States. At some point in adolescence, children move from the somewhat nurturing environment of elementary school, where they tend to spend most of the day with one generalist teacher, to a high school with a more specialized teaching staff. All around the world, schools tend to have some kind of break or transitional school between the cozier schools of childhood and high schools. However, how old children are when they break out of elementary school and enter high school varies significantly around the world and has been going through a rethinking and a transition in the United States.

In general, the United States has seen a change from junior high schools (where students are in a separate school for grades 7 and 8) to middle schools where students move into a separate school for grades 6-8 or 5-8. Another popular option is to keep children in elementary school longer—so that elementary school enrolls students from kindergarten to grade 8. Another, that seems less popular, is to extend high school to include grades 7 and 8

All of these changes reflect ambivalence about exactly what an early adolescent is capable of and how they can best be nurtured. Is a 12-year-old a little adult, ready for the rigors of high school? Should they be protected from older children who potentially have more disciplinary problems? Is it okay to mix kindergartners with pubescent 7th graders on the school bus or in the hallway?

Research also reflects a sense that students tend to suffer in the transition out of elementary school, whether the schools they transition to are called middle schools or junior high schools. The rate of learning seems to slow down and children have more disciplinary problems. Children who stay in their elementary school, rather than moving to middle schools, tend to improve more in a year of school than children who transition. However, this research is complicated: are students moving from an elementary school to a middle school of equal quality? Are the class sizes the same? Is there a difference in school culture? It is difficult to make a precise recommendation about how to improve the experience of children in school at these grade levels.

However, researchers do have a sense of some schools that do a better job with middle school students than others. These schools tend to have a positive culture with high expectations for all children and motivated and engaged staff. These schools can look quite different—some of them can be quite high school-like with specialized courses (forensic science anyone?) and others can be more elementary school-like with pods or learning groups.

Homeschooling. About 3 percent of children in the United States are homeschooled. How well home-schooled children do depends largely on whether their parents follow a structured academic program, in which case children do very well, or whether they practice a more flexible routine, or something called “unschooling”, which tends to have lower academic outcomes (Joseph Murphy, Homeschooling in America: Capturing and Assessing the Movement, Sage, 2012). Children who are homeschooled tend to have high academic outcomes and, contrary to common opinion, aren’t necessarily badly socialized. Their motivated parents tend to find them social opportunities and home-schooled children report having as many friends as their public school counterparts.

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Learn More

Look Inside

Review what we understand about puberty and the timing of puberty in these video clips.

Now that {model.babyName} is ready for middle school, it is time for another check up. You’re starting to wonder whether you’ll have to leave the room when {model.babyName} changes during the physical examination. You certainly never felt that way when {model.babyName} was still in diapers. But that was a long time ago.

Now that {model.babyName} is ready for middle school, it is time for another check up. You’re starting to wonder whether you’ll have to leave the room when {model.babyName} changes during the physical examination. You certainly never felt that way when {model.babyName} was still in diapers. But that was a long time ago.

{model.babyName} is still just 12, but could pass for 15 any day. She’s already noticing that people are looking at her differently.

{model.babyName} is still just 12, but could pass for 15 any day. He’s really excited that he’s one of the tallest boys for his age.

{model.babyName} is still just 12, but could pass for 15 any day. He’s really excited that he’s isn’t the shortest boy for his age.

Thankfully, {model.babyName} still looks young for {model.baby_his_her} age. But {model.baby_he_she} doesn’t always see it that way. {model.baby_He_She_cap} seems to want to be big already.

{model.babyName} has already gotten so tall. You wonder whether {model.babyName} is average for {model.baby_his_her} age.

{model.babyName} refused to come with you to the pediatrician for their annual check-up. {model.partnerName} told you that this was crazy, but you promised to upgrade {model.baby_his_her} phone if {model.baby_he_she} came with you, so {model.baby_he_she} ended up coming with you. You just wanted to make sure {model.baby_he_she} was healthy!

{model.babyName} refused to come with you to the pediatrician for their annual check-up. Your best friend told you that this was crazy, but you promised to upgrade {model.baby_his_her} phone if {model.baby_he_she} came with you, so {model.baby_he_she} ended up coming with you. You just wanted to make sure {model.baby_he_she} was healthy!

{model.babyProviderName} has been reminding you for some time to try and do something to address {model.babyName}’s weight challenges. Now that {model.babyName} is an adolescent, there may be more serious consequences for being overweight–like diabetes or even high blood pressure.

Even though you and {model.babyName} have been trying to address some of the extra weight {model.baby_he_she} gained, it doesn’t seem to be helping as much as you might have hoped. {model.babyProviderName} tells you not to be discouraged and to keep up the good work.

Congratulations! After your work trying to improve {model.babyName}’s diet and get more activity, {model.baby_he_she} is now at a more healthy weight. What a relief!

Fortunately, {model.babyName} is now at a more healthy weight. {model.baby_His_Her_cap} height must have outpaced {model.baby_his_her} weight. You should think about a healthier diet and more activity to keep the weight off. Now that {model.babyName} is an adolescent, there may be more serious consequences for being overweight—like diabetes or even high blood pressure.

Even though {model.babyName} seems to be making safe choices right now, you’ll still want to make sure you keep open lines of communication with {model.baby_him_her} as the months move on. You’ll be surprised how quickly kids grow up. Most experts and pediatricians advise to talk openly with your kids about substances and sex to make sure they have the information they need to make healthy choices.

You weren’t shocked that {model.babyName} was already among those kids who have already tried {model.ADO2_substance_list}. But you’ll need to make sure that {model.baby_he_she} doesn’t run into more trouble and that {model.baby_he_she} starts making healthier choices. {model.babyProviderName} recommends that you keep a closer eye on where {model.babyName} is after school and on weekends and that you talk to {model.baby_his_her} friends’ parents to see whether you can figure out whether this is a problem that is just happening with your child. You need to talk with {model.babyName} to understand better what is going on and set firm limits about what’s acceptable. And in a 12-year-old, remember {model.ADO2_substance_list_verb} is never an okay choice.

You were shocked that {model.babyName} was already among those kids who have already tried {model.ADO2_substance_list}. But you’ll need to make sure that {model.baby_he_she} doesn’t run into more trouble and that {model.baby_he_she} starts making healthier choices. {model.babyProviderName} recommends that you keep a closer eye on where {model.babyName} is after school and on weekends and that you talk to {model.baby_his_her} friends’ parents to see whether you can figure out whether this is a problem that is just happening with your child. You need to talk with {model.babyName} to understand better what is going on and set firm limits about what’s acceptable. And in a 12-year-old, remember {model.ADO2_substance_list_verb} is never an okay choice.

Before you even had a chance to talk with {model.babyName} about the fact that {model.baby_he_she} is sexually active, {model.babyProviderName} was starting to tell them about birth control and preventing sexually transmitted infections. Even though {model.babyName} is only 12, she may be able to get pregnant and could definitely still get a STI. The {model.babyProvider} shared some information about condoms and birth control. You were surprised to find that {model.babyName} was already sexually active. Sounds like you need to start talking to {model.babyName} a bit more to find out what is going on. Age 12 is probably too young for any kid to take on the responsibility for being sexually intimate with someone else. You’ll want to make sure that these relations are consensual—and find out who {model.baby_his_her} partners have been. You’ll need to keep a much closer eye on what {model.babyName} is up to after school—and maybe you’ll find out that {model.babyName} is just posing. Maybe {model.baby_he_she}’s trying to seem older than {model.baby_he_she} is.

Before you even had a chance to talk with {model.babyName} about the fact that {model.baby_he_she} is sexually active, {model.babyProviderName} was starting to tell them about birth control and preventing sexually transmitted infections. Even though {model.babyName} is only 12, he could still get someone pregnant and could definitely still get a STI. The {model.babyProvider} shared some information about condoms and birth control. You were surprised to find that {model.babyName} was already sexually active. Sounds like you need to start talking to {model.babyName} a bit more to find out what is going on. Age 12 is probably too young for any kid to take on the responsibility for being sexually intimate with someone else. You’ll want to make sure that these relations are consensual—and find out who {model.baby_his_her} partners have been. You’ll need to keep a much closer eye on what {model.babyName} is up to after school—and maybe you’ll find out that {model.babyName} is just posing. Maybe {model.baby_he_she}’s trying to seem older than {model.baby_he_she} is.

Explain

While you were shocked that your {model.babyProvider} started asking your child about {model.baby_his_her} use of substances and {model.baby_his_her} sexual activity, most medical professionals start asking kids as young as fourth grade about their tobacco use, drinking, and possible sexual activity. While most kids aren’t doing these risky things—a substantial minority of children are starting to take new risks and may be especially vulnerable because they are so young. {model.baby_He_She_cap} may be particularly vulnerable to being taken advantage of by older children. But remember that {model.baby_he_she} may be particularly inclined to boast about {model.baby_his_her} adventures, so even if your little one claims that {model.baby_he_she} is doing some risky things—you may want to make sure that {model.baby_he_she} isn’t just trying to sound more grown up than {model.baby_his_her} years.

Let’s review some of the numbers and see how your little one compares.

While rates of traditional cigarette smoking are going down in teenagers, rates of new, alternative smoking methods are increasing. Young people increasingly prefer to use e-cigarettes or water-pipes. There is a general, and inaccurate, perception that these are safer than traditional cigarettes, although they still contain nicotine. These e-cigarettes also don’t leave as much of a telltale odor as traditional cigarettes, so it may be more challenging to figure out whether your little one is using tobacco.

While most kids aren’t drinking in middle school, in some groups, almost one-in-four children have tried their first beer. And almost one in five middle-schoolers reports that they have smoked marijuana. Not only is drinking and smoking marijuana in middle school illegal (and sets children up for possible troubles with the law), alcohol and marijuana can be harmful to children’s developing brains. Younger children are particularly vulnerable to drinking too much (binge drinking) and even getting alcohol poisoning. Some children believe that smoking marijuana is safe, particularly in states where use has been legalized—but marijuana smoke contains a host of carcinogens and spending time under the influence is never a good idea for young kids.

Many 12-years-olds haven’t even had their first menstrual period or first spermarche, but some report that they are already having sexual intercourse. Some of these reports may be exaggerated—some boys might want to appear older and more sophisticated than they are by exaggerating their sexual exploits. However, some children are definitely having intercourse in middle school. While the rates or pregnancy in girls under 14 is extremely low (just about 1 out of 1,000 girls under 14 gets pregnant), the rates of STIs begin to climb in children who are between 10 and 14. One major concern when children report that they are having sex at such young ages is consent. Who are they having sex with and is this sex abusive, coercive or consensual? With more than 10% of teenage girls and about 4% of teenage boys reporting having been the victim of sexual abuse or rape, if an adult hears that a middle-schooler is sexually active, they should ask questions.

For physical and developmental reasons, young adolescents are at particular risk for pregnancy and STIs and pediatricians strongly recommend that sexually active children be counseled about safe sex, including using condoms and using birth control—including using long-acting birth control to avoid pregnancy.

Learn More

Look Inside

What is going on inside your child’s head as they go through puberty and enter into adolescence? Review adolescent brain development in this video clip.

Are you ready for puberty? These two video clips follow boys and girls as they reach puberty between the ages of 11 and 14.

Explain

Researchers have spent careers trying to figure out the most effective interventions for adolescents with challenges—and to make sure that these interventions work in the real world for real kids. None of these challenges in adolescence or adulthood has an easy answer, a button to push or a drug to take to make them disappear. From anorexia nervosa to acting out, there are a number of things that parents, schools and adolescents themselves can do to make things better. Effective interventions—like those for depression, for example—can sometimes take more than 6 months require regular follow-up, and often require the help of a trained and experienced mental health professional, who may be difficult for some parents to find.

In general, teenagers seem to benefit from a team approach to behavior change that includes the teenager {model.baby_him_her}self, and {model.baby_his_her} family. So whatever parents can do to improve what happens at home can be extremely effective. Interventions differ in effectiveness. Some therapies—like group therapy for teenagers with substance abuse problems or medication for teens with anxiety disorders—may not be as effective as others, like family therapy or exposure treatments. Others, like Scared Straight programs, may end up having exactly the opposite result of what you intended. Be careful to evaluate the claims and the quality of every intervention program, and use your critical thinking skills to gauge the value of every program or therapy. Also, remember that you shouldn’t expect to see changes overnight. Many challenges, from depression to substance abuse, take some time to address—and may be ongoing challenges.

Continue

Learn More

Look Inside

Review what we understand about puberty and the timing of puberty in these video clips.

Are you ready for puberty? These two video clips follow boys and girls as they reach puberty between the ages of 11 and 14.

You come home in the afternoon to find that {model.babyName} has eaten the casserole you had put aside for dinner as well as the rest of the gallon of milk in the refrigerator along with a full size bag of potato chips he’d bought with his own money. You are annoyed that you’re going to have to find something else to make for dinner, but how is {model.babyName} going through all this food? Is he normal?

{model.babyName} asks you the same question as soon as you get back home from the grocery store with food for dinner. He is wondering if he is the right size for a kid his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

{model.babyName} has always been big for his age but for the past year, he’s been eating you out of house and home. {model.child_taller_than_parent} You know teenage boys eat a lot, but you’re not sure how much is normal and how much is going to make him heavier.

{model.babyName} asks you the same question as soon as you get back home from the grocery store with food for dinner. {model.babyName} is wondering if he is the right size for a kid his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

{model.babyName} is only in middle school but you had to talk to him about shaving the other day. He was looking a little scruffy on his upper lip and he’s been eating you out of house and home for months. {model.child_taller_than_parent}

You know some kids develop early, but you’re not sure how early is early. Is this normal? He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds. Has he hit puberty already? {model.babyName} asks you the same question as soon as you get back home from the grocery store with food for dinner. He is wondering if he is the right size for a kid his age.

{model.babyName} is only in middle school but you had to talk to him about shaving the other day. He was looking a little scruffy on his upper lip and he’s been eating you out of house and home for months. {model.child_taller_than_parent} You know some kids develop early, but you’re not sure how early is early. He’s telling you that he feels really proud to be bigger than all the other boys his age. “Everyone looks up to me,” he tells you. You’re worried that he may be taking advantage of his size.

Is this normal? He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

{model.babyName} is hesitant to sign up for {model.MC10_sport} again this year although he really enjoyed it last year. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

Like clockwork, {model.babyName} has been sick almost every day he’s had gym in school this fall. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

Like clockwork, {model.babyName} has been sick almost every day he’s had gym in school this fall. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy in his grade who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

Like clockwork, {model.babyName} has been sick almost every day he’s had gym in school this fall. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

This year has been a tough one for {model.babyName}. You knew that middle school was a tough transition for some kids, but for {model.babyName}, it seems like it has been especially hard. He just seems sad too much of the time. He hasn’t wanted to sign up for sports again this year although he really enjoyed it last year. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

This year has been a tough one for {model.babyName}. You knew that middle school was a tough transition for some kids, but for {model.babyName}, it seems like it has been especially hard. He just seems sad too much of the time. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

This year has been a tough one for {model.babyName}. You knew that middle school was a tough transition for some kids, but for {model.babyName}, it seems like it has been especially hard. He just seems sad too much of the time. Like clockwork, {model.babyName} has been sick almost every day he’s had gym in school this fall. You aren’t sure what’s going on. He won’t tell you why and just storms off into his room and slams the door. When he emerges later he says: “I just want to be normal,” he says. He complains that he is {model.childData.age.years} years and {model.r5} months old and he’s the only boy his age who still looks like a little kid. “I look like a baby,” he says. You think he’s cute of course, but he doesn’t seem quite as developed as the other kids his age. He’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

You hadn’t even thought that you had to talk to {model.babyName} about puberty because she wasn’t even in middle school yet. But then she came home in tears after some boys started calling her names when she was at {model.ADO3_location}. She’s been wearing a bra since she was {model.age_wear_bra} but had never talked about what to do about boys looking at her.

“I just want to be normal,” she says. She complains that she is {model.childData.age.years} years and {model.r5} months old and she’s the only girl her age who has gotten her period. “I look like a freak,” she says. You think she’s beautiful, of course, but she does look so much older than her age. She’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

You hadn’t even thought that you had to talk to {model.babyName} about puberty because she wasn’t even in middle school yet. But then you saw one of the {model.text_or_photo} She doesn’t look like a {model.childData.age.years} year old girl. She was sending it to a boy you’d never heard of. She’s been wearing a bra since she was {model.age_wear_bra} but had never talked about what to do about boys. {model.intervene}

“Don’t you think I look nice?” she asks. She tells you that older boys are telling her that she looks beautiful and that she can’t talk to girls her own age about it. She tells you that at {model.childData.age.years} years and {model.r5} months old and she’s the only girl her age who has gotten her period. You think she’s beautiful, of course, but she does look so much older than her age. She’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

You hadn’t even thought that you had to talk to {model.babyName} about puberty because she wasn’t even in middle school yet. But then she came home from {model.ADO3_location1} complaining that she had to get a new bra. Some of the other kids in class were teasing her because of how she looked running {model.ADO3_activity1}. She had been wearing a bra since she was 9, but apparently, it hasn’t been doing the job right.

“I just want to be normal,” she says. “Does this mean that I am going to get my period?” she asks. “I feel like a freak,” she says. You think she’s beautiful, of course, but she is a bit big for her age. She’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

You hadn’t even thought that you had to talk to {model.babyName} about puberty because she wasn’t even in middle school yet. But she came out of her room one morning with a pimple on her nose telling you that she couldn’t possibly go to {model.ADO3_activity2} because everyone would make fun of her.

“I just want to be normal,” she says. “Does this mean that I am going to get my period?” she asks. “I feel like a freak,” she says. You think she’s beautiful, of course, even with the pimple on her nose, which you are sure the other kids won’t notice. She’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

It is summertime and {model.babyName} won’t go to the pool with her friends. She won’t tell you why and just storms off into her room and slams the door. When she emerges later she has clearly been crying. “I just want to be normal,” she says. She complains that she is {model.childData.age.years} years and {model.r5} months old and she’s the only girl her age who hasn’t gotten her period yet. “I look like a freak,” she says. You think she’s beautiful, of course, but she doesn’t seem quite as developed as the other kids her age. She’s {model.childData.height.ft} tall now and {model.childData.weight.lbs} pounds.

Explain

What is normal? Are girls hitting puberty earlier than they used to? What happens to early and late developers? There is a lot to think about and understand when it comes to the timing of puberty.

First, let’s review some basics about the timeline of puberty. Notice that there are both external signs of puberty (the things we can see—like developing breasts and facial hair) and internal signs of puberty, like hormones changing. Remember that the external signs of puberty can vary significantly—heavier girls may develop breasts faster than thin girls and dark haired boys may sprout facial hair sooner than light haired boys. And the timing of these external events doesn’t necessarily signal anything definitive about where these children are in terms of their pubertal development. However, all children generally follow the same timeline.

It is difficult to tell on an individual level precisely whether a child has fully reached an adult state of sexual maturation without doing sophisticated medical tests. The major signs of puberty—menarche or spermarche—don’t necessarily indicate that a child has begun to ovulate or create sperm. Even if a child knows that they are menstruating or ejaculating, without testing it is impossible to say if they are actually ovulating or creating sperm. Children may become fertile a few months or even a year after they have these major markers of puberty—and exact patterns are unknown.

The timing of puberty for girls and boys differs. Girls tend to hit their growth spurt before boys—leading to middle school chorus concerts with lots of tall girls in the back row. But boys and girls end up at roughly the same spot and become sexually fertile at about the same time.

Some children are early developers. About one in four girls hits puberty significantly earlier than her friends. While the average age for most girls to hit puberty is around 12 ½, early developers can get their periods at 10. Girls who are overweight may show signs of breast development earlier than this, with breasts appearing as young as 8. Much public attention has been paid to early development in girls, but it is still quite unusual for girls who are younger than 10 to get their periods. However, because of increases in the rate of overweight children, more young girls are developing breasts at younger ages. But remember, that breast development doesn’t necessarily mean that a girl has finished hitting puberty and is about to menstruate. However, girls who are early developers are at risk for a constellation of complications including increased rates of eating disorders, depression, substance use, early sexual activity, and troubles in school. Girls who develop early may feel isolated and may be vulnerable to being taken advantage of. Parents can try and protect their children from the risks of early development by careful parental monitoring and communication.

Some girls are late developers. While most girls get their periods around 12 ½, more than a quarter don’t get their period until they are 13 or almost 14. The most important factor in pubertal timing is genetics—so if you or your child’s other biological parent hit puberty a bit late, you should expect the same of your daughter. Other important factors are weight (if your daughter is a bit underweight that might delay things a bit). Your daughter may ask if there is any way to speed up puberty—and the answer is that physicians typically don’t want to intervene in cases of late puberty until your child is much older, like 15.

Boys also have variations in the timing of puberty. It is more difficult for parents or researchers to pin-point pubertal markers in boys—who may not report their first spermarche or semenarche as readily as girls who get their menstrual period for the first time. But most boys hit these milestones around 12 ½, but some can hit them even 18 months earlier, making them taller and stronger than other boys. In cultures that value male strength and size, boys who reach puberty early may have some social advantages. They may get picked first for sports teams and may be perceived as being stronger leaders. While early puberty is often worrisome in girls, for boys it can confer some social benefits.

Boys who are late developers are often concerned about being smaller than their peers. They frequently feel self-conscious looking younger while their friends are sprouting facial hair and broader bodies. Most boys experience spermarche round 12 ½ but about a quarter of boys won’t hit these milestones until they are close to 14. Puberty is primarily controlled by genetics, so there isn’t very much your son can do to speed the process up. Physicians are wary of intervening unless puberty is extremely delayed—say past age 15 or 16.

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You didn’t want to think this day would come. You’d always thought in the back of your mind that maybe one day things would end in wedding bells, but things have been difficult for the past few months between you and {model.partnerName}. You are breaking up. {model.partnerName} is going to move into an apartment nearby.

You can read more about the risk factors for separation and divorce in the Explain and Learn More—think about what might have contributed to this situation.

{model.babyName} is just {model.childData.age.years} years old. About {model.divorceRate} separate or divorce among kids’ {model.baby_his_her} age.

You didn’t want to think this day would come. When you got married you thought it was forever. But things have been difficult for the past few months between you and {model.partnerName}. You are breaking up. {model.partnerName} is going to move into an apartment nearby.

You can read more about the risk factors for separation and divorce in the Explain and Learn More—think about what might have contributed to this situation.

{model.babyName} is just {model.childData.age.years} years old. About {model.divorceRate} separate or divorce among kids’ {model.baby_his_her} age.

{model.babyName}’s best friend’s parents are breaking up. You were shocked to hear it, but you heard that they just haven’t been getting along and that they are moving into separate apartments. To read more about the risk factors for separation and divorce in the Explain and Learn More articles.

This child is just the same age as {model.babyName}. About {model.divorceRate} separate or divorce among kids’ {model.baby_his_her} age.

Your best friend is breaking up with {model.user_his_her} partner. You were shocked to hear it, but {model.user_he_she} tells you that they just hadn’t been getting along and that they are moving into separate apartments. {model.user_he_she_cap} has a son your child’s age. To read more about the risk factors for separation and divorce in the Explain and Learn More articles.

This child is just the same age as {model.babyName}. About {model.divorceRate} separate or divorce among kids’ {model.baby_his_her} age.

Explain

Children, particularly young children, often undergo family transitions. As you’ll see in the chart, fewer than half of all children live in married, two-parent households. And almost 3 out of 10 children undergo a family transition before they start kindergarten.

While every romantic break-up is different in its own way, researchers have identified some common risk and protective factors for separation and divorce. We’ll separate these characteristics by context, couple characteristics and individual characteristics.

Risk Factors for relationship instability

• Context:
  • Living in a stressful environment, including struggling financially can raise the risk of separation.
• Couple:
  • Every couple has disagreements, but having a pattern of volatile, hostile interactions increases the risk of breaking up.
  • As you’ll see in the figure below, getting together when you are younger—like under 22—or much older (like after 40) are also risk factors for breaking up.
  • In the United States, cohabiting (or living together) rather than being legally married seems to be associated with higher chance of breaking up.
• Individual:
  • Having a personal history of exposure to separation and divorce in your own family can make it easier for parents to contemplate breaking up.
  • Having a personality that is less conscientious or easy to get along with also increases the risk of separation or divorce.
  • A history of secure attachment styles with your own parents also makes it less likely that you will experience a separation or divorce.

Protective Factors for relationship stability

• Cultural, community or religious beliefs that prohibit or discourage divorce or separation make it much less likely that you will separate. This doesn’t necessarily mean that your relationships will be happier (although some research does indicate that this may be the case in some families), but that you will stick it out.
• Higher education. For some reason, the more education you have, the less likely you are to break up. This could be because people with more education tend to have higher incomes or that people who stick it out through college are more likely to commit to a marriage for the long term.

Separation and divorce inevitably cause some stresses in a family. From having to move, to changes in routines, changing parental relationships can be difficult on parents and children. In the short-term children who are undergoing family turmoil can be more depressed, do worse in school and feel badly about themselves. Families can be under particular stress if the break-up causes financial strain, as is often the case, as families try and provide for two households on an income that used to provide for just one. And in breakups with ongoing major conflict (estimated to be less than 20 percent), the continuing emotional and legal battles can be devastating for the entire family—and have long term repercussions for everyone’s happiness and mental health.

In the long term, parents can do a great deal to buffer children from the stresses of divorce or separation. Continuing to have a close, warm, authoritative parenting style and being able to focus on children’s needs—rather than the stresses of parents—seems to help children thrive and grow after a divorce. If parents are able to manage the separation well, most children seem to be able to do just as well as other children into adulthood.

What should happen to children after separation or divorce? Children benefit from ongoing, multiple attachments with parents and parent-figures, whether biological, adoptive or step-parents. In most cases, a shared parenting situation—including substantial time with both parents (including overnights) seems to work best for children—allowing them to create meaningful ongoing relationships with both parents (Warshak et al, 2014).

However, not all parenting and family situations are ideal. The vast majority of divorces end up to be fairly neutral or even friendly after the initial stress of the separation—but some remain profoundly conflictual. In other families, one or both of the parents may be struggling with mental health or substance abuse challenges. In some there may have been abuse or domestic violence. In other families, one of the parents may not have had any meaningful contact with the child—and may not have even cohabitated with the child before the official, legal separation. In these cases, what is best for children is not always clear. While children benefit from ongoing attachment relationships with all their parents—their emotional and physical safety is also critical. Building relationships that may have been damaged takes time and avoiding a perpetuation of significant parental conflict is also helpful for the ongoing health of the entire family unit. In situations like these, there are rarely easy answers—and very often there are not enough legal, financial or emotional resources to help these families through what can be lengthy and trying times.

In general, kids seem to do better with fewer transitions. However, particularly for young children, like infants and toddlers under 3, it is important to have frequent contact—if parents can only see their children once a week or on weekends, it is often not frequent enough to sustain a relationship. Longer visits allow children and parents time to get used to each other.

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Look Inside

Review what we understand about brain and cognitive development during adolescence in these three video clips.

{model.babyName} is now in the seventh grade and the work {model.baby_he_she} brings home is starting to be a little over your head.

{model.babyName} is now in the seventh grade and the work you are assigning {model.baby_him_her} with your home-study program is starting to be a little over your head. Home schooling is getting harder.

Especially with the challenges {model.babyName} has had with {model.ADO4_SLD_ADHD_list}, the extra work has been difficult. You are starting to wonder whether {model.baby_he_she} will need some intervention after all. {model.baby_He_She_cap} seems to be really struggling.

Especially with the challenges {model.babyName} has had with {model.ADO4_SLD_ADHD_list}, the extra work has been difficult. But thankfully, the extra intervention has been helpful.

{model.babyName} is having even more challenges in school. The work seems to be getting harder—there is more of it and {model.babyName} seems to be struggling.

The transition to a new middle school has been challenging for {model.babyName} who has had to make new friends.

The transition to middle school hasn’t brought the best out in {model.babyName}. You’ve gotten to know the new principal again this year. You had hoped that a new school would bring a fresh start but, apparently, that hasn’t been happening.

The transition to middle school has been challenging for {model.babyName}. {model.baby_He_She_cap} is still having some conflicts with other kids from time to time, but it seems like the move to a new school has brought a bit of a change—for the better.

{model.babyName} is hoping that he grows a few inches this year and that everyone forgets that he was the scrawny kid in sixth grade.

You are hoping that this year the other kids catch up to {model.babyName} so she doesn’t feel so self-conscious about her older looking body.

{model.babyName} has some special gifted classes this year. You are hoping that they inspire {model.baby_him_her} more in school.

{model.babyName} read in {model.baby_his_her} textbook a basic problem in physics to work out in an online animation. {model.baby_He_She_cap} challenged you to see if you could figure it out before {model.baby_he_she} gave it a try.

{model.babyName} came home from school today with a basic problem in physics to work out in an online animation. {model.baby_He_She_cap} challenged you to see if you could figure it out before {model.baby_he_she} gave it a try.

Explain

A balance scale is now typically just a toy, but used to be used to weigh things back in the days before computerized equipment. Jean Piaget adapted a balance scale to measure logical reasoning in children. In the balance scale task, which Piaget and his colleague, Bärbel Inhelder, tested children’s understanding of the relationship between weight and distance. Children of varying ages apply their understanding of this relationship to predict the movement of the arm of a balance scale.

The balance scale problem is an excellent way to analyze a child’s ability to use logical reasoning because it tests whether {model.baby_he_she} can predict the outcome accurately while also offering researchers an opportunity to observe the explanation that the child uses to justify {model.baby_his_her} prediction. The original research by Piaget and Inhelder found consistent age differences in performance on the balance scale task. More recently, these differences have been studied in detail by developmental psychologist, Robert Siegler, who found that children today tend to reach the formal operations stage at 14 or 15, not 12 as Piaget had predicted.

Please keep in mind that, while research has revealed age parameters that generally mark different reasoning abilities, children, their brains, experiences, and development are unique, so please think of the age brackets as general guidelines. Young children under the age of six generally do not understand how to balance the scale. If you ask them to balance the scale, they place the weights at random, sometimes putting all the weights on the same side of the fulcrum!

Children in elementary school realize that, in order to balance the scale, there must be weights on both sides of the fulcrum. Until about age nine, children tend to focus only on weight and ignore the influence of the weights’ distance from the fulcrum. When you ask them to predict whether the scale will balance, they generally guess that the side with more weights will tip down regardless of the position of the weights.

By the time children reach middle school, they generally can balance the scale if allowed to place the weights themselves. They tend to use a trial-and-error approach because they still do not completely understand the relationship between weight and distance even though they take both weight and distance into account. However, they do make errors when asked to predict whether a scale with weights placed by someone else will balance, and furthermore, they have trouble explaining how the scale works.

Teens older than about 14 or 15 can generally anticipate the correct position for the weight needed to balance the scale without touching it. They demonstrate formal operational thinking by recognizing that weight and distance interact and can repeatedly solve the balance scale problem by understanding exactly how weight and distance are related.

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Look Inside

Review what we understand about the development of romantic and sexual relationships in adolescence.

At your last visit to the pediatrician, you were shocked to find out that {model.babyName} said that {model.baby_he_she} was already sexually active. You’ve been putting off having “The Talk,” but the two of you ended up stuck on a long car trip to your grandmother’s house and you feel like this may be just the time that you have been waiting for. At the very least, you’re worried about STIs and pregnancy.

{model.babyName} left {model.baby_his_her} cell phone on the kitchen table last night and you saw a text come in from another {model.baby_boy_girl} with a photograph that made you feel uncomfortable. Later at dinner, you asked who this {model.baby_boy_girl} was and {model.babyName} blushed. You are wondering whether you should have a talk about sex.

{model.babyName} left {model.baby_his_her} cell phone on the kitchen table last night and you saw a text come in from another {model.baby_boy_girl} with a photograph that made you feel uncomfortable. Later at dinner, you asked who this {model.baby_boy_girl} was and {model.babyName} blushed. You are wondering whether you should have a talk about sex. You thought that, considering that you are gay yourself, that {model.babyName} would feel a little more open in talking to you about {model.baby_his_her} relationships, but apparently not.

You were trying to remember a URL for a website on your computer the other day, when you were shocked to find a bunch of pornographic websites in the history. You know that you hadn’t been looking at them. But {model.babyName} had been up late on your computer. What do you do? You’ve been avoiding having “The Talk” with {model.babyName}. It just feels awkward. But you know that, at some point, you need to make sure he knows where babies come from and how to protect himself from STIs. His {model.babyProvider} even brought it up at his last office visit. Now, the two of you ended up stuck on a long car trip to your grandmother’s house and you feel like this may just be the time that you have been waiting for.

You have made a lot of decisions to protect {model.babyName} from some of the cultural values that concern you in the world. Now that {model.baby_he_she} is a teenager, you want to make sure that you give {model.baby_him_her} the right information about sex—and communicate how important it is to you that {model.babyName} waits until {model.baby_he_she} has found the right person and gotten married before having it.

You’ve been avoiding having “The Talk” with {model.babyName}. It just feels awkward. But you know that, at some point, you need to make sure that {model.baby_he_she} knows where babies come from and how to protect {model.baby_him_her}self from STIs. {model.baby_His_Her_cap} {model.babyProvider} even brought it up at {model.baby_his_her} last office visit. Now, the two of you ended up stuck on a long car trip to your grandmother’s house and you feel like this may be just the time that you have been waiting for.

Explain

For most parents, talking to their children about sex may be awkward—but being open and communicative about sex and intimate relationships seems to be extremely helpful in combating teen pregnancy, STIs, and even delaying sexual intercourse. It also helps solidify the parent-child relationship.

For children who are questioning their sexual orientation, or who may be gay, lesbian, bisexual or transgender, being able to talk with their parents about their sexuality can make an enormous difference in their lives. Children and teenagers who aren’t heterosexual often struggle, in part because of widespread stress due to discrimination, with mental health issues as they go through their teenage and young adult years. Parental acceptance seems to help these children have lower rates of depression.

Researchers aren’t sure how many teenagers are gay. Part of the challenge in understanding whether 5 or 10 or even 30 percent of adolescents are gay or lesbian comes from what definitions we use (Savin-Williams, 2006). Does being gay mean you have “come out” and told the community or your parents you are gay? If so, the numbers of “out” teenagers may be low, because many teens wait to come out until their late teens or early twenties. Does being gay mean that you have felt some sexual attraction to a person of the same sex? If so, that may mean a larger number of teens are gay, since many adults and adolescents seem to fall on a spectrum of sexual orientation rather than being universally either heterosexual or homosexual.

Some teenagers and children feel that their physical gender doesn’t match their sense of their own gender. These children often identify as transgender. For example, a child raised as a boy may self-identify as a girl and feel that she wants to become a girl, potentially by undertaking hormonal therapy and even gender-reassignment surgery. Researchers aren’t sure why some children are gay, lesbian, or transgender. While some scientists have tried to find specific brain areas or hormonal triggers that distinguish gay and heterosexual adults, very few of these studies have been found to apply to the general population.

Even if parents have strong beliefs about the importance of waiting until marriage to become sexually active, there are benefits to talking with teenage children about sexuality, healthy relationships, and the biology of sex, pregnancy, and STIs. Talking about sex with parents doesn’t seem to lead to more sex. Watching a lot of sexually explicit programs on television seems to, however, so parents may want to turn off the TV and have a frank conversation about contraception instead (Chandra A et al., 2008).

And how many kids are having sex? Very few kids are having sex in middle school, but most kids seem to have had sex by the time they graduate from high school. Experts advise starting to talk to kids about sex and intimate relationships sometime in middle school.

Experts are concerned that children who don’t know how to prevent pregnancy and STIs may be liable to get a sexually transmitted infection or get pregnant. STIs can be deadly—and teen pregnancy, although declining in recent years, can be a challenge for mother, father, and child. Teenagers don’t always get accurate information about how to prevent STIs or pregnancy online or from their friends. Fewer than 30% of middle school sex education curricula discuss contraception or how to prevent STIs, other than abstinence, and only around 60% of high school sex education curricula discuss these topics (Guttmacher Institute, 2014).

It may be helpful for everyone to have a refresher on STIs, which are common among teenagers for a number of reasons. Young women seem to be biologically vulnerable to STIs. Teenagers aren’t screened frequently enough (sexually active teens should be screened frequently—which doesn’t involve an invasive pelvic exam for women—it can be just a swab or a urine test). And teens have difficulty being open with everyone—from their parents to their health care providers about their sexual history, which makes them difficult to treat. But more than 1 in 4 adolescents have an STI—many of which can be easily treated before they become something serious.

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Look Inside

Review what we understand about brain development and the development of some common psychological disorders in adolescence.

You’ve always worried about {model.babyName} at school ever since {model.baby_he_she} started being the target of bullies when {model.baby_he_she} was just 11. Now that {model.babyName} is in middle school, {model.baby_he_she} comes home almost every day worried about something new. Yesterday, it was a pimple that {model.babyName} was sure everyone would take pictures of and post online with nasty captions. You could hardly see it. Today, {model.babyName} spilled a drink on {model.baby_him_her}self during lunchtime and was sure that {model.baby_he_she} was going to get beaten up after school for being so clumsy. {model.baby_He_She_cap} seems to think that everyone is looking at {model.baby_him_her} all the time.

{model.babyName} came home from school completely upset. {model.baby_He_She_cap} said that {model.baby_he_she} wasn’t sure that {model.baby_he_she} could go to school the next day. Apparently, {model.baby_he_she} was asked to give a presentation in front of {model.baby_his_her} science class and bumped into the teacher’s desk on the way to the front of the room. {model.baby_He_She_cap} said that {model.baby_he_she} got all hot and {model.baby_his_her} heart was beating so fast that {model.baby_he_she} could hardly believe it. {model.baby_He_She_cap} was so embarrassed. {model.baby_He_She_cap}’s sure that everyone could tell.

{model.babyName} came home from the mall completely upset. {model.baby_He_She_cap} said that {model.baby_he_she} wasn’t sure that {model.baby_he_she} could go to co-op the next day. Apparently, {model.baby_he_she} was eating an ice cream bar and most of the ice cream fell out the bottom and onto {model.baby_his_her} lap. {model.baby_He_She_cap} said that {model.baby_he_she} got all hot and {model.baby_his_her} heart was beating so fast that {model.baby_he_she} could hardly believe it. {model.baby_He_She_cap} was so embarrassed. Even though you could barely see the spot on {model.baby_his_her} pants, {model.baby_he_she}’s sure that everyone could tell.

{model.babyName} just told you that she has been dieting for the past three weeks. Apparently, someone at lunch told her that “skinny” girls don’t eat pizza. So, she has been skipping lunch. But she hasn’t lost any weight because she is starving and has been stopping to get fast food on the way home from school every day.

{model.babyName} just told you that she has been dieting for the past three weeks. Apparently, a friend told her that “skinny” girls don’t eat pizza. You noticed that she has been cutting back on what she eats at meals and just skipping them entirely. But she hasn’t lost any weight because she is starving and has been stopping to get fast food on the way home from the library where she meets with her study group.

{model.babyName} has always been thin for her age, but in the past few months, it seems like she has been losing weight by the day. You’ve noticed that she has been missing dinner a lot lately, saying she has to stay late at school to practice and study with friends. But you’re not sure where she’s really been. And when you checked her search history, you saw some websites that had pictures of really scarily thin women on them. {model.babyName} says that she thinks that she’s actually fat, even though you think that you can see hipbones through her leggings.

{model.babyName} has always been thin for her age, but in the past few months, it seems like she has been losing weight by the day. You’ve noticed that she has been missing dinner a lot lately, saying she has to has to study or that she is going to eat at a friend’s house. But you’re not sure where she’s really been. And when you checked her search history, you saw some websites that had pictures of really scarily thin women on them. {model.babyName} says that she thinks that she’s actually fat, even though you think that you can see hipbones through her leggings.

{model.babyName} has been wearing an XL hoodie even though it comes almost down to his knees. He likes to wear the same hoodie every day, so you both have to coordinate making sure that you’re doing laundry almost every night. You asked him the other day why he is so obsessed with this one sweatshirt. “It makes me look bigger,” he said. “I’m so scrawny. Everyone can tell. I look like an 11-year-old. With this on, I look huge.”

{model.babyName} has been wearing an XL hoodie even though it comes almost down to his knees. He likes to wear the same hoodie every day, so you both have to coordinate making sure that you’re doing laundry almost every night. You asked him the other day why he is so obsessed with this one sweatshirt. “It makes me look bigger,” he said. “I’m so scrawny. Everyone can tell. I look like an 11-year-old. With this on, I look huge.”

You have always assumed that {model.babyName} was obsessed with what {model.baby_he_she} looked like just like any other teenage {model.baby_boy_girl}. But you are starting to worry that it might be something more serious. Last night, {model.baby_he_she} disappeared into the bathroom for a long time right after eating a tub of chocolate chip ice cream at dinner. You finally barged in and it reeked of vomit. You demanded to know how long this had been going on. {model.babyName} admitted that {model.baby_he_she} has been trying to lose weight to look more normal and has been trying this out for a few months now. What do you do?

You have always assumed that {model.babyName} was obsessed with what {model.baby_he_she} looked like just like any other teenage {model.baby_boy_girl}. But you are starting to worry that it might be something more serious. Last night, {model.baby_he_she} disappeared into the bathroom for a long time right after eating a tub of chocolate chip ice cream at dinner. You finally barged in and it reeked of vomit. You demanded to know how long this had been going on. {model.babyName} admitted that {model.baby_he_she} has been trying to lose weight to look more normal and has been trying this out for a few months now. What do you do?

You’ve always assumed that {model.babyName} was just eating a lot just like any other teenage {model.baby_boy_girl}. After all, {model.baby_he_she} just had a growth spurt and needs extra food to grow into {model.baby_his_her} adult sizes, right? But food has been disappearing lately—like bags of chips and the pack of cookies that you were saving for a special occasion. You were up late last night and found {model.babyName} standing at the refrigerator eating ice cream out of the carton. You demanded to know what was going on. {model.babyName} choked up and said that {model.baby_he_she} didn’t feel like {model.baby_he_she} could stop {model.baby_him_her}self.

You’ve always assumed that {model.babyName} was just eating a lot just like any other teenage {model.baby_boy_girl}. After all, {model.baby_he_she} just had a growth spurt and needs extra food to grow into {model.baby_his_her} adult sizes, right? But food has been disappearing lately—like bags of chips and the pack of cookies that you were saving for a special occasion. You were up late last night and found {model.babyName} standing at the refrigerator eating ice cream out of the carton. You demanded to know what was going on. {model.babyName} choked up and said that {model.baby_he_she} didn’t feel like {model.baby_he_she} could stop {model.baby_him_her}self.

Explain

Very few teenagers in the United States have any kind of diagnosable eating or anxiety disorder. But many girls and boys, are self-conscious about their bodies and sometimes excessively self-critical or self-conscious. Being self-conscious and easily embarrassed even seems to be biologically based—and particular linked to the adolescent years (Somerville, 2013). In the North American culture, the majority of boys and girls seem to also be dissatisfied with what they look like. Most girls report wanting to lose weight and having been on a diet at some point. The more media that young people are exposed to— whether online or on television—the more susceptible they are to feeling that they need to be thin to fit in.

Although eating disorders are only diagnosed in a small percentage of teenagers, they are well-known to most adolescents. Many more teenagers may suffer from these disorders but may not be treated or properly diagnosed. Anorexia Nervosa is the most uncommon—effecting less than one percent of teenaged girls. It is characterized by an obsession with being thin and a consuming concern about being fat, although the individual is often extremely underweight. In order to be diagnosed with anorexia, someone needs to be “significantly” underweight, which typically means they have a BMI under 17. Someone with anorexia may refuse to eat, eat only special foods, or exercise excessively. Or they may purge—by vomiting, abusing laxatives, or the like. The extreme weight loss caused by this disease can be life threatening—and the suffering caused by the obsessive focus on weight can cause social isolation, depression, and even suicide in some individuals.

In bulimia nervosa, an individual is similarly preoccupied with their physical appearance and weight, but tries to manage his or her weight by episodes of binge eating and purging—at least once a week. However, unlike in anorexia nervosa, someone suffering from bulimia nervosa manages to maintain an appropriate body weight. However, the repeated purging can cause damage to the body—and can cause depression and social isolation. In binge-eating disorder, which is probably the most common eating disorder among adults and teenagers, someone eats an excessive amount—without feeling that they can control or manage the situation—and does so at least once a week. Typically, they feel embarrassed and even depressed by the amount that they are eating. Unsurprisingly, binge-eating disorder can lead to obesity and weight gain. Treatment can be effective for eating disorders—and can help reduce the excessive focus on food and personal appearance that is common to them.

Explain

Researchers have spent careers trying to figure out the most effective interventions for adolescents with challenges—and to make sure that these interventions work in the real world for real kids. None of these challenges in adolescence or adulthood has an easy answer, a button to push or a drug to take to make them disappear. From anorexia nervosa to acting out, there are a number of things that parents, schools and adolescents themselves can do to make things better. Effective interventions—like those for depression, for example—can sometimes take more than 6 months require regular follow-up, and often require the help of a trained and experienced mental health professional, who may be difficult for some parents to find.

In general, teenagers seem to benefit from a team approach to behavior change that includes the teenager {model.baby_him_her}self, and {model.baby_his_her} family. So whatever parents can do to improve what happens at home can be extremely effective. Interventions differ in effectiveness. Some therapies—like group therapy for teenagers with substance abuse problems or medication for teens with anxiety disorders—may not be as effective as others, like family therapy or exposure treatments. Others, like Scared Straight programs, may end up having exactly the opposite result of what you intended. Be careful to evaluate the claims and the quality of every intervention program, and use your critical thinking skills to gauge the value of every program or therapy. Also, remember that you shouldn’t expect to see changes overnight. Many challenges, from depression to substance abuse, take some time to address—and may be ongoing challenges.

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Look Inside

What do we know about why teenagers like to take risks and try new things? What is safe and what is dangerous? What is driven by their changing brain and what is caused by the world around them. Two video clips help us understand the context for adolescent risk-taking.

{model.babyName} has signed up for {model.baby_his_her} first classes as a ninth grader. You can’t believe the math homework {model.baby_he_she} brought home. {model.ADO9_math_phrase} It has been a long time since you did that kind of math. Hard to believe that {model.babyName} has gotten so smart!

But as mature as {model.babyName} is, you are worried about {model.baby_his_her} judgment sometimes.

{model.babyName} is starting to get ahead of you in math. This year you are going to have to find a tutor to help {model.baby_him_her} with the math work. {model.ADO9_math_phrase} It has been a long time since you did that kind of math. Hard to believe that {model.babyName} has gotten so smart!

But as mature as {model.babyName} is, you are worried about {model.baby_his_her} judgment sometimes.

You got a new cell phone over the weekend and you had to ask {model.babyName} for help setting it up. It was embarrassing, but {model.babyName} clearly had the thing figured out. Hard to believe that a few years ago, {model.baby_he_she} couldn’t even read and now {model.baby_he_she} has the whole syncing, contacts sharing, and fine print thing down.

But as mature as {model.babyName} is, you are worried about {model.baby_his_her} judgment sometimes.

Just yesterday you had to sit down with {model.babyName} because a friend texted you to say that she’d seen {model.babyName} and a bunch of other kids jumping the train turnstiles. They all had passes from school so there was no reason for them to do it. When you asked {model.babyName} what {model.baby_he_she} had been thinking, {model.baby_he_she} told you that {model.baby_he_she} hadn’t been. “I don’t know what I was thinking,” {model.baby_he_she} said. “It seemed fun at the time.”

Just yesterday you had to sit down with {model.babyName} because a friend texted you to say that she’d seen {model.babyName} and a bunch of other kids jumping the train turnstiles. They all had passes so there was no reason for them to do it. When you asked {model.babyName} what {model.baby_he_she} had been thinking, {model.baby_he_she} told you that {model.baby_he_she} hadn’t been. “I don’t know what I was thinking,” {model.baby_he_she} said. “It seemed fun at the time.”

Just yesterday you had to sit down with {model.babyName} because a friend texted you to say that they’d seen {model.baby_him_her} in a car that was driving recklessly and probably 20 miles over the speed limit. {model.babyName} just got {model.baby_his_her} drivers’ license and you’d cautioned {model.baby_him_her} to be careful. When you asked {model.babyName} what {model.baby_he_she} had been thinking, {model.baby_he_she} told you that {model.baby_he_she} hadn’t been. “I don’t know what I was thinking,” {model.baby_he_she} said. “There were a bunch of us in the car and it seemed fun at the time.”

Just yesterday you picked up {model.babyName}’s phone only to read a message from a friend that read something like, “OMG we were so {model.ADO9_drug_slang} last night.” When you asked {model.babyName} what {model.baby_he_she} had been thinking, {model.baby_he_she} told you that {model.baby_he_she} hadn’t been. {model.baby_He_She_cap} says that it is the first and only time {model.baby_he_she} has ever done anything like that. “I don’t know what I was thinking,” {model.baby_he_she} said. “There were a bunch of us and it seemed fun at the time.”

Just yesterday you were cleaning out {model.babyName}’s pockets to do laundry and found matches and a pack of cigarettes. While {model.ADO9_smoking_parent} smoked for years, you always told {model.babyName} what a terrible habit it is. You never want to see {model.baby_him_her} start. When you asked {model.babyName} what {model.baby_he_she} had been thinking, {model.baby_he_she} told you that {model.baby_he_she} hadn’t been. {model.baby_He_She_cap} says that it is the first and only time {model.baby_he_she} has ever bought cigarettes. “I don’t know what I was thinking,” {model.baby_he_she} said. “There were a bunch of us and it seemed fun at the time.”

Just yesterday you got a call from {model.ADO8_schoolname} saying that they had suspicion that {model.babyName} had drugs on the school grounds. This could be grounds for some major legal trouble, since possession of drugs on school grounds can sometimes be a federal offense! You’ve known that {model.babyName} has struggled with drugs for some time now and you’ve tried to keep an eye on {model.baby_him_her} but it doesn’t seem to be working. When you asked {model.babyName} what was going on, {model.baby_he_she} said that “all” of {model.baby_his_her} friends are doing stuff and that is why the school thinks that {model.baby_he_she} is in trouble.

Just yesterday you got a call from {model.ADO8_schoolname} saying that they had suspicion that {model.babyName} had drugs on the school grounds. This could be grounds for some major legal trouble, since possession of drugs on school grounds can sometimes be a federal offense! You’ve known that {model.babyName} has struggled with drugs for some time now but things just seem to be getting worse. The school counselor says that there have been reports that {model.babyName} is skipping school, too. You’ve tried some therapy but it doesn’t seem to be working. {model.baby_He_She_cap} is smoking cigarettes all the time now. You’d always hoped that {model.baby_he_she} wouldn’t pick that up from you, but every time you say something to {model.baby_him_her} about it, {model.baby_he_she} just tells you that {model.baby_he_she} thinks it won’t affect {model.baby_him_her}.

Explain

Experts often talk about teenage risk-taking in a bad way. Risk-taking often means a collection of scary behaviors—from binge drinking or drag racing, to drug dealing and promiscuity. Compared to adults, teenagers seem to have higher rates of these behaviors, which is something that has confounded researchers who try to protect teenagers from the sometimes dangerous consequences of these behaviors. But sometimes the risks teenagers take aren’t all bad. Some risks are helpful and healthy to take—like the risk to leave home and go to college or to start a new job.

Our understanding of the teenage brain tells us that by the time they are early adolescents, most teenagers are capable of sophisticated, logical, adult reasoning. If they are placed in a testing situation, they are able to make similarly smart decisions in a hypothetical situation. Where adolescents typically differ from adults is that they tend to be more easily overcome by the thrill of the moment, and therefore take more risks, particularly if they are with other peers. Some neuroscientists propose that this risk-taking is caused by immaturity in the prefrontal cortex, which is comparatively late to develop in the teenage brain.

In one sense, teenage risk taking can be understood as an important, potentially positive and essential part of development. All children face the challenge of moving from dependent children to more independent adults who are able to care for some (if not all) of their own needs by the end of adolescence. If teenagers weren’t able to take risks—if they were always timid and afraid to leave the house—they would have tremendous difficulty taking the developmental appropriate risks parents need them to take. An increased interest in thrill-seeking and risk-taking makes it possible for children to try to drive for the first time, ask someone out on a date, or apply for a job—all things that can be challenging for adults and can be particularly difficult when done for the first time. However, the downside of a brain that is primed for adventure is that it may lead some kids down a dangerous path— toward rock climbing, or thrill riding, or smoking cigarettes.

So even though it may be the teenaged brain that makes them more open to something exciting after they hit puberty, it doesn’t mean that it is necessarily safe all the time. Data from all around the world seems to indicate that the adolescent years are particularly dangerous.

However, standard teenage risk taking should be distinguished from more problematic risks that are taken by some teenagers. The 15-year-old who drives over the speed limit a few times isn’t quite the same as the 16-year-old who is breaking into houses, drinking regularly, and bullying younger children on the way to school. Unfortunately, some children have ongoing challenges with behaviors that are often called “risk-taking” but may just be a sign of a person who is overly tolerant of risk in general and perhaps even more aggressive than other children. Examine some of the data below to see where your child fits compared to other children {model.baby_his_her} age.

Around the world, we see that teenagers are uniquely at risk. As they leave the protection of their parents and venture into the world, they are in danger from car accidents, war, physical violence, suicide, drug and alcohol abuse, and injury from childbirth or sexually transmitted diseases. For parents and policy-makers, this makes it especially important to design intervention programs to help protect young people.

What are these teenagers dying from? The major causes of death in teenagers aren’t illnesses or birth defects—as they are in younger children—but things that reflect their sometimes risky engagement with the outside world. (Note that when teenagers die from HIV, this does not necessarily mean they contracted HIV as adolescents. It could mean that they contracted HIV at birth or as children and are only dying from the disease as teenagers, which is, unfortunately, common in parts of the world where there is inadequate treatment.) And in some places around the world, these rates are shockingly high. In South and Central America, one out of every 3 deaths in adolescent boys is because of violence. In Southeast Asia, one out of six deaths in girls is due to suicide.

If you compare the causes of disability and sickness among young adolescents and older adolescents, the risks of growing up become clear. Teenagers are suffering from mental health disorders, car accidents and violent interactions with each other.

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Look Inside

What is going on inside your child’s head as they go through puberty and enter into adolescence? Review adolescent brain development in this video clip.

{model.babyName} has been staying up past midnight to study and has to be up early for school, which starts earlier than it did in middle school—at {model.ADO10_school_start_time}.

{model.babyName} has been staying up past midnight to study.

You aren’t quite sure what {model.babyName} is doing late at night, but the light is definitely on in {model.baby_his_her} room when you go to bed and a few nights ago you woke up after midnight and {model.baby_he_she} was still up. {model.ADO10_phrase1} But {model.baby_he_she} has to be up early for school, which starts earlier than it did in middle school—at {model.ADO10_school_start_time}.

You aren’t quite sure what {model.babyName} is doing late at night, but the light is definitely on in {model.baby_his_her} room when you go to bed and a few nights ago you woke up after midnight and {model.baby_he_she} was still up. {model.ADO10_phrase1}

You wish that {model.babyName} was up late doing school work, but no matter what time you check on {model.baby_him_her}, {model.baby_he_she} seems to be texting or playing games online. But {model.baby_he_she} has to be up early for school, which starts earlier than it did in middle school—at {model.ADO10_school_start_time}.

You wish that {model.babyName} was up late doing school work, but no matter what time you check on {model.baby_him_her}, {model.baby_he_she} seems to be texting or playing games online.

The only way you can get to sleep lately is with earplugs. {model.babyName} is always staying up late—and being loud. You’ve had trouble getting through the night since {model.baby_he_she} is always playing music or screaming at a video game. Sometimes {model.baby_he_she} just isn’t making it to school at all. And {model.baby_he_she} has to be up early for school, which starts earlier than it did in middle school—at {model.ADO10_school_start_time}.

The only way you can get to sleep lately is with earplugs. {model.babyName} is always staying up late—and being loud. You’ve had trouble getting through the night since {model.baby_he_she} is always playing music or screaming at a video game. Sometimes {model.baby_he_she} stays in bed and skips schoolwork altogether.

You’ve tried to talk to {model.babyName} about staying up so late—and being so loud—but it hasn’t worked. You’ve had trouble getting to sleep since {model.baby_he_she} is always playing music or screaming at a video game. But no matter what you do, it seems like {model.baby_he_she} is up too late. And {model.baby_he_she} has to be up early for school, which starts earlier than it did in middle school—at {model.ADO10_school_start_time}. {model.baby_He_She_cap} has missed school a couple of times because {model.baby_he_she} just can’t get up in the morning.

You’ve tried to talk to {model.babyName} about staying up so late—and being so loud—but it hasn’t worked. You’ve had trouble getting to sleep since {model.baby_he_she} is always playing music or screaming at a video game. But no matter what you do, it seems like {model.baby_he_she} is up too late.

Explain

Even though your teenager may look like an adult, even the best-behaved adolescent is still not quite a grown-up. Teenagers still need a different amount of sleep than adults do (a little bit more), and they need adults to continue to keep track of them (including being aware of whether they’re getting enough rest), even though this may, from time-to-time, lead to conflict.

So how much sleep are adolescents supposed to be getting? Experts advise that teenagers are supposed to be getting between 8 ½ and 9 ½ hours of sleep a night (National Sleep Foundation. 2014). But most are getting around 7 ½ or 8 hours of sleep, but there is great variability. On some nights, kids may get just 6 hours of sleep.

What are they doing up so late? It depends on the child: some are up late playing around on the computer or on the phone, some are texting or talking to friends, and others are working on homework or trying to catch up after work or family obligations (Fuligni and Hardaway, 2006). And even if the child is staying up late to cram for that algebra mid-term, it may be counter-productive. Lost sleep not only leads to more anxiety but can also lead to less focus and lower grades (Gillen-O’Neel, Huynh, Fuligni, 2012).

Sleep experts recommend setting bedtimes and advising kids on proper sleep hygiene. This also means parents should be following these rules themselves. Don’t keep technology in the bedroom! And don’t wake up in the middle of the night to respond to a text. But few teenagers or their parents are able to stick to these rules, which may be part of the reason why we all feel like we are getting less sleep than we used to.

Sleep is only the beginning of the things parents are keeping track of—and potentially bickering with their children about. Parents and children both report that low-level conflicts between children and their parents are increasing during the years of early adolescence. However, this perception is, in part, because young adolescents are simply home less than they used to be—so even if they have the same number of run-ins with mom or dad about bedtimes, clothing, or that social studies exam, they are having them in a smaller block of time—so it simply feels like more conflict. Add to this the fact that some parents have multiple adolescents in one family and you can understand why rates of depression might be higher among parents of adolescents than parents of children in any other age stage.

However, rates of conflict vary significantly among cultural groups, with European-American families and families that tend to stress independence reporting more conflict overall. And for about ten to twenty percent of families, this isn’t just an everyday disagreement about who should put the milk away, it is more significant disagreements that are not easily resolved— these are conflicts beyond simple bickering—that may signal deeper mental health, behavior or substance abuse problems.

Researchers think that many episodes of parent-child conflict in early adolescence tend to be about what they call autonomy issues. As they grow older, teenagers want to become responsible and self-sufficient—and parents want this as well. Everyone wants a child who is able to take care of him or herself as an adult. However, the timeline for self-sufficiency and independence may be perceived differently by parents and children, particularly in early adolescence. For example: Your thirteen-year-old may think that {model.baby_he_she} is ready to take the train home alone late in the evening but you may think that {model.baby_he_she} is too irresponsible to travel alone. Your fourteen-year-old may think {model.baby_he_she} is ready to stay home by {model.baby_him_her}self overnight, but you may feel {model.baby_he_she} won’t be ready until {model.baby_he_she} is a bit older.

So, just like toddlers, young adolescents have an increased drive for independence. They want to do things their way and don’t like hearing “no” for an answer. What is a parent to do? Researchers recommend that parents tread a fine line between not being too controlling while maintaining close parental monitoring. Maintaining contact is particularly important in adolescence—parents who are able to monitor their child’s behavior consistently seem to have kids with fewer behavioral and substance abuse problems. However, parents who are overly controlling seem to have behavioral problems with their children. Similarly to parenting children at younger ages, parenting adolescents seems to require a balance of limits and warmth. Rather than arbitrarily assigning an early bedtime or taking away a smartphone, parents are probably wiser to have conversations with their children, allow for some compromise, while setting some firm limits and keeping both eyes open.

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Look Inside

How do peers—friends, classmates and teammates—change how our adolescents develop? Review the importance of social relationships in adolescence in this brief video clip.

Every time you look around, it seems like {model.babyName} is {model.ADO11_para1_phrase}

You are still worried about how {model.babyName} has been doing at school ever since you found out {model.baby_he_she} {model.ADO11_issue_list} But things seem to be going along okay in terms of friendships at school.

It isn’t just {model.babyName}’s BFF {model.friend1Name_gr1} anymore. Now that {model.babyName} is in ninth grade, it seems that all of the kids are moving in packs.

Even though {model.babyName} still has to spend a lot of time at home working alone, {model.baby_he_she} is linked in with kids from the local school and other home-schoolers doing some activity or just texting back and forth.

Whenever you see {model.babyName} in a group setting, the other kids seem to be talking to each other all the time, but {model.babyName} seems a bit lost all by {model.baby_him_her}self. Except for {model.baby_his_her} BFF {model.friend2Name_gr1}, {model.babyName} doesn’t seem all that involved in school.

Whenever you see {model.babyName} at a school event, the other kids seem to be talking to each other all the time, but {model.babyName} seems a bit lost all by {model.baby_him_her}self. Except for {model.baby_his_her} BFF {model.friend2Name_gr1}, {model.babyName} doesn’t seem all that involved in middle school.

The school counselor contacted you the other day to let you know that she is worried about how {model.babyName} was doing in school. She is worried that {model.babyName} isn’t quite fitting in and invited you to a meeting after school to discuss how {model.baby_he_she} is doing.

Explain

As children grow older, they spend more time with their friends and less time with their parents. Their relationships with peers—the kids in their classes, friends, team-mates, and best friends—all become more complicated and important to them. In middle and high school, adolescents tend to split off into somewhat separate groups. Across a variety of countries and different class and ethnic groups in North America and Europe, teens tend to segregate themselves into some stereotypic categories, groups, or cliques that you may remember from your own high school experience or watching “Clueless” or “Mean Girls”: The popular kids, athletes, studious kids, burnouts, or rebels. Or you may have had more contemporary groups at your school—skaters or goths or those who have segregated themselves by ethnic or cultural categories. However, whatever the name of the category, the idea is that when they are grouped together into large groups—kids tend to group themselves into somewhat homogenous categories. There are some exceptions, however—but these mostly occur at schools that are fairly dysfunctional, where the children don’t identify with the school culture or the other children at the school at all.

As you know already, adolescents are very sensitive to their social status and to what other teenagers think of them. They tend to be very perceptive or sensitive to their own social hierarchies—with specific ideas about who is more popular than who, and in which group they are in. This is partly why parents, schools, and researchers worry about peer pressure, the idea that teenagers are susceptible to the norms of their particular sub-group. In fact, research does indicate that teens are invested in impressing their peers—teens will take risks to impress their friends or, at the same time, strive to excel if that is what their peer group is doing. Peer pressure can influence kids for good as well as risky behaviors. Researchers who study adolescent peer groups find that teenagers do move within groups over the years of high school. Just because your teenager is a “burnout” in the 7th grade doesn’t mean {model.baby_he_she} is going to be a “burnout” in high school. Similarly, a socially isolated 15-year-old may be a flourishing high school senior with a number of friends (although it is unlikely that he will metamorphose into the class president).

In middle and high school, as throughout life, children who have strong social skills—who know how to get along with others, are sensitive to group norms, and are able to emotionally regulate themselves, tend to do better, no matter what subgroup they are in (and kids with good social skills and emotional regulation are less likely to be in problematic groups like the “burnouts” or “rebels”).

In elementary school, the popular children are generally children who are agreeable and well-liked. This seems to change over the years of middle and high school, where the “Popular” kids become those with status and power. These tend to be children who are aggressive enough to run for class president or to try for other positions of formal or informal leadership. However, for the most part, these aren’t kids who use physical aggression to get their way. They tend to be children who, if they use aggression with other kids, use relational aggression—things like manipulating relationships for personal gain, by sharing malicious gossip, or spreading rumors.

Social groups do seem to differ depending on the quality of the middle or high school. At some struggling schools, there may not be enough of a school culture or a sense of unity among students for cliques to form. At other schools struggling with issues of crime and delinquency, the rebels may be at the top of the social hierarchy.

But even if they are at the top of the pack in some schools, children who end up as “rebels,” who may be flirting with criminal activity and may not be engaged in the academic part of school, tend to have higher rates of risk-taking and involvement with the law. These tend to be children with higher rates of depression, less sense of their own efficacy, and who have had parenting that is less consistent and less authoritative than other kids.

And do these relationships matter? Most of the evidence seems to indicate that it does. Children who have supportive relationships with their peers (and with teachers and parents) seem to do better in adolescence. Children who are isolated or unengaged tend not to do as well in school—and their trouble with relationships during their adolescence may continue into adulthood.

First, many of these children report a pattern of lax parental supervision that has been present from their early lives. Despite the fact that the children are often supported and often in close contact with their parents, they report that their wishes were persistently fulfilled with no clear indication of the consequences that they had to face when they broke rules.

A second path seems to emerge once children hit their teen years. This group of children have parents who are authoritative until the children reach their teen years. Similar to the reactions of parents in several studies on the life course of delinquent adolescents, conducted by the Oregon Social Research Center, parents' actions changed near puberty. Many parents of children with late conduct problems stop supervising their children upon their entrance to middle or junior high school. Perhaps parents find that their children can take care of their basic needs and note that their children can talk in mature ways, which leads them to conclude that their children can supervise themselves. This conclusion fails to recognize that adolescents do not have adult judgment. Compared with adults, adolescents have a much shorter view into the future and rarely anticipate all of the possible consequences.

The third path is laissez-faire; several students describe disregard and disconnection in which parents and kids rarely cross paths.

All of the paths described make the adolescents vulnerable to other important effects. Once out of adult supervision or influence, they use substances, primarily alcohol, which only makes poorly controlled behaviors even more likely. Second, they often act in groups. All people are more susceptible to take risks in the presence of a group and adolescents are especially vulnerable to group pressures. There does not need to be an overt statement of pressure; simply observing others succumb to temptation is enough to set new standards for action. Then, status is achieved through some of the acts which only reinforce kids for participating. Thus, it is easy to propose that factors from the adolescents' backgrounds and factors unique to their party experiences make important contributions to unhealthy conduct.

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Look Inside

Review what we understand about brain and cognitive development during adolescence in these three video clips.

Baby Avatar will load here.

It’s hard to believe that {model.babyName} will be starting High School in the fall. You got {model.baby_his_her} final report card in the mail.

You’d been worried about how {model.baby_he_she} was doing and you were reassured to get the report in the mail. Now you can stop fretting about it!

Since {model.babyName} is going to have to start thinking about high school next year, you decided to take {model.baby_him_her} into the local school department to have a comprehensive set of academic tests run to see how {model.baby_he_she} has been doing and how {model.baby_his_her} performance compares to other kids.

{model.ADO1_schoolname}

Home School End Of Program Summary Report: At the end of eighth grade, you took {model.babyName} to the local school system to receive a full evaluation and testing to see how {model.baby_he_she} is doing compared to {model.baby_his_her} traditionally schooled peers. Here’s how {model.babyName} fared.

Home School End of Program Summary Report

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Look Inside

Review what we understand about education in adolescence in this short video clip.

Should {model.babyName} continue with homeschooling? You know of other home-schooling parents who can help you out in in areas where you don’t have subject matter expertise, but it may be a bit more challenging than it was when {model.babyName} was younger.

{model.babyName} has been going to {model.ADO1_schoolname}. You have been pleased with how things have gone and you are a bit sad to see it come to an end.

While {model.babyName}’s years at {model.ADO1_schoolname} have been challenging, you are even more nervous about high school. You hear so much about kids being exposed to so much danger in high school. Is it all really true?

While {model.babyName}’s years at {model.ADO1_schoolname} have been difficult academically, {model.baby_he_she} has certainly learned a lot. You are nervous about the move to high school next year. But {model.babyName} says {model.baby_he_she} is excited for the challenge.

Explain

Researchers, students and parents tend to agree that the quality of a high school education can make an enormous difference in a students’ life. Students who go to a better quality high school— even if we control for variations in parental income and student characteristics—end up making more money and have a better chance of staying in school than those who go to poor quality high schools.

In the United States, some parents have a variety of public options for high school education, but about 60% of parents need to send their children to their zoned public high school or figure out a way to move to another district or pay for private or religious schooling. For students in rural or suburban areas, there may only be one high school, public or private, that is close enough to attend. Wealthier students—or families lucky enough to benefit from a scholarship or financial aid program—may be able to choose a private or religious school. Almost 20% of families report having moved in order to get their children into a better high school (U.S. Department of Education, 2014).

In the United States, most students—almost 93%—end up with either a high school degree or a GED (General Equivalency Diploma) by the time they are 24. But this means that about 1 in 5 ninth graders don’t graduate from high school with a standard diploma in 4 years. Some of these kids will end up with a GED. Others will get a diploma from adult education or some kind of alternative high school. And the rest will end up without any kind of certificate and with, sadly, low chances of landing a good job. Unfortunately, for the students who get a GED instead of a diploma, getting a GED doesn’t mean quite as much as a high school diploma. Earnings for students with just a GED are substantially lower than those of kids with a traditional high school diploma and practically as low as if the students hadn’t sat down for the GED test at all. And a high school degree—while it is a requirement for entry in many jobs, and for two and four-year colleges—doesn’t necessarily mean that students have mastered core material. About half of students who enroll at 2-year-colleges, and one in five students at four-year colleges, need remedial work.

In looking at the quality of high school, researchers tend to examine some of the following:

High School graduation rate. This seems quite straightforward—how many students graduate. But you may want to examine the details. Do students who end up dropping out in ninth grade to take the GED count as having “graduated”? What about students who transfer and the administrators lose track of them? What about students who take five years to graduate?

Test Scores. Again, this seem like it could be straightforward. But in this era of multiple-tests, parents could be confused by which tests are important. Should parents look at a high school’s average SAT scores? Their NEACP scores? Questions to ask include whether all the students are taking all these tests or whether the test scores just represent a sub-set of students..

College readiness. How many students are taking a rigorous college preparatory curriculum, like four-years of English and three or four years of math? Do they offer a more rigorous track, including calculus or advanced placement courses in English? Only about half of the high schools in the United States offer Advanced Placement courses—making these rigorous courses unavailable to more than 50 percent of high school students in the United States

And, finally, parents may want to ask some even more basic questions. Is the high school safe? What is the rate of reported violence in the school? And are students engaged or are they playing hooky? If a large proportion of students just aren’t showing up every day, one can safely assume that something has gone wrong and the school is not doing an adequate job in motivating students to learn.

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It has been a long time since you and {model.partnerName} broke up. You never imagined that the fighting would go on this long. You are just about as upset about {model.partnerHimHer} as you were the day {model.partnerHeShe} left for the first time. Everything seems to be a fight. Birthdays. Holidays. Where {model.babyName} should go to school. What kind of after school activities you should pay for. {model.babyName} goes to see {model.partnerName} every week but seeing {model.baby_him_her} go brings up all the disagreements.

It has been a long time since you and {model.partnerName} broke up. You never imagined that this would become the new normal. But {model.babyName} has seemed to adjust nicely—and actually you and {model.partnerName} are getting along. {model.babyName} has been able to maintain a great relationship with both of you and you feel really proud of that.

You’ve actually started seeing someone new. What do you think about introducing {model.babyName} to your new {model.partnerGirlfriendBoyfriend}.

Explain

Life after a divorce or separation depends on how much conflict the parents are going through. Most parents are able to move beyond the conflict in a year or so. But about 20 percent linger in corrosive conflict for longer—with potentially harmful effects on children. Most experts advise trying to enlist a mediator, family therapist, religious elder or respected family member to help cool down the fighting and help put the family first.

While many children can thrive in single-parent households, households with more adults tend to have more income, which can help. And parents tend to benefit from stable, committed intimate relationships—being with a loving partner can help adults buffer stress and parent better. However, millions of single mothers do an amazing job every day raising successful children.

It is very common for separated or divorced adults to re-couple. About 15 percent of children live in a “blended” family where the parents have legally remarried to a new partner. Many others live in families with two adults who are less formally partnered.

Children seem to thrive on stable, committed relationships with adults—whether biological, adoptive or step-parents. Step-parents—a term that is often used by children and adults to refer to anyone who takes a parent role with children, regardless of whether they are legally married to a biological parent—can benefit children if they have strong, attached and long-term committed relationships.

Explain

Most children in United States have at least one sibling—and potentially more biological or step-siblings.

Some siblings are just months apart in age and other can be separated by decades. As you can see in the figure below, most children are less than five years apart. Medical experts advise that women—and their babies—will be healthiest if they wait at least a year after giving birth before getting pregnant again.

Researchers who have looked at the school performance of siblings have noted that first children tend to do better in school—and that younger children tend to do better in school if there is a bigger age gap between children. First children tend to get more attention than children who are born later—but much of this extra time comes in the first few years, so waiting a few years before having a second child may make sure that the second child gets enough attention.

The relationship between siblings can be an important way for children to practice relating and getting along. Relationships between siblings may be close—or distant—and siblings can teach each other good, or bad lessons. Challenging relationships with siblings can make development challenging—but loving relationships can be a buffer and a support for a lifetime. Making sure that young children learn how to manage conflict and their emotions with their siblings can be an important place for your children to learn how to relate to their friends and others outside of your family.

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Look Inside

What is going on inside your child’s head as they go through puberty and enter into adolescence? Review adolescent brain development in this video clip.

Baby Avatar will load here.

{model.babyName} is almost fully grown. You’re taking her back to the {model.babyProvider} for a check-up and she’s as tall as you are. Most girls hit their adult height around 15.

{model.babyName} is almost fully grown. You’re taking her back to the {model.babyProvider} for a check-up and she’s taller than you are. Most girls hit their adult height around 15.

{model.babyName} is almost fully grown. You’re taking her back to the {model.babyProvider} for a check-up and she’s almost grown-up height. Most girls hit their adult height around 15.

You’ve noticed that {model.babyName} is a little smaller than a lot of other girls her age. At this visit to the {model.babyProvider}, {model.babyProvider_he_she} told you that with many girls who dance or do gymnastics intensively, like {model.babyName}, end up growing a little later and a little slower. Apparently their adolescent growth spurt is delayed by all that exercise.

You think {model.babyName} is looking huge! He is as tall as you are. But he probably still has another few years of growth. Boys start growing a bit later than girls but continue growing until they are about 17.

You think {model.babyName} is looking huge! He is taller than you are. But he probably still has another few years of growth. Boys start growing a bit later than girls but continue growing until they are about 17.

You think {model.babyName} is looking huge! He is almost grown-up height. But he probably still has another few years of growth. Boys start growing a bit later than girls but continue growing until they are about 17.

And here’s a report card on {model.babyName}’s health based on this office visit and that form that {model.baby_he_she} filled out “privately.” If it looks like you need it, you’ll get a chance in the next event to choose some interventions to help {model.babyName}.

As you know from previous visits, {model.babyProvider} has been worried about how {model.babyName} is doing. {model.PN2_shortdoctorName_He_She_cap} had been hoping that {model.babyName} has been doing better but the form that {model.babyProvider_he_she} filled out doesn’t seem to indicate that.

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Baby Avatar will load here.

Explain

We’ve covered a lot of topics in this doctor’s visit—some of which you may want to flip back to and review in later events.

Physical Growth: How do I know if I’m full grown? Kids wonder how tall they are going to be throughout middle school and high school. They worry that they are not quite as tall as their friends, or maybe that they’re too tall. They fret about being tall enough to play on the basketball team or being taller than the boys at the 7th grade dance. Most of our height is determined by genetics (about 80%) before we are born. As with many aspects of what makes us who we are, the genetics of our height are complicated—more than 600 separate genes play a part in how tall we are—but, for most of us, we can predict that we’ll be approximately as tall as the average of our parents’ height. So if your mom was about 2 inches above average for a woman (about 5 foot 5 inches) and your father was about 2 inches shorter than the average for a man (about 5 foot 10 inches), you’ll probably end up about average.

However, the environment does play a part in determining how tall we are. If kids have a healthy diet while they are growing (particularly in infancy)—with lots of calcium and protein—they are likely to reach their maximum height. Most adults in the developed world are around their maximal height— give or take an inch or so. However, if children have a poor quality diet—with too many refined foods, sugar and not enough protein and calcium—or are sick during infancy, they’re likely to not reach their maximum height. In fact, a concerning study comparing the growth patterns of various ethnic groups within the United States revealed that the average African-American woman has actually lost about a half-inch in height in the past few generations changing diets—which lead to more overweight and reduced bone strength (Komlos, 2009).

When we stop growing is usually determined by the time we hit puberty. So, children who hit puberty earlier generally stop growing earlier than kids who hit puberty later. Boys continue growing for about 5 years after hitting spermarche (at about 17), but girls stop growing only about 2 1/2 years after their first menstrual period. So, boys and girls start out at about the same height, but because boys grow for a few more years, they tend to end up taller than most girls. One exception is for kids—like dancers and gymnasts—who have low levels of body fat and may not hit puberty until later. These children may have a “catch up” growth spurt when they stop their intensive training, although many may end up smaller than their peers.

What are teens eating? It is probably not shocking that many teens are not eating an ideal diet. Almost ten percent of teens never eat any vegetables (YRBS, 2013). And about 1 in 5 never drinks milk (an important and convenient source of calcium and protein) (YRBS, 2013). In order to see them through their growth spurts, teens need to make sure they’re getting a diet filled with the right nutrients. Many are not getting enough calcium, folate, magnesium and iron (particularly girls) and are getting too much salt and fat (Munoz et al, 1997).

But a bigger challenge for some teens is figuring out where their next meal is going to come from. In the United States, few children are starving—but many suffer from food insecurity because they live in families where food is not consistently available. In families where food is insecure, food may “run out” at the end of a pay-period or children may have to skip certain meals if groceries are in short supply. Children who are food insecure are at a higher risk for nutritional complications, including iron-deficiency anemia, because they eat high-iron foods (like meat) less frequently than less expensive foods like cereal and grains. Teenagers seem to be at special risk in families that are food insecure, perhaps because younger children are protected by parents who give them the more nutrient-rich foods, while adults and teenagers make do.

The combination of somewhat typical, poor adolescent nutrition and food insecurity lead to an increase in iron-deficiency among teenagers who are food insecure. Teenage girls, in particular, need extra iron during adolescence because of menstruation and rapid growth, and they have higher rates of iron-deficiency anemia, which can lead to exhaustion. This is easily remedied with iron supplementation or dietary changes to increase intake of iron-rich foods like meat and leafy greens.

Unhealthy beliefs about body image continue to be common, particularly among teenage girls. Many of these girls report dieting and using unhealthy diet practices, like taking laxatives or throwing up to lose weight. Few teenage girls meet the rigorous criteria required to be diagnosed with an eating disorder, but these practices aren’t good for their nutrition or their sense of well-being

How to keep an eye on them?

So...how to monitor what kids are doing during the day? There are many methods—talking, texting and just spending quality time together in the car. Analyzing whether families are eating dinner together has recently become a new way of looking at whether parents are keeping in touch with kids every night. Some research suggests that teens who have dinner with their parent or parents every night do better than other kids whose families are too busy—or perhaps too chaotic—to manage a family meal every night. Critics of this research remind us that teenagers who are working during dinnertime, or who have parents who are shift workers and not available at night, may also turn out okay. Monitoring kids can be done in many different ways and doesn’t always have to include sharing an evening meal, although sharing a meal can often be a convenient way to check-in. However, whether we believe the family meal is a valid indicator of parental monitoring, in many families, the consistent family meal begins to disappear as kids get older and busier with peers, activities or work.

Taking Risks with Substances

First, let’s cover tobacco. While a number of children have tried cigarettes during adolescence, fewer are smoking cigarettes than in previous generations. However, teens seem to be early adopters of new cigarette alternatives like e-cigarettes—which many believe to be safer than traditional cigarettes. About 40% of kids have tried cigarettes, and 16 percent are regularly using cigarettes, e-cigarettes or cigars. Teens may need a reminder that vaping isn’t without safety risks. We still don’t understand whether there are risks from inhaling the aerosol and the additives that are contained in electronic cigarettes. And we know already from years of research about nicotine addiction that, whatever the delivery mechanism, addiction to nicotine can be a difficult habit to break. Interventions to prevent or stop teens from smoking typically focus on behavioral interventions rather than pharmaceutical treatments that have been popular in treating adult smokers

By the time they graduate from high school, about two-thirds of teenagers have tried alcohol at least once (despite a legal drinking age of 21). But only a third are drinking every month. About 20 percent of adolescents have problem drinking behaviors like binge drinking. Teens who are binge drinking are at increased risk for a whole host of challenges, from driving accidents, sexual violence, depression and alcohol dependence later in life. Pediatricians recommend asking teenagers some simple questions about their drinking: Are they drinking more than their peers? Are they drinking alone? To relax? And are they drinking and driving (Knight, et al, 2002)? If they answer yes to any of these questions, you may want to investigate further—or seek some professional intervention.

About one in four teenagers is using substances every month. And by the time they have graduated from high school, about half of all seniors have tried an illegal drug—probably marijuana. This is a broad category, with the most “popular” drug being marijuana, now legalized for use by adults in some states. Students also seem to favor using (and abusing) prescription drugs, with Adderall and Ritalin being the favorites. For a full list, see the figure below. Experimenting with drugs can be risky. Teens may not understand that prescription drugs aren’t safe and that they are still illegal. About five percent of adolescents have serious problems with substances, with the most common problems being either smoking pot every day or abusing stimulants. These problems are often combined with depression— kids who are using and abusing substances are about twice as likely to be depressed—which can lead not only to misery and problems at school but also to various types of self-harming behaviors and even suicide.

In general, strategies for tackling problem drinking or substance abuse behaviors in adolescence focus on family and individual treatments. Generally, putting teens in a group situation with other teens with problem behaviors may end up making the problems worse. Hanging out with other kids who have problems with substances may normalize your teen’s challenges rather than encouraging him/her to turn a new leaf. Individual or family counseling—and a change in the substance or alcohol abusing peer group—may be a better way to target a teenager’s problems with alcohol or other substances.

Sex: What’s Risky?

It shouldn’t be extremely surprising that many teenagers are having sex. Around the world, many teenage girls are mothers before they hit 20. In the United States, by the time they have graduated from high school, about 60% of teenagers have had sex, but most of them are not having it with any frequency. During high school, only about 1 in 5 students having sex has had sex in the past three months. About 1 in 12 teens identifies as gay or lesbian, but many of them don’t “come out” until they are out of high school.

Teenagers have all sorts of risks connected with sex—mostly concerning things like having sex without birth control; having sex while drunk or under the influence of substances; getting a STI. About 10 percent of 9th grade boys (and fewer than 5 percent of 9th grade girls) report having more than 4 sexual partners. But risky behaviors, like not using birth control (common for about 15 percent of sexual contacts among teenagers) and drinking before sexual activity (common in about 20 percent of sexual contacts), clearly lead to the high rate of STIs among teens. About 1 in 4 teenagers has an STI. Experts recommend thorough sex education, regular medical visits and the use of barrier birth control, like condoms, to prevent transmission of STIs.

The rate of teenage pregnancy has been dropping in the United States in the past decade, although the United States still has the highest rate of teenage childbirth in the developed world (at about 42 babies born for every 1,000 women between 15-19; Sedgh et al, 2015 ). Current recommended medical practice, designed to reduce the rates of teen pregnancy, is to provide sexually active teenage girls with long acting birth control, like implanted hormones, an IUD or a birth control shot.

Almost 15 percent of teens have been a victim of sexual violence—either from a partner or from a stranger. This includes about 15 percent of girls and 5 percent of boys. Like all victims of assault, teenagers can develop chronic post-traumatic stress syndrome after rape. Young victims of sexual assault often struggle with questions of embarrassment, shame and fear, and may be reluctant to pursue police intervention.

More violence

In addition to sexual violence, teenagers are also exposed to violence at home and at school. Shockingly, about 1 in 5 American girls and 1 in 3 American boys reports having been in a physical fight in the past year. However, only a few of these—less than 5%—were hurt in these altercations. And in the past year, about 8% of American teenagers have been exposed to domestic violence in their homes, either as witnesses to assaults between adults or children or—for about 2% of teenagers—as victims.

Being a victim or witness to violence can make kids more likely to be depressed, or to engage in risk-taking behaviors, from drug-abuse to self-harm. But being an aggressor in physical fights where other kids really get hurt is even more dangerous. Being physically aggressive as a teenager is a signal that kids may not have learned the self-regulation and empathy skills that will keep them out of more serious trouble as an adult.

And if all this has made you depressed, you are not alone.

The rate of depression in teenagers is high—about three times as high as in children. Researchers believe there are a number of reasons for increasing rates of depression in teenagers—including brain changes that may trigger depression and increased stress due to increased social and academic challenges, combined with cultural expectations for independence. It is common for teenagers to report feeling sad or hopeless, with girls especially comfortable talking about how sad they are and especially vulnerable. However, for some kids, this adolescent-typical malaise can turn into diagnosable major depression—because they are no longer able to do things they need to, like socializing with peers, attending school, etc. Unfortunately, things like non-suicidal self-injury (NSSI), like cutting, or even suicide attempts may then become potential issues

Many teenagers who are depressed don’t get treatment. Fewer than half of adolescents sought treatment and those who did typically got help from someone at school or their pediatrician. Very few got help from someone with specific, advanced training in mental health, and even fewer with expertise in adolescents.

Continue

Look Inside

What is going on inside your child’s head as they go through puberty and enter into adolescence? Review adolescent brain development in this video clip.

It is the summer before {model.babyName}’s eleventh grade year in high school and some people are starting to ask {model.babyName} what {model.baby_he_she} is going to do with {model.baby_his_her} life. You need to decide what sort of classes you want to teach {model.babyName} and whether you will need to find tutors for some courses.

It is the summer before {model.babyName}’s eleventh grade year in high school and some people are starting to ask {model.babyName} what {model.baby_he_she} is going to do with {model.baby_his_her} life. The school counselor just sent out a note saying it is time to sign up for classes.

{model.babyName} tells you that {model.baby_he_she} isn’t sure why {model.baby_he_she} is continuing with school. “It seems pointless. Why do I need to know what X or Y or Z is in order to get a job? No one I know has ever used Algebra after high school. This is so stupid. Why are we both wasting time on this?”

{model.babyName} tells you that {model.baby_he_she} isn’t sure why {model.baby_he_she} is continuing with school. “It seems pointless. Why do I need to know what X or Y or Z is in order to get a job? No one I know has ever used Algebra after high school. This is so stupid. No one seems to notice if I turn in my assignments anyway. And I think half the kids in my English class cheated on the last test.”

{model.babyName} has had {model.baby_his_her} challenges in school and was even suspended, but {model.baby_he_she} still keeps on going to school and says {model.baby_he_she} plans on graduating on time. You’re proud, but you also think that you need to help {model.baby_him_her} make a plan for what comes next.

{model.babyName} has had {model.baby_his_her} challenges in school and is still getting called to the office for acting out in class, but {model.baby_he_she} still keeps on going to school and says {model.baby_he_she} plans on graduating on time. You’re proud, but you also think that you need to help {model.baby_him_her} make a plan for what comes next.

{model.babyName} has had {model.baby_his_her} challenges with learning and paying attention while you are trying to teach, but {model.baby_he_she} still keeps on progressing and should graduate on time. You’re proud, but you also think that you need to help {model.baby_him_her} make a plan for what comes next.

{model.babyName} isn’t sure how much to focus on school work. {model.baby_He_She_cap} is still hoping for a career as a professional {model.MC10_sport} player. {model.baby_He_She_cap} would like to spend all {model.baby_his_her} time practicing. But you aren’t sure what the chances are that {model.baby_he_she} could actually succeed. How realistic do you need to be with a 16-year-old? How do you help {model.baby_him_her} make a wise decision?

{model.babyName} isn’t sure how much to focus on school work. {model.baby_He_She_cap} is still hoping for a career as a professional musician. {model.baby_He_She_cap} would like to spend all {model.baby_his_her} extra time working on some demos. But you aren’t sure what the chances are that {model.baby_he_she} could actually succeed. How realistic do you need to be with a 16-year-old? How do you help {model.baby_him_her} make a wise decision?

{model.babyName} isn’t sure how much to focus on school work. {model.baby_He_She_cap} is still hoping for a career as a professional actor. {model.baby_He_She_cap} has spent all {model.baby_his_her} extra time doing a community theater production. {model.baby_He_She_cap} would like to spend all {model.baby_his_her} time rehearsing. But you aren’t sure what the chances are that {model.baby_he_she} could actually succeed. How realistic do you need to be with a 16-year-old? How do you help {model.baby_him_her} make a wise decision?

{model.babyName} isn’t sure how much to focus on school work. {model.baby_He_She_cap} is still hoping for a career as a professional actor. {model.baby_He_She_cap} has spent all {model.baby_his_her} extra time doing the high school musical. {model.baby_He_She_cap} would like to spend all {model.baby_his_her} time rehearsing. But you aren’t sure what the chances are that {model.baby_he_she} could actually succeed. How realistic do you need to be with a 16-year-old? How do you help {model.baby_him_her} make a wise decision?

{model.babyName} has started {model.ADO14_randomCS} and is wondering whether it is even worth it to think about college. {model.baby_He_She_cap} wonders if {model.baby_he_she} should go the Bill Gates route and just skip college altogether. How realistic do you need to be with a 16-year-old? How do you help {model.baby_him_her} make a wise decision?

{model.babyName} has wanted to be a doctor ever since {model.baby_he_she} was a little kid. You don’t know whether that is still a reasonable hope for {model.baby_him_her}. How would you afford medical school? Or even college? Shouldn’t {model.babyName} think about looking into other professions?

{model.babyName} has wanted to be a doctor ever since {model.baby_he_she} was a little kid. You don’t know whether that is still a reasonable hope for {model.baby_him_her}. Is it reasonable that {model.baby_he_she} would still want to be a doctor? Shouldn’t {model.babyName} think about looking into other professions?

{model.babyName} has wanted to be a veterinarian ever since {model.baby_he_she} was a little kid. You don’t know whether that is still a reasonable hope for {model.baby_him_her}. How would you afford veterinarian school? Or even college? Shouldn’t {model.babyName} think about looking into other professions?

{model.babyName} has wanted to be a veterinarian ever since {model.baby_he_she} was a little kid. You don’t know whether that is still a reasonable hope for {model.baby_him_her}. Is it reasonable that {model.baby_he_she} would still want to be a veterinarian? Shouldn’t {model.babyName} think about looking into other professions?

{model.babyName} has wanted to be an artist ever since {model.baby_he_she} was a little kid. But how would {model.baby_he_she} ever make money doing that? {model.ADO14_art2} suggested that there might be a career for {model.baby_him_her} in graphic design, though {model.babyName} didn’t think it was ‘arty’ enough. {model.ADO14_art1}

{model.babyName} has wanted to be a writer ever since {model.baby_he_she} was a little kid. But how would {model.baby_he_she} ever make money doing that? {model.ADO14_art2} suggested that there might be a career for {model.baby_him_her} in journalism, but {model.babyName} wants to be a novelist. {model.ADO14_art1}

{model.babyName} has wanted to be a teacher ever since {model.baby_he_she} was a little kid. What type of classes should {model.baby_he_she} be taking to do this? Should you encourage {model.baby_him_her}?

{model.babyName} has wanted to be a scientist ever since {model.baby_he_she} was a little kid. And now {model.baby_he_she} is talking about astronomy. {model.ADO14_science} What type of classes should {model.baby_he_she} be taking to do this? Should you encourage {model.baby_him_her}?

School has never been easy for {model.babyName} because of {model.baby_his_her} struggles with {model.ADO14_SLD}. {model.baby_He_She_cap} has been a hard worker, though, so you have encouraged {model.baby_him_her} to think about college or a skilled trade. What should you advise {model.baby_him_her} to think about now?

School has never been easy for {model.babyName} because of {model.baby_his_her} struggles with {model.ADO14_SLD}. {model.ADO14_SLD_other} Should {model.baby_he_she} think about college? What about a trade? What should the future hold for {model.baby_him_her}?

{model.babyName} has been staying up late studying and came home yesterday telling you that {model.baby_he_she} didn’t think that {model.baby_he_she} was doing enough to get into the “right” college. “My grades aren’t good enough. I’m not smart enough. I’m not doing enough. My personal brand isn’t strong enough.” Is there too much stress about getting into college for a kid like yours? What do you tell {model.baby_him_her}?

{model.babyName} has been working hard in school {model.ADO14_SLD_other} {model.baby_he_she} should think about going to college—and maybe even think about going away to a university or a private college. How would you afford something like that? Is this really a good path for {model.baby_him_her}?

You’ve always expected that {model.babyName} would go on to college, but {model.baby_he_she} hasn’t done that well in school so far. Do you think {model.baby_he_she} will be able to turn things around, or should you think about alternatives?

Back when {model.babyName} was a little kid, {model.baby_he_she} always wanted {model.MC10_future_career}, but you’re not sure how realistic that is anymore. What kind of decisions should you advise {model.baby_him_her} to make now?

{model.babyName} has always struggled with figuring out what {model.baby_he_she} wants to do when {model.baby_he_she} grows up. You’re not sure how to advise {model.baby_him_her}. What should {model.baby_he_she} be focusing on?

Explain

Planning for life after high school is one of the most exciting—and stressful—parts of parenting an adolescent. There are a lot of decisions to be made! Some of them are critically important, and adolescents often have trouble making them on their own. As we’ve learned before, adolescents make decisions a little differently than adults. They tend to be very prone to peer approval, are self-conscious and can be impulsive. How does this affect decisions about what comes after high school? Smart kids who are surrounded by less high-achieving kids may not push themselves as hard as they should. But, by the same token, kids with learning disabilities who are friends with high-achieving kids may end up pushing themselves harder than they might in another clique. Try to be aware of the influence of peers and give adolescents adequate time to make important decisions—like what classes to sign up for or whether to take the SATs (or ACTs).

These decisions also bring to light some substantial differences in the experiences of adolescents around the country and around the world. Some teens are lucky enough to have many choices and rich opportunities for learning while in high school. Others are not so lucky. Remember that over 2 million students don’t have access to calculus (considered a core part of a “rigorous” high school curriculum) and only 60 percent of students have access to physics. More than 3,000 high schools don’t even offer Algebra II. (If you’ve forgotten the typical high school math sequence, students usually have to take Algebra I, Geometry, Algebra II, Pre-Calculus and Calculus. Calculus is recommended for students taking a “rigorous” curriculum.) These schools tend to be attended by a higher concentration of poor, non-white students.

While everyone agrees that getting through high school and earning a diploma is a good idea—whether your goal is to go to a four-year-college, a community college or just get a job after graduation—not every high school diploma means the same thing. Some high school graduates take a more rigorous curriculum, which tends to lead to more success in college. Others take a less challenging path in high school. As a result, more than half of college students are forced to take some remedial courses in college (Sparks/Markus, 2013). About one in four students who take the ASVAB, the entrance exam for the military, fail it (Theokas, 2010).

However, any kind of curriculum works out for students better than simply dropping out of school. Dropping out of school tends to lead to poorer job success. Many jobs, even in retail or manufacturing, now require at least a high school degree. And high school drop-outs tend to have social challenges as well. In the United States, fewer than ten percent of students drop-out. Students who drop out of high school are more likely to have disabilities, to be English Language Learners (ELLs) and to have been held back (to be older than their peers). They are also likely to have moved schools, have parents who are either not well-educated or not deeply engaged in their children’s education, and to attend poorer-quality schools.

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Learn More

Look Inside

Review what we understand about the development of romantic and sexual relationships in adolescence.

You came home the other day to find your kitchen a complete disaster. Flour on the floor. Cookie crumbs all over the counters. Apparently {model.babyName} had decided to make chocolate chip cookies for {model.baby_his_her} {model.ADO12_has_boyfriend_or_girlfriend} because {model.ADO12_dating_partner_he_she} had a bad week. You had known that {model.baby_he_she} been dating for a few weeks but you didn’t realize that it was a cookie-worthy relationship. You feel relieved that {model.ADO12_romantic_partner_name} seems quite responsible. And you’re not surprised to hear that they are going to prom together in a few weeks.

{model.babyName} told you that Facebook was for “old people like you” but you noticed the other day that {model.baby_he_she} still changed {model.baby_his_her} relationship status. {model.baby_He_She_cap} has been dating {model.ADO12_romantic_partner_name} for a few weeks now. You feel relieved that {model.baby_he_she} seems quite responsible. {model.ADO15_randomphrase_A} And you’re not surprised to hear that they are going to prom together in a few weeks.

You are a little concerned because your friend told you that she’d seen {model.babyName} in a car with a much older boy. You have worried about {model.babyName} being sexually active and dating for some time. Surprisingly, however, she admitted to dating {model.ADO12_romantic_partner_name} and said that he was “just” 21. You pointed out that since she is just seventeen, he is legally not allowed to be dating her. She said that he was taking her to prom and showed you a photo of them posing together in her outfit. You’re particularly concerned because you know one of her friends got pregnant earlier this year.

You’ve known for some time that {model.babyName} was into {model.ADO12_romantic_partner_boy_girl}s. Mostly you have worried about how this was going to impact {model.baby_him_her} with other peers. What would {model.baby_he_she} say to the other kids? Would {model.baby_he_she} get bullied? What about going to prom? Would {model.baby_he_she} ever find the right person? You have a suspicion that {model.baby_he_she} has been dating a little bit but {model.baby_he_she} hasn’t really told you very much about anyone in particular. {model.ADO15_C_phrase}

You’ve known for some time that {model.babyName} has been hooking up with girls but now he has a girlfriend. You’re not sure how deep the relationship is, however. As far as you can tell, they have never actually been on a date together—they just seem to go places together and sit next to each other at school events. And, of course, they went to prom together. You’re particularly worried because you know that one of his friends got someone pregnant earlier this year.

You’ve known for some time that {model.babyName} has been hooking up with girls but now he has a girlfriend. You’re not sure how deep the relationship is, however. As far as you can tell they have never actually been on a date together. And, of course, they are planning on going to prom together. You’re particularly worried because you know that one of his friends got someone pregnant earlier this year.

Some of {model.babyName}’s friends have been out on dates, but {model.babyName} hasn’t ever talked about there being anyone special. {model.baby_He_She_cap} went to the prom last year with some friends. You’re kind of relieved that you haven’t had to worry about any serious relationships.

You know {model.babyName} has liked {model.baby_boy_girl_opp}s over the years. And last year {model.baby_he_she} even went to prom with someone. This year {model.baby_he_she} went to a movie with someone in the fall and dated someone else for long enough to buy them a birthday present, but it didn’t last.

You aren’t totally naïve about technology, after all you have a phone and you know how to use it. And you know that kids start dating in high school. {model.babyName} even went to prom last year with someone. And you’ve talked to {model.babyName} about which apps {model.baby_he_she}’s downloaded and how much data {model.baby_he_she}’s using. You’ve even heard about those kids who have apps disguised as other apps so they can send explicit photos. Still, you were surprised to look over {model.babyName}’s shoulder while {model.baby_he_she} was eating cereal before school and see {model.baby_him_her} looking at someone’s behind on Snapchat.

You’re a little worried because {model.babyName} is in {model.baby_his_her} junior year of high school and while {model.baby_he_she} goes out from time to time with big groups of kids, {model.baby_he_she} has never been out on a date. Junior prom is coming up and you don’t think {model.baby_he_she} has a chance of pairing off. Instead, {model.baby_his_her} room is filled with posters of various celebrities you have only the briefest familiarity with. And {model.baby_he_she} seems to have a crush on a senior—or so you heard from one of {model.baby_his_her} friends. But nothing serious.

Explain

As children grow up and their social network becomes more important to them, adolescents begin to become interested in romance and intimate relationships. By the time they are 18, most adolescents have been in at least one romantic relationship—and many have also had sexual relationships.

As with so much else in development, scientists have tried to discern a pattern in these changing relationships. With the strong caveat that much with relationships is influenced by a child’s community—they have established some stages that seem to be predictable in a wide variety of social contexts.

The original stages were described by the sociologist Dexter Dunphy in the early 1960s based on his observations of kids in Sydney, Australia. He set out 5 stages of peer development:

• Stage One: Small groups, cliques, of same-sex kids that don’t have very much interaction between cliques.
• Stage Two: Small cliques of same-sex kids that interact together in the beginnings of what Dunphy called the crowd.
• Stage Three: Transition period. Popular kids begin to form boy-girl cliques while less-popular kids remain in same-sex cliques.
• Stage Four: Boy-girl cliques or groups that associate with other boy-girl cliques in a crowd.
• Stage Five: The beginning of the end of the crowd as cliques begin to break down as stable, intimate relationships between pairs.

Other developmentalists have developed upon Dunphy’s original ideas and updated them into a stage theory of romantic relationships in adolescence. They suggest the following typical sequence.

• Stage one: Early adolescents move around in large groups, which can be boy-girl or same-sex.
• Stage two: Crushes. Adolescents have, sometimes intense, fantasy and imaginary relationships or obsessions—which can be with celebrities or peers.
• Stage three: The Status relationship. Early relationships tend to be mostly for show—as a way of showing other peers that you have the maturity and sophistication to be in a relationship—but the relationship itself lacks closeness and the couple spends little time together.
• Stage four: Exclusive relationships. Later in adolescence, more mature exclusive relationships begin to last longer and show some of the hallmarks of quality relationships including mutual support, emotional intimacy and shared interests.

Research seems to indicate that relationships can be helpful for some adolescents. Adolescents who are otherwise doing well—who have supportive relationships with their parents and peers—tend to have positive intimate relationships during adolescence and these positive teen relationships tend to lead to increased likelihood of marriage and cohabitation in young adulthood. These are teens with good social skills who tend to expand their social skills in developing new, closer relationships in late adolescence.

However, romance isn’t always a good thing. Particularly for young adolescents, romance can be risky. Teens who have romantic relationships in early adolescence tend to be more troubled than those who begin relationships later on. And these relationships don’t tend to make their lives better. Typically romantic and sexual relationships early in adolescence tends to be tied to a constellation of challenges including alcohol and substance abuse, troubles in school, and mental health problems like depression, anxiety and conduct disorders. Some of these relationships can even be violent.

There are significant cultural variations in dating during adolescence. Some communities, endorse sexual abstinence until marriage and advocate delaying any intimate relationships until marriage. Other communities endorse later initiation of romantic activity. Asian-American adolescents tend to have lower rates of romantic relationships in adolescence. Gay and lesbian teens tend to have their first serious relationships later in than heterosexual adolescents—partially because there are fewer possible partners available.

Amidst all this however are some of the peer and relationship trends that can be particularly alarming to teachers and parents: things like hooking up and sexting. Survey reports seem to indicate that at all stages of adolescence, some teenagers are having sex—sometimes within and often without of a committed “exclusive” relationship. And we also know that adolescents are sharing intimate photographs of themselves absent any kind of mutual friendship or relationships.

Rates of sexting seem to vary depending on the type of survey conducted, but it seems that between one in three and one in five teens have participated—either by viewing or sending—explicit photographs of themselves—either as a prelude to a sexual relationship, a part of an exclusive romantic relationship or as part of a heterosexual peer group. These photographs are seen to be particularly destructive if they are used as part of online bullying or online blackmail. However, some young women report that they find it empowering to be able to pose and share their images with others. And reports vary as to whether texting is connected with promiscuity. Many teens don’t seem to take sexting as seriously as adults, with many reporting in surveys that the naked pictures are just “a joke”. Parents seem to have limited ability to prevent their kids from sexting—but as with other aspects of adolescence—the recommendation is to monitor what children are doing and remind them that even “funny” photos may be hurtful or damaging to peers. And a reminder to those teens who are sharing their pictures: If you don’t want the pictures to have currency, make sure that your image is not recognizable. Take a photo of yourself against a blank background and don’t include your face (or anything people might notice later—like a tattoo or a scar).

About half of sexually active teenagers are having sex or have had sex with partners they are not exclusively dating. These casual sexual relationships, or hook-ups, are sometimes thought to be substitutes or preludes to more serious romantic relationships. At other times, they are thought to be separate, sexual encounters between peers. These more casual relationships, while common, are thought to be part of a pattern of riskier romantic relationships than more exclusive, committed sexual contacts.

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Look Inside

Teenagers may not always appreciate their parents—but the job of adults doesn’t end when their children become teenagers. Parenting bigger kids is different from parenting small children—but is just as important. This brief video clip reviews the challenges and benefits of parenting adolescents.

Explain

Teenagers spend almost half their time on their own—not at school. There is great variability in what kids are doing with this time. Some spend hours on schoolwork. Others spend late nights working or sweaty weekends practicing sports. And others are at home—taking care of siblings and helping their families. Is all this time on their own a good thing or a bad thing? Are adolescents better off staying busy or should they have some leisure time?

Like so much else in development, much depends on the child and much depends on the context. For some kids—like a highly motivated child from a stable family, coming home and spending a few hours without adults in the house might be a great time to do homework, take care of a younger sibling and even get dinner started before grown-ups get back from work. But for a less conscientious child from a more chaotic household, those under-supervised hours might be a time to get into trouble.

Organized activities tend to be good for kids—particularly if they are academic. It is probably not surprising that being in the Math Club or the Science Team are good for kids’ academic performance—they are able to make deeper relationships with teachers and develop skills that are good for school and work success. But in general organized after school activities—whether basketball or drawing classes—seem to help kids by teaching them both practical skills and interpersonal skills. However, some organized activities—particularly aggressive sports (like wrestling) or very competitive sports (like league soccer) can be both stressful for kids and associated with increases in risky behaviors from substance abuse to violence. In general, however, kids seem to benefit from the new relationships with adults like coaches or other mentors, the new skills they are learning, and the opportunity for a moment to participate in something important—whether that is a great game or a winning entry in the talent show.

In general, kids like working. It allows them the freedom to pay for their own phones, buy music and outfits and go out when they want to. Most teenagers like the autonomy even though they may not love the dreariness of the typical entry-level work they do. Most adolescents are employed in food service or retail. However, when teenagers spend too much time working—more than 20 hours a week—during the school year, their academic work tends to suffer and these kids end up at more risk for dangerous behaviors like substance abuse, law-breaking and unsafe sex. About 40% of high school sophomores are working—but almost seventy-five percent of high school seniors are working part time during the school year. (Although almost 10% of these seniors are working more than 30 hours a week—which isn’t really part time at all.) Experts advice that some limited work may be a good idea for teenagers—but not if it comes at the expense of more educational and inspiring activities that may teach kids skills, offer mentoring opportunities that can help set them up for a more successful future.

In many families kids spend time helping out around the house. For a few kids, this is formal work—like working in a family restaurant or working on a farm. For many others it includes taking care of younger siblings, straightening up, or doing chores around the house. While some teenagers feel overburdened by what they need to do to help out, according to recent research, helping out makes many kids feel good about themselves and connected to their families.

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Learn More

Look Inside

What do we know about why teenagers like to take risks and try new things? What is safe and what is dangerous? What is driven by their changing brain and what is caused by the world around them. Two video clips help us understand the context for adolescent risk-taking.

You never thought you’d have to worry about {model.babyName} getting into trouble. {model.baby_He_She_cap} has been such an easy kid. But last Friday night, you were shocked to get a call from the local police station. Apparently {model.baby_he_she} was caught with some friends spray painting the neighborhood playground. {model.baby_He_She_cap} says {model.baby_he_she} doesn’t know what {model.baby_he_she} was thinking. {model.baby_He_She_cap}’s never done anything like this.

You never thought you’d have to worry about {model.babyName} getting into trouble. {model.baby_He_She_cap} has been such an easy kid. But last week you got a call from the principal’s office. Apparently {model.baby_he_she} was caught writing graffiti in the bathroom stalls. They showed you a picture and it is clearly {model.baby_his_her} handwriting. {model.baby_He_She_cap} says {model.baby_he_she} doesn’t know what {model.baby_he_she} was thinking. {model.baby_He_She_cap}’s never done anything like this.

Your 17-year-old has now received three speeding tickets. {model.baby_His_Her_cap} most recent ticket is for reckless driving and {model.baby_his_her} license was suspended for driving with other teenagers in your car without your permission. {model.baby_He_She_cap} is going to have to go to court to explain what happened. You are concerned that all the help you’ve tried to get {model.baby_him_her} isn’t working.

Your 17-year-old was kicked off the high school {model.ADO17_activity} and suspended for a week after being caught with alcohol. You are frustrated. You are concerned that all the help you’ve tried to get {model.baby_him_her} isn’t working.

Last week, {model.babyName} was caught with marijuana on school property and was arrested. Luckily, {model.baby_he_she} hasn’t turned 18 quite yet, so {model.baby_his_her} case will be handled by the Juvenile Court. But {model.baby_he_she} had to spend the night in jail with adults and {model.baby_he_she} was terrified. It is a week later and {model.baby_he_she} is still not home yet.

Explain

In many communities, rule-breaking and some mostly petty criminal behavior is typical of adolescents and in fact a majority of adolescents report this type of behavior. Whether it is underage drinking, some vandalism in groups, or drug use, adolescents are more likely than any other age group to break the law. As you’ll see in the figures below, adolescents are at risk not only for arrest—but also to be the victims of crime.

However, for the vast majority of adolescents—this adolescent rule-breaking, even if it is quite significant, does not lead to a life time of crime. Most adolescent rule-breakers stop breaking the law by the time they are in their mid-twenties. One of the concerns, however, for many adolescents is that their rule-breaking may not just hurt other people or property—but may hurt themselves. Adolescents’ rule-breaking behavior can easily cascade into being suspended from school, being arrested, or any other behaviors that could be difficult to recover from in adulthood.

A few of us, however, end up with a lifetime of challenges with criminal behavior. Typically these are children who had trouble managing their aggressive behavior early in childhood—and their challenges were never managed or addressed.

Why are adolescents so reckless and potentially criminal? Theorists suggest that adolescents’ are at a bad intersection of impulsivity, drive for excitement and sensitivity to peer influence. In emotional, exciting moments, teenagers have trouble controlling themselves and do things, literally “without thinking.” Particularly in groups of peers, adolescents have trouble controlling themselves. Adolescents are also sensitive to group popularity—and if doing something a bit reckless grants them more popularity, they may be more prone to doing it.

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Learn More

Look Inside

Teenagers may not always appreciate their parents--but the job of adults doesn’t end when their children become teenagers. Parenting bigger kids is different from parenting small children--but is just as important. This brief video clip reviews the challenges and benefits of parenting adolescents.

Baby Avatar will load here.

{model.babyName} didn’t end up finishing high school. {model.baby_He_She_cap} ended up dropping out after eleventh grade and is now looking for a job working in retail. You are hoping that {model.baby_he_she} will sign up for classes to finish {model.baby_his_her} GED soon. {model.ADOcap_interest_phrase}

{model.babyName} didn’t end up in college this year. {model.baby_He_She_cap} graduated on time, which was a relief, and is now working in retail. You are hoping that {model.baby_he_she} will sign up for some classes at the community college soon. {model.ADOcap_interest_phrase}

{model.babyName} ended up signing up for classes at the local community college, {model.ADOcap_CCname}. {model.ADOcap_CCremediation}

{model.babyName} ended up enrolling in {model.ADOcap_4yname}. {model.ADOcap_CCremediation}

{model.babyName} ended up enrolling in {model.ADOcap_4yname} and is so excited. {model.baby_He_She_cap} is excited about getting out of high school and maybe pursuing a career in {model.ADOcap_interest}.

{model.babyName} enlisted in the {model.ADOcap_military_branch}. {model.baby_He_She_cap} started boot camp over the summer and is stationed far from home. You’re nervous about whether {model.baby_he_she} will end up serving in Iraq or Afghanistan, but for now {model.baby_he_she} is stationed in California, so things seem okay. {model.baby_He_She_cap} is excited about the opportunities {model.baby_he_she} will have—and the adventures that will be to come.

This weekend, {model.babyName} let you know that {model.baby_he_she} has started dating someone recently. They’ve been together for about 6 months. {model.baby_He_She_cap} sounds really happy about {model.ADO12_romantic_partner_name}. {model.ADOcap_dating_ph1}

{model.babyName} isn’t currently in a relationship. {model.baby_He_She_cap} says that {model.baby_he_she} hasn’t found the right person yet. And you are kind of relieved that {model.baby_he_she} is waiting until {model.baby_he_she} finds the perfect person. {model.baby_He_She_cap} has so much going on already without worrying too much about romance. After all {model.baby_he_she} is only 19! {model.ADOcap_dating_ph2}

You still try and keep on top of what is going on in {model.babyName}’s personal life, since you know that {model.baby_he_she} has been “hooking up” for some time—but {model.baby_he_she} is still not in a steady relationship. You hope that someday {model.baby_he_she} will find a special person. But you aren’t sure how to make that happen—particularly now that {model.baby_he_she} is living so much more independently.

{model.babyName} has had a number of {model.ADO12_has_boyfriend_or_girlfriend}s over the past years. A few have lasted a few months and there was a sweet one who {model.ADOcap_sweet}. But none of them has worked out for the long term, which seems to be pretty typical for other teenagers you know. {model.babyName} is hoping to find someone special this year—but {model.baby_he_she} already has so much going on without worrying too much about finding the right person.

You may be shocked to read this, but {model.babyName} and {model.ADO12_romantic_partner_name} got married this year. Fewer than two percent of 19-year-olds get married in the United States, but {model.babyName} says that she is one of the lucky ones. She’s sure {model.ADO12_romantic_partner_name} is “the one” and she’s already talking about having a baby.

And beyond romance, {model.babyName} seems to continue to have friends—and be able to make new ones {model.ADOcap_where}.

And beyond romance, {model.babyName} seems to continue to have trouble finding the right friends. You’re hoping that now that {model.baby_he_she} has a fresh start after high school, that the right niche may come.

{model.babyName} is still in good health—and you just hope that {model.baby_he_she} keeps eating healthy now that {model.baby_he_she} is off on {model.baby_his_her} own.

{model.babyName} is still struggling with {model.ADOcap_health_issue_string}.

You’re hoping that as {model.baby_he_she} grows up, you’ll be able to work together to get the help {model.baby_he_she} needs to get healthier in adulthood.

Who we end up to be is an unpredictable combination of where we start and what happens to us as we grow. {model.babyName} started life with some special talents. Did you ever notice that {model.baby_he_she} was especially good at being {model.ADOcap_special_talent_list}? {model.ADOcap_bad_context_phrase} {model.ADOcap_good_context_phrase} {model.ADOcap_risk_factors_phrase}

Who we end up to be is an unpredictable combination of where we start and what happens to us as we grow. {model.ADOcap_bad_context_phrase} {model.ADOcap_good_context_phrase} {model.ADOcap_risk_factors_phrase}

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Video: 11 to 14 Years of Age: The Female Journey

This clip shows the changes girls go through as they approach and experience puberty. A pair of identical twin girls are profiled as they age from eleven to fourteen. The clip demonstrates their expectations and apprehensions about puberty, and then shows the girls go through emotional and physical changes, including hormonal changes as they go to a new school, become interested in boys, develop breasts, and begin to menstruate. The clip also shows illustrations of what is happening inside their bodies during this time.

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Isabelle Caro explains her experience suffering from anorexia and her decision to participate in a campaign against the disease where a photograph of her naked was displayed on billboards. She explains that she realized that the disease was deadly after being in a coma. She also explains why she paints freckles on her face, to draw attention to her eyes instead of the rest of her body.

Video: Adolescence: Interview with Anne Petersen

In this interview, Anne Petersen, an expert on adolescent behavior, describes the role of parents and community in helping children navigate through adolescence.

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In this clip, Michael Lewis, a researcher of the psychosocial development of schoolchildren and adolescents, talks about body image in male and female adolescents and how it relates to interactions with peers and sexual activity.

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Video: College Binge Drinking

The number one health threat to college students is binge drinking. One third of all college students binge drink and do so in order to get drunk. College students from Michigan State University explain why they binge drink: peer pressure from friends, the atmosphere of the college campus, and the desire to experiment with alcohol. The video goes on to explain the death of a college student as a result of alcohol poisoning.

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This clip demonstrates an experiment at Harvard Medical School into whether adolescents can recognize the emotions expressed by others while the adolescents are viewing photographs of easily identifiable facial expressions. The experimenters find that adolescents are not able to effectively empathize with or recognize emotions in others. Moreover, fMRI findings indicate that the adolescents, while appearing fully formed, do not yet have fully functioning frontal brain regions—regions that control planning, insight, and judgment. This may help account for their poor empathy skills.

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Scientific American Article: Less Sleep Means More Stress for Teens

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Scientific American Article: Less Sleep Means More Stress for Teens

Teens stay up late at night and sleep late into the morning, a result of a natural shift in their circadian rhythms. That biological schedule puts them at odds with the adult world, as well as early start times for high school.

December 10, 2014

By Mark Fischett

Teens stay up late at night and sleep late into the morning, a result of a natural shift in their circadian rhythms. That biological schedule puts them at odds with the adult world, as well as early start times for high school. But does the mismatch cut down on how much they actually sleep, and does that affect how stressed they feel? Data from Sleep Cycle reveals some intriguing insights: Teens who live in states that have early school start times get less shut-eye than those who live in states with later start times, and the short snoozers report greater levels of stress than those who sleep even just a little longer. Overall, by the way, American teens sleep less than those in Europe, but more than those in South Korea and Japan.

Sleep Cycle is a company that makes a smart-phone app by the same name. When a phone is placed on a bed, the app records a person’s movements during the night, using the phone’s accelerometer. The movements are a proxy for when the individual is in light sleep, deep sleep or REM sleep (the dream state). The app tracks the sleep cycles and adjusts an alarm to wake the person in the morning when he or she is in the lightest sleep, which some scientists think helps people feel more rested, compared with being woken up during deep sleep.

Of course, the app records when people go to bed and rise, and users can enter comments, such as how stressful their day was. When Sleep Cycle asked teens ages 14 to 19 if they would voluntarily share data about their sleep patterns, 63,234 said yes.

The results back up sleep researchers, biologists and social scientists who say high school should start later in the morning, allowing teens to get more sleep. Here are some data, sent to me by Amanda Parmer at Sleep Cycle:

• Across all 50 states, the average bedtime for teenagers is 11:38 p.m.; the earliest average is 11:15 p.m. in Wyoming. Teens in Washington, D.C., have the latest bedtime at 12:08 a.m.
• In U.S. states where districts start high school earlier than 8:00 a.m., teenagers are sleeping less. For instance, teenagers in New Jersey, Georgia, Tennessee, Arizona and Louisiana get between 6 hours, 52 minutes and 6 hours, 56 minutes of sleep a night, 12 to 16 minutes less than the national average of 7 hours, 8 minutes.
• In states with later school start times (after 8:30 a.m.), teenagers are getting more sleep than the national average. For instance, teenagers in Minnesota, New Mexico and Iowa get between 7 hours, 11 minutes and 7 hours, 18 minutes.
• West Virginia teens spend the least time in bed; at 6 hours, 47 minutes, they sleep 21 minutes less than the national average. They are also the most stressed out of teens in all states.
• Louisiana teens sleep 12 minutes less than the national average and hold the number two spot for the most stressed.
• Vermont teens hold the number 2 spot for most time in bed, at 7 hours, 23 minutes—15 minutes more than the national average. They have the third latest wake-up time, at 7:10 a.m., and they are the least stressed nationwide.
• American teenagers, at an average of 7 hours, 8 minutes, get less sleep than their counterparts in Europe (an average of 7 hours, 38 minutes in the U.K., for example), where secondary schools start much later. But teenagers in South Korea and Japan get an hour and 20 minutes less sleep than American teens, with an average of 5 hours, 47 minutes.

I wonder how stressed those teens are.

It’s worth noting that other apps and gadgets such as Fitbit also track certain aspects of sleep. And if you like gadgets, check out our holiday gadget guide.

Reproduced with permission. Copyright © (2014) Scientific American, a division of Nature America, Inc. All rights reserved.

Scientific American Article: Early Puberty: Causes and Effects

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Scientific American Article: Early Puberty: Causes and Effects

Increases in obesity appear to be the major culprit, but family stress and exposure to chemicals may also play a role

May 1, 2015

By Dina Fine Maron

For the past two decades scientists have been trying to unravel a mystery in young girls. Breast development, typical of 11-year-olds a generation ago, is now occurring in more seven-year-olds and, rarely, even in three-year-olds. That precocious development, scientists fear, may increase their risk for cancer or other illnesses later in life. Time has not resolved the puzzle. Nor is there any indication that this trend is slowing. More and more families are finding themselves in the strange position of juggling stuffed animals and puberty talks with their first and second graders.

Obesity appears to be the major factor sending girls into these unchartered waters. The rate of obesity has more than doubled in children over the past 30 years. And whereas only 7 percent of children aged six to 11 were obese in 1980, nearly 18 percent were obese in 2012. The latest studies, however, suggest that weight gain does not explain everything. Family stress and chemical exposures in the environment may also play a role, but the data do not yet paint a very clear picture of their contribution. As for boys, the data are murkier, but one 2012 study did suggest that they, too, may be starting puberty earlier than before—perhaps by as much as six months to two years.

Clinicians say that slightly early development of breasts is likely not physically harmful and so does not require medical or pharmaceutical therapy for most girls. (Among the few exceptions are pituitary disorders.) The psychological effects, though, are another matter that warrants more attention from schools and parents; early puberty seems to augment the risk of depression and to promote substance abuse and early initiation of sexual intercourse.

Obesity's role

Precocious development was first thrust into the spotlight in 1997, when a landmark U.S. study declared that at least 5 percent of white and 15 percent of black girls had started to develop breasts by age seven—much earlier than expected. “That finding evoked a lot of passion,” says Paul B. Kaplowitz, a pediatric endocrinologist at Children's National Health System in Washington, D.C. Moreover, the 1997 work found that the trend toward early development was not happening only in outliers. Puberty was happening earlier in most girls and again differed by race: instead of age 11, the typical age of breast development by the early 1990s was 8.87 years in African-Americans and 9.96 in white girls, researchers found. Other studies soon reached similar conclusions in Europe as well as the U.S. According to the most recent U.S. data (from 2013), 23 percent of black girls, 15 percent of Hispanic girls and 10 percent of white girls have started to develop breasts by the age of seven. Those findings suggest the proportion of girls with significantly earlier breast development may still be ticking upward.

From a biological point of view, whether puberty begins early or late, it still starts in the brain. Something cues the brain to produce a substance called gonadotropin-releasing hormone, or GnRH. This process activates the pituitary gland, which then signals the ovaries to produce estrogen, which in turn stimulates the breasts to grow and puberty to begin. (Pubic hair forms as the result of a different biological process.) Menstruation usually begins a few years later. Focusing too much on the latter meant researchers tended to overlook the breast trend.

The ovaries are not the only place in the body where estrogen is produced, however. Fat cells manufacture the hormone as well. Thus, with obesity levels on the rise around the world, it is not surprising that earlier puberty would result. Although girls' breasts are developing earlier than before, the age at which they start to menstruate—and at which ovaries start pumping out large amounts of estrogen on a regular basis—has advanced by about only three months compared with decades past. As a result, puberty not only begins earlier but lasts longer than before.

The most obvious physical consequence of early puberty is a prolonged exposure to estrogen. Although excessive amounts of the hormone appear to increase the risk of developing breast cancer, no data so far indicate that starting one's period a few months earlier than the previous norm exposes a girl to enough extra estrogen to cause a health problem. The potential effect probably is minimal, researchers say—particularly when weighed against myriad other factors—such as genetics, alcohol consumption and exercise—that also affect cancer risk. The much smaller exposure to estrogen that occurs in conjunction with early breast development has not yet been definitively studied.

Against that backdrop, many experts now believe parents should focus on the psychosocial consequences of early puberty rather than the potential physical risks. Frank M. Biro of Cincinnati Children's Hospital Medical Center has spent his career studying puberty. He is also the father of three children. In his estimation, one of the biggest issues with early puberty is social well-being. “We interact with girls as they appear,” Biro says. “People relate to an early-maturing girl as if she is older than she is, but there is really no correlation between age of onset of puberty and one's social or emotional maturation.” The result can be incredibly confusing for girls—who may face sexual innuendo or teasing long before they (or their parents) are ready for it.

Beyond obesity

Although researchers agree that obesity plays the central role in the earlier development of puberty, there is evidence implicating other factors as well. Lise Aksglaede and her colleagues at Rigshospitalet in Copenhagen followed more than 2,000 girls and discovered that although heavier individuals were indeed entering puberty earlier, a similar—if slightly less pronounced—trend also existed among normal-weight girls. In a 2009 study published in Pediatrics, they concluded that the increases in body mass index (a standard measure of weight in relation to height) between 1991 and 2006 were simply not large enough to account for girls' breast development dropping by a year during that period. “In my view, this is the best study that suggests it may not all be body fat and that there's something else here,” Kaplowitz says.

What might that something else include? Researchers have long suspected that exposure to certain compounds known as endocrine disruptors might have a part in triggering early puberty. These substances, among them pesticides, polychlorinated biphenyls and bisphenol A, mimic the effects of estrogen in the body—and so could potentially stimulate early breast growth. Discerning how much of an influence exposure to these chemicals might play is complicated, however, by the obesity epidemic. Because the body often stores chemicals in fat cells, an overweight girl is more likely to be exposed to more chemicals—making it difficult to apportion blame between endocrine disruptors and weight gain. Other investigators have implicated intense stresses in childhood, such as sometimes occurs with the absence of the biological father in the home or if a child is sensitive to conflict around her, as possible causes of earlier puberty—although the biological mechanism of action is not known. What is evident is that there is a symphony of moving parts to make puberty happen instead of a solo actor.

What to do?

Girls are not hapless creatures, of course, buffeted by the winds of change without any control over their actions. Regular physical activity may prove beneficial to help counteract at least some of the trend toward early puberty by improving mood and combating weight gain. Helping daughters to maintain a healthy diet rich in fruits and vegetables may also offer some protection, psychologist Julianna Deardorff and pediatric endocrinologist Louise Greenspan write in their new book, The New Puberty: How to Navigate Early Development in Today's Girls.

One thing mothers can do to try to avoid the problem in the first place is to breast-feed their children. Children who are breast-fed appear to be less likely to enter puberty early, although the reasons are still unclear. A 2015 study that tracked some 1,200 girls and their mothers' breast-feeding habits found that breast-feeding—and longer duration of breast-feeding—correlated with later onset of breast development in daughters in some populations. Parents and communities can also help protect girls from the painful psychological effects of early development. One way, Deardorff says, is preparing girls for puberty by talking about developmental changes in a positive, nonstigmatizing way. Living in a homogeneous neighborhood may also be helpful: early-maturing fifth graders of Mexican descent showed fewer symptoms of depression by seventh grade when they lived in Hispanic neighborhoods compared with similar girls living in more diverse neighborhoods, according to another study. It is unclear, however, why homogeneity may have helped.

Regardless of where girls live, they could well benefit from a change in school curriculums. Schools typically do not offer sexual education classes covering body maturation until fifth grade, when most children are around age 10 or 11. Puberty education should start earlier, Deardorff and Greenspan believe, with age-appropriate materials beginning in the first semester of fourth grade to more closely conform with present reality.

Identifying the triggers that push individual girls into early puberty remains a challenge that leaves parents short of a simple action plan. As Marcia E. Herman-Giddens, lead author of the watershed 1997 early puberty paper, says, “People always want to know the reason, but I don't think people will ever be able to sort out the reason or the fix. It's a lot of things interacting together, and they have different effects on different individuals.”

It remains to be seen if the early puberty trends will continue. “You would think at some point you would hit a biologic minimum, but I don't know when that is or when it would be,” Biro says. Will every girl start maturing earlier? If obesity trends reverse course, will puberty begin later? As researchers look for answers, it is clear that parents and doctors alike need to be aware of the changes happening right now.

Reproduced with permission. Copyright © (2015) Scientific American, a division of Nature America, Inc. All rights reserved.

Scientific American Article: How to Turn Around Troubled Teens

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Scientific American Article: How to Turn Around Troubled Teens

Research reveals that get-tough tactics may worsen rates of juvenile delinquency

November 1, 2014

By Scott O. Lilienfeld, Hal Arkowitz

Mike S. (not his real name) was 13 years old when one of us (Lilienfeld) met him on an inpatient psychiatric ward, where Lilienfeld was a clinical psychology intern. Mike was articulate and charming, and he radiated warmth. Yet this initial impression belied a disturbing truth. For several years Mike had been in serious trouble at school for lying, cheating and assaulting classmates. He was verbally abusive toward his biological mother, who lived alone with him. Mike tortured and even killed cats and bragged about experiencing no guilt over these actions. He was finally brought to the hospital in the mid-1980s, after he was caught trying to con railroad workers into giving him dynamite, which he intended to use to blow up his school. According to psychiatry's standard guidebook, the Diagnostic and Statistical Manual of Mental Disorders (now in its fifth edition), Mike's diagnosis was conduct disorder, a condition marked by a pattern of antisocial and perhaps criminal behavior emerging in childhood or adolescence.

Psychologists have long struggled with how to treat adolescents with conduct disorder, or juvenile delinquency, as the condition is sometimes called when it comes to the attention of the courts. Given that the annual number of juvenile court cases is about 1.2 million, these efforts are of great societal importance. One set of approaches involves “getting tough” with delinquents by exposing them to strict discipline and attempting to shock them out of future crime. These efforts are popular, in part because they quench the public's understandable thirst for law and order. Yet scientific studies indicate that these interventions are ineffective and can even backfire. Better ways to turn around troubled teens involve teaching them how to engage in positive behaviors rather than punishing them for negative ones.

You're in the Army Now

One get-tough technique is boot camp, or “shock incarceration,” a solution for troubled teens introduced in the 1980s. Modeled after military boot camps, these programs are typically supervised by a drill instructor and last from three to six months. They emphasize strict rules and swift punishments (such as repeated push-ups) for disobedience, along with a regimen of physical work and demanding exercise. According to the National Institute of Justice, 11 states operated such programs in 2009. Indeed, Mike S. was sent to a boot camp program following his discharge from the hospital.

Even so, research has yielded at best mixed support for boot camps. In a 2010 review of 69 controlled studies, criminologists Benjamin Meade and Benjamin Steiner, both then at the University of South Carolina, revealed that such programs produced little or no overall improvement in offender recidivism. For reasons that are unclear, some of them reduced rates of delinquency, but others led to higher rates. Boot camps that incorporated psychological treatments, such as substance abuse counseling or psychotherapy, seemed somewhat more effective than those that did not offer such therapies, although the number of studies was too small to draw firm conclusions.

Another method is “Scared Straight,” which became popular following an Academy Award–winning documentary (Scared Straight!), which was filmed in a New Jersey state prison in 1978. Typically these programs bring delinquents and other high-risk teens into prisons to interact with adult inmates, who talk bluntly about the harsh realities of life behind bars. Making adolescents keenly aware of prison life is supposed to deter them from criminal careers. Yet the research on these interventions is not encouraging. In a 2003 meta-analysis (quantitative review) of nine controlled studies of Scared Straight programs, criminal justice researcher Anthony Petrosino, now at the research agency WestEd, and his colleagues showed that these treatments backfired, boosting the odds of offending by 60 to 70 percent.

The verdict for other get-tough interventions, such as juvenile transfer laws, which allow teens who commit especially heinous offenses to be tried as adults, is no more promising. In a 2010 summary, psychologist Richard Redding of Chapman University found higher recidivism rates among transferred adolescent offenders than among nontransferred ones.

Perils of Punishment

Psychologists do not know for sure why get-tough treatments are ineffective and potentially harmful, but the psychological literature holds several clues. First, researchers have long found that punishment-based strategies tend to be less effective than reward-based strategies for lasting behavioral change, in part because they teach people what not to do but not what to do. Second, studies indicate that highly confrontational therapeutic approaches are rarely effective in the long term. For example, in a 1993 controlled trial psychologist William Miller of the University of New Mexico and his colleagues found that counselors who used confrontational styles with problem drinkers—for example, by taking them to task for minimizing the extent of their drinking problem—had significantly less success in helping their clients overcome their addictions than did counselors who used supportive styles that relied on empathy. Similarly, a 2010 review by criminal justice researcher Paul Klenowski of Clarion University and his collaborators found that delinquency programs that involved confrontational tactics, such as berating children for misbehavior, were less effective than programs that did not use them.

What is more, adolescents with conduct disorder often enter treatment angry and alienated, harboring feelings of resentment toward authority. Get-tough programs may fuel these emotions, boosting teens' propensity to rebel against parents and teachers. Finally, some programs may inadvertently provide adolescents with role models for bad behavior. For example, some of the at-risk teens exposed to prisoners in Scared Straight programs may perceive them as cool and worth emulating.

These results show that merely imposing harsh discipline on young offenders or frightening them is unlikely to help them refrain from problematic behavior. Instead teens must learn enduring tools— including better social skills, ways to communicate with parents and peers, and anger management techniques—that help them avoid future aggression. Several effective interventions do just that, including cognitive-behavior therapy, a method intended to change maladaptive thinking patterns and behaviors, and multisystemic therapy, in which parents, schools and communities develop programs to reinforce positive behaviors. Another well-supported method, aimed at improving behavior in at-risk children younger than eight years, is parent-child interaction therapy. Parents are coached by therapists in real time to respond to a child's behavior in ways that strengthen the parent-child bond and provide incentives for cooperation [see “">Behave!” by Ingrid Wickelgren; Scientific American Mind, March/April 2014].

The negative data on get-tough programs remind us that we should be wary of our subjective impressions of strategies that simply seem right or that we feel ought to work. Although we lost track of Mike S., we now know that a concerted effort to teach him more adaptive behaviors would have been more likely to put him on a productive path than would any attempt to scare him straight.

Reproduced with permission. Copyright © (2014) Scientific American, a division of Nature America, Inc. All rights reserved.

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