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