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Practical Advice for Parents Teens

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   Contents
            details
  Alcohol . . . . . . . . . . . . . . . . . . . . .2    Injuries . . . . . . . . . . . . . . . . . . . .45
  All-terrain vehicles (ATVs) . . . . . .4              Internet use . . . . . . . . . . . . . . . . .47
  Baby-sitting . . . . . . . . . . . . . . . . . .5     Lawn mower safety . . . . . . . . . . .49
  Bike safety . . . . . . . . . . . . . . . . . . .7    Nutrition . . . . . . . . . . . . . . . . . . .50
  Birth control . . . . . . . . . . . . . . . . .8      Parenting resources . . . . . . . . . . .54
  Bullying . . . . . . . . . . . . . . . . . . . .10    Peers . . . . . . . . . . . . . . . . . . . . . .56
  Career planning . . . . . . . . . . . . .12           Pregnancy . . . . . . . . . . . . . . . . . .57
  Clothing fads . . . . . . . . . . . . . . . .14       Puberty . . . . . . . . . . . . . . . . . . . .59
  Conflict . . . . . . . . . . . . . . . . . . . .15    Rape . . . . . . . . . . . . . . . . . . . . . .61
  Curfews . . . . . . . . . . . . . . . . . . . .16     Religious issues . . . . . . . . . . . . . .62
  Dating . . . . . . . . . . . . . . . . . . . . .17    Risky behavior . . . . . . . . . . . . . . .63
  Death and dying . . . . . . . . . . . . .18           School issues . . . . . . . . . . . . . . . .64
  Dental care . . . . . . . . . . . . . . . . .20       Self-esteem . . . . . . . . . . . . . . . . .65
  Divorce . . . . . . . . . . . . . . . . . . . .22     Sexuality . . . . . . . . . . . . . . . . . . .66
  Driving . . . . . . . . . . . . . . . . . . . .24     Sexually transmitted
  Drugs . . . . . . . . . . . . . . . . . . . . . .26     infections . . . . . . . . . . . . . . . . .67
  Eating disorders . . . . . . . . . . . . .29          Skin problems . . . . . . . . . . . . . . .71
  Employment . . . . . . . . . . . . . . . .31          Sleep . . . . . . . . . . . . . . . . . . . . . .72
  Extracurricular activities . . . . . . .32            Sports . . . . . . . . . . . . . . . . . . . . .74
  Eye care . . . . . . . . . . . . . . . . . . .33      Suicide . . . . . . . . . . . . . . . . . . . .77
  Eye emergencies . . . . . . . . . . . . .34           Summer activities . . . . . . . . . . . .79
  Family relationships . . . . . . . . . .35            Telephone usage . . . . . . . . . . . . .81
  Family time . . . . . . . . . . . . . . . . .36       Tobacco . . . . . . . . . . . . . . . . . . . .83
  Firearm safety . . . . . . . . . . . . . . .37        Violence . . . . . . . . . . . . . . . . . . .84
  Gangs . . . . . . . . . . . . . . . . . . . . .38     Water safety . . . . . . . . . . . . . . . .85
  Health care . . . . . . . . . . . . . . . . .40       Winter safety . . . . . . . . . . . . . . . .86
  Home alone . . . . . . . . . . . . . . . .42          Additional resources . . . . . . . . . .88
  Immunizations . . . . . . . . . . . . . . .44




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   Alcohol details
  In America, alcohol is the only mind-altering drug sold
  widely and legally, without a prescription. Yet for people   Consider your
  younger than 21, alcohol is as illegal as any street drug.
  Teenagers in Wisconsin can lose their driver’s licenses
                                                               own behavior.
  by being caught drinking any amount of alcohol.              Some parents
  Despite the laws, teens are drinking more than ever.         choose to give
  It is estimated that more than half of the 20.7 million      up or limit
  junior and senior high school students in the United         alcohol to
  States drink alcohol. In a recent survey, 27 percent of      provide a
  high school seniors reported binge drinking (five or
                                                               better example
  more drinks in a row) during the month before the
  survey was taken. Every year, 8,000 adolescents die          to their teens.
  in alcohol-related motor vehicle accidents. Another
  45,000 are injured.




                                            2
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   Alcohol details
  Alcohol is too big of an issue to avoid in parent/teen discussions. A good way to
  diffuse some of the danger is to talk in advance and set some clear guidelines on
  alcohol use. As a start, consider the following ideas:
  • Share your feelings clearly and early. Most parents expect teens to obey the law
    and not drink prior to age 21. The sooner you say this the better, since use at
    a younger age makes problem drinking more likely.
  • Consider your own behavior. Some parents choose to give up or limit alcohol
    to serve as a better example to their teens.
  • Allowing teens to drink in your home makes you legally responsible for
    anything that happens.
  • Act out potential situations together. If a teen is offered a drink, what are ways
    to gracefully refuse a drink or an invitation to a drinking party? What could be
    said to a friend who wants to drive drunk?
  • Insist on responsibility when teens gather. Find out whether an adult will
    chaperone teen parties and who will attend. Consider keeping your teen away
    if known alcohol abusers are involved or if the party will have no adult
    supervision. It is a good idea to discuss the party with the adults who will be
    attending to find out their attitude toward drinking.
  • Stress safety if your teen does drink. Offer a ride home, no questions asked,
    if your teen calls.
  • Caution your teen about dangers, such as date rape, which often are associated
    with alcohol. Tell your teen to never leave a drink, even a non-alcoholic drink,
    unattended.
  • Before a drinking incident happens, make clear any punishments you choose
    for alcohol use.
  • Make certain your teen is aware of school rules. Many schools don’t allow
    teens who have been caught drinking to participate in sports.
  • Watch for signs of serious abuse. Look for long-term changes in mood or a
    major change in grades. If you are worried, talk to a family physician, a member
    of the clergy or a school guidance counselor.
  At some point, every teen is faced with the temptation to try alcohol. Your child’s
  ability to resist could depend on the steps you take to help today.




                                           3
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   All-terrain vehicles
                 details
  All-terrain vehicles can be fun to ride and a great way
  for teens to explore nature. They also can cause serious      Always wear
  injuries if not driven safely.
                                                                an approved
  Before your child rides an ATV you both should attend a       helmet and eye
  driver’s safety course. You always should supervise your
  teen when riding ATVs.
                                                                protection
                                                                when riding
  The American Academy of Pediatrics recommends that
  no one younger than 16 years of age drive a full-size         an ATV.
  ATV. Full-size ATVs are not built for younger children,
  and children cannot ride them safely.
  Always wear appropriate clothing and protective gear, including:
  • An approved helmet with eye protection.
  • Sturdy non-skid, closed-toe shoes or boots.
  • Long pants and a long-sleeved shirt or jacket.
  Never:
  • Carry passengers. ATVs are designed for one person.
  • Ride on roadways.
  • Ride at night.
  • Ride a three-wheeled ATV. They are unsafe and no longer are manufactured.
  • Operate an ATV under the influence of drugs or alcohol.




                                          4
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   Baby-sitting details

  Baby-sitting is a common first job. In this role, teens are responsible for their own
  safety as well as the safety of other children. Before you allow your child to
  become a baby sitter, make sure he or she has the skills, maturity and personality
  required to care for young children. The following tips will help ensure your teen
  has successful baby-sitting experiences:
  • Teach your teen that baby-sitting is a job with important responsibilities.
    Encourage your child to act in a businesslike way by being on time, dressing
    appropriately, canceling only for emergencies, charging reasonable fees and
    keeping you informed about job commitments. Talk with your teenager about
    how he or she would respond to different situations. For example, “What would
    you do if one of the children refuses to listen? What would you do if one of the
    children was hurt?”
  • Introduce your child to baby-sitting responsibilities a little at a time.
    For example, a first job might
    be playing with a preschooler
    for a short period of time
    while the parent is home
    but busy around the house.
    When your child is ready to
    baby-sit a child alone, be
    sure the first job will not be
    much longer than an hour
    and there is only one child
    to watch.
  • Be sure your child can
    handle each request. There
    is a real chance for tragedy
    whenever a sitter takes on
    more than he or she can
    control safely. Make sure you
    know how many children
    your child will be responsible
    for and their ages. Find out if
    any of the children have
    special needs or if your teen
    will have additional
    responsibilities, such as
    caring for pets.



                                           5
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   Baby-sitting details

  • Take time to discuss each baby-sitting job with your child. This should be done
    just after completing the job, before problems can be forgotten. If your child
    has had a bad experience, you may not want to allow another job with that
    family. If your child reports the job was a success, offer your praise.
  • Establish a way to help your teen in unsafe situations. If your son or daughter
    has difficulties, will he or she be able to reach you for advice or guidance? If
    your teen can’t reach you, who else (a trusted neighbor, a family friend or
    another relative) can he or she call for advice?
  • Do not let your child baby-sit for strangers. In addition, do not let your teen
    recruit baby-sitting jobs by putting fliers or posters in public places or on the
    Internet. Instead, use word-of-mouth advertising to family friends, relatives or
    your co-workers.
  • Be sure the information you need to contact your child is written down before
    your child leaves for the baby-sitting job. This includes name, address and
    phone number of the family your child will be baby-sitting for as well as the
    time the family plans to return home.
  Children’s Health Education Center offers a Successful Sitter class for children
  ages 11 to 14. Infant/child cardiopulmonary resuscitation instruction also is
  available. For information on enrolling your child in these courses, call
  (414) 765-9355 or visit www.BlueKids.org.




                                           6
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   Bike safety details

  Insisting on bicycle helmets is the most important step parents can take to keep
  children and teens who ride bicycles safe.
  Helmets reduce the risk of serious head injuries by 85 percent. Head injuries are
  the leading cause of injury-related deaths among children. Helmets and other
  protective gear also should be worn while in-line skating, skateboarding, sledding,
  skiing, ice skating or using a scooter. Make certain helmets are approved by the
  U.S. Consumer Product Safety Commission.
  Parents should buy and wear bicycle helmets as well. It is important for your
  safety and to set a good example for your teen.
  Below are some steps you can take to prevent bicycle injuries:
  • Avoid bicycles that are too large or too small. A rider should be able to straddle
    the bike and stand with both feet flat on the ground.
  • Be certain all family bicycles have effective, safe brakes.
  • Most fatal accidents occur at dusk and at night. If it is necessary to bike after
    dark, make it clear that the bicycle light must be turned on and light-colored
    clothing must be worn. Encourage your teen to wear clothing with reflective
    strips when riding after dark.
  • All bikes must have reflectors on the front and rear of the frame and on the
    wheel spokes.
  • Follow the same rules whether driving a car or riding a bicycle: obey traffic
    signs, signal turns and stops, ride with traffic on the far right side of the lane
    and ride in the bicycle lane if one is available.
  Children’s Health Education Center offers free helmet fitting events throughout
  the community. For more information, call (414) 765-9355 or visit
  www.BlueKids.org.




                                            7
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   Birth controldetails

  Many parents believe the best, most effective method of
  birth control for teens is to postpone sexual intercourse     Teens need
  until after marriage. Many American teens agree. The
  wisest choice for parents is to offer full information and
                                                                to hear their
  recognize their teen will make the decision.                  parents’
  A good time to approach the subject of birth control is       perspective. It
  in a “facts of life” parent-child talk. It is easiest to beginis OK to make
  these conversations when your child is young. The             suggestions on
  important thing, in today’s world of dangerous sexually       the wisest
  transmitted infections and unplanned pregnancies, is
                                                                course of
  that the conversation takes place. It also is important to
  take less formal opportunities to educate your teen           action.
  about birth control. Examples could include: discussing
  a pregnant/parenting teen in a TV show, whether or not the situation portrayed is
  realistic, and how that situation may have been prevented. It is important to
  always have an “open door” relationship with teens because when they feel
  comfortable talking about a variety of issues, they are more likely to talk about
  birth control and sexuality.




                                           8
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   Birth controldetails

  Consider the following when discussing birth control or contraception:
  • An atmosphere of openness between parents and teens is important. An open
    dialogue gives a teen support on important sexuality decisions. Be respectful of
    your teen’s thoughts, even when you are not in agreement.
  • Teens need to hear their parents’ perspective. It is OK to make suggestions on
    the wisest course of action and to state reasons clearly and convincingly. It may
    not seem like it at the time, but teenagers do listen to their parents.
  • Reinforce a teen’s right to say no to sexual activity. Encourage a healthy body
    image. Don’t judge. Although it is generally in the best interest of the sexually
    active teen to have a trusted adult to confide in, ideally a parent, there may be
    times when the teen may need confidential care from a doctor.
  • Clearly state the facts about birth control. Get information from your doctor or
    another health care provider.
  • Other than total abstinence from all sexual contact, no completely effective
    method of preventing sexually transmitted infections (HIV/AIDS, gonorrhea,
    chlamydia and others) exists.
  • Clearly state that birth control is a personal responsibility of both the male and
    female partner.
  • A visit to your health care provider is the best way to begin a program of birth
    control. Health care providers can suggest methods, offer cautions about side
    effects and make informational materials available, if necessary.
  Many birth control methods exist. These include:
  • Birth control pill. A hormone pill is taken daily.
  • Ortho Evra Contraceptive patch. A small patch is applied to the skin every
    week.
  • Nuva Ring. A small, flexible ring is inserted into the vagina each month.
  • Depo-Provera birth control injections. An injection is given every three months.
  • Norplant implants. Five plastic rods are placed under the skin. The implants
    last five years.
  • Intrauterine devices. These are not recommended for teens.
  • Diaphragm with spermicidal foam. Diaphragms require fitting by a health care
    provider.
  • Condoms and spermicide are recommended for use together. Spermicides
    containing nonoxynol-9 are not recommended.
  Removing the penis from the vagina before ejaculating (coitus interruptus) and
  avoiding sex when the female might be ovulating (the rhythm method) are not
  reliable methods of birth control.



                                           9
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   Bullying details
  Bullying is aggressive behavior that is intentional and
  involves an imbalance of power or strength. Typically,      Tell your teen
  it is repeated. Bullying can take many forms, such as:
  hitting or punching (physical bullying); teasing or name-
                                                              that you are
  calling (verbal bullying); intimidation through gestures    concerned and
  or social exclusion (nonverbal bullying or emotional        that you’d like
  bullying); and sending insulting messages by phone          to help. Listen
  or computer e-mail (cyber bullying). Many children,         carefully to
  particularly boys and older children, do not tell their
  parents or adults at school about being bullied. It is
                                                              your teen’s
  important that adults watch for possible signs of           worries.
  bullying.
  Possible warning signs that a teen is being bullied
  He or she:
  • Comes home with torn,
    damaged or missing pieces
    of clothing or other
    belongings.
  • Has unexplained cuts,
    bruises and scratches.
  • Has few, if any, friends
    with whom he or she
    spends time.
  • Seems afraid of going to
    school, walking to and
    from school, riding the
    school bus or taking part
    in organized activities with
    peers (such as clubs).
  • Takes a long or unusual
    route when walking to or
    from school.
  • Loses interest in school
    work, suddenly begins to
    do poorly in school or
    talks about dropping out
    of school as a solution.
  • Appears to be sad, moody, angry or depressed when he or she comes home.


                                          10
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   Bullying details
  • Complains often of headaches, stomachaches or has other physical symptoms.
  • Has trouble sleeping or has frequent bad dreams.
  • Doesn’t feel like eating.
  • Seems anxious or starts to say negative things about himself or herself.
  If your son or daughter shows any of these signs, this does not absolutely mean
  that he or she is being bullied, but it is a possibility worth exploring. Talk with
  your teen and talk with staff at school to learn more.
  Tell your teen that you are concerned and that you’d like to help. Listen carefully
  to your teen’s worries without making any judgments.
  Call or set up an appointment to talk with your teen’s teacher. He or she will
  probably be in the best position to understand the relationships between your
  child and peers at school. If you obtain information from your son or daughter
  or from school staff that leads you to believe your teen is being bullied, take
  quick action.
  Bullying can have serious effects on children.
  If you have talked with your teen and school staff and you don’t suspect your
  teen is being bullied, stay watchful for other possible problems. A number of
  the warning signs listed above may indicate other serious problems. Share your
  concerns with a counselor at your teen’s school.




                                           11
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   Career planning
               details
  Teens are faced with tough decisions as their high
  school education ends. Do they continue their                    Recognize and
  education at a university or technical school? What
  employment opportunities do they want to pursue?
                                                                   point out
  Are marriage and family immediate options?                       abilities. Note
  Success is important to most American adults.                    the things your
  Sometimes, the competitive rush for success can cloud            teen does well,
  a teenager’s thinking about education and employment             and mention
  beyond high school.                                              them in a
  Reactions to these competitive challenges tend to fall           positive light.
  between two extremes. On one hand, a young person
  may be so focused on achieving a single goal that other good alternatives are
  ignored. Other young adults lack a vision for their future and tend to “drift” into
  schools or jobs that offer the path of least resistance.




                                           12
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   Career planning
               details
  Parents can help by being a centering force. Here are some ideas to move your
  teen toward a healthy, well-rounded life.
  • Recognize and point out your teen’s abilities. Note the things your teen does
    well, and talk about these things in a positive light. This feedback helps shape
    the positive sense of self that leads to sound career choices.
  • Stress the importance of good choices. Not choosing also is a choice. Teens
    should be helped to recognize that “drifting” today may mean financial hardship
    later.
  • Be aware of interests. Suggest careers that dovetail with your teen’s natural
    talents and areas of interest. Discourage a single-minded focus on status or
    income when choosing a career path. Help your teen find out more about jobs
    that sound interesting.
  • Work with a guidance counselor. Encourage your teen to use the resources in
    the high school guidance office. Meet with the counselor yourself, if possible,
    to discuss test scores, school grades and possible educational choices.
  • Use aptitude tests. Most school guidance offices offer tests that can show the
    direction of a teen’s natural skills and interests. They cannot offer ultimate
    career answers but may suggest directions to explore.
  • Encourage your teen to become involved in community service projects or
    volunteer positions as a way to explore future career opportunities. Volunteer
    opportunities are available in many areas of Children’s Hospital and Health
    System. Placements are determined by the volunteer’s availability and the
    organization’s need. To volunteer at Children’ s Hospital of Wisconsin, a six-
    month commitment of a minimum of two hours per week is required, and
    volunteers must be at least 16 years old. Call (414) 266-2180 for more
    information about volunteering at Children’s Hospital. Volunteers also are
    needed for fundraising events in the community. Call (414) 266-6100 for
    information.
  • Share your perspective, then step back. Your opinion matters, but what matters
    most is offering the freedom to make an adult choice. A good choice here sets
    the stage for many good ones to come.




                                         13
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   Clothing fads
               details
  It is tempting, when looking at a teen in the latest
  fashion, to say, “What is the purpose of that?”                The crazy
  Most teenage dress serves a very specific purpose.             outfit that
  Clothes often reinforce a sense of belonging and fear of
                                                                 seems offensive
  being “different.” In truth, most adults are equally
  concerned about the opinions of others. This is why            today may be a
  some parents wish to limit the wild clothing choices           funny picture
  teens often make.                                              in the family
  Are battles over clothing worthwhile? Should teens dress       scrapbook
  to a parent’s standards? These questions can be                someday.
  answered only on a family-by-family basis. When setting
  a family standard for dress, here are some thoughts to consider:
  • You may wish to avoid sports clothing or expensive items that often are
    subjects of theft or may increase the risk of assault.
  • Look back into fashion history. Previous generations, including yours, had their
    own far-out fashions. Did these excesses do any long-term harm?
  • Some styles change a teen’s physical appearance permanently. Tattooing and
    body piercing are examples of physical changes that are difficult to reverse
    when fashions change and may be risks to your teen’s health. These “fashion
    statements” put your teen at risk of hepatitis B, hepatitis C and HIV infection.
    Bacteria also may infect the area before it is completely healed. See the chapter
    about dental care on Pages 20 and 21 for more information about oral piercings.
  • Think of job consequences. People with radical hair or clothing styles, tattoos
    or body piercing may have a tougher time getting work.
  • Parents may wish to limit access to clothing imprinted with messages
    contrary to their family’s values. Some schools also have rules against clothes
    with drug or sexual themes or overly revealing clothing.
  • Above all, keep a sense of perspective. The crazy outfit that seems offensive
    today may be a funny picture in the family scrapbook someday.




                                           14
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   Conflict details
  Arguing with parents is a healthy, normal part of the teenage experience. The
  security and freedom to have disagreements – even loud, heated ones – is a
  positive part of growing up. Unfortunately, some parent/child relationships get
  hurt in the process.
  The key to bearing these disagreements safely is to separate the people from the
  issue. Without this separation, arguments can quickly move from harmless
  disputes to hurtful personal attacks.
  Before arguments begin is the time to discuss the boundaries of disagreements
  between parent and teen. You may wish to begin the discussion with a list, such
  as the one below, setting out beliefs and procedures to make sure everyone’s view
  is heard and appreciated. A “no-fault” strategy is a good way to keep the lines of
  communication open.
  • Disagreements should be about issues, not people. Personal attacks put people
    on the defensive and communication breaks down.
  • Ask yourself: “Am I leaving any room for compromise?” Stubbornness on one
    side often leads to stubbornness on the other and an impasse.
  • Consider brainstorming solutions, rather than arguing absolutes. Write down
    possible solutions.
  • Give your teen the same respect reserved for a co-worker or adult friend. Are
    you saying things that could not be said in the workplace?
  • Revisit the rules periodically. As teens mature, they learn a greater ability to deal
    with parents on an adult level.
  • Do not avoid conflicts. Bringing things out into the open is healthy for all if it is
    done with respect.
  • Pick your battles. Not every conflict needs the same intensity.
  • Do not be afraid to stop a discussion if things get too heated. Cool down and
    discuss the issue another time. This may help prevent violence or an exchange
    of angry words that later may be regretted.
  • Do not argue if you or your teen are under the influence of alcohol. Sometimes
    conflict and alcohol can be a violent combination.
  • Make the best interest of the opposing family member your bottom line.




                                           15
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   Curfews details
  Most teens dislike curfews. Feelings aside, rules about
  arriving home at a reasonable hour make good sense.              Base a teen’s
  Curfews bring greater safety and help teens learn to be
  responsible.
                                                                   curfew on your
                                                                   family’s needs,
  Some tips for curfews                                            instead of the
  • Base a teen’s curfew on your family’s needs, instead of
    the curfew time in other families.
                                                                   curfew time in
  • Set a curfew time by considering past ability to stay          other families.
    within time limits. If a 10 p.m. time is not kept,
    chances are an 11 p.m. curfew also will not be obeyed.
  • Keep curfews flexible, depending on the activity involved. A time that is too late
    for a school night may be too early for prom night.
  • If a teen plans to stay the night at a friend’s home, get in touch with the friend’s
    parents to discuss your curfew expectations.
  • Some communities establish and enforce curfews for children and teenagers.
    Find out if your community has a curfew law and the consequences for
    violating the curfew.
  • Be reasonable, but firm. Remember, negotiation skills are critical in many areas
    when dealing with teens.




                                           16
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   Dating  details
  One of the biggest milestones in a child’s transition to adulthood is dating. Keep
  the following tips in mind when your teen becomes interested in dating.
  Begin by talking to other parents. Ask about rules that have worked in their
  families concerning:
  • Age to begin dating.
  • Dating older partners.
  • Single or group dating.
  • Rules about being alone in the house with boyfriends/girlfriends.
  Before your teen starts dating
  Before your teen begins dating, discuss the characteristics of good and bad dating
  choices.
  Tell your teen to look for someone who:
  • Is respectful, both toward your teen and adults.
  • Can listen respectfully.
  • Never does things that scare your teen.
  Encourage your teen to avoid dating someone who:
  • Has had a lot of former partners.
  • Doesn’t want your teen to have other friends or spend time with your family.
  If your teen is dating
  • Get to know the boyfriend/girlfriend personally. Include him or her in family
    activities. Try to meet his or her parents. Find out who his or her friends are,
    because your teen also may be spending time with these new friends.
  • Communicate any family rules to the boyfriend/girlfriend. For example, talk
    about curfews, automobile rules and other safety concerns.
  If you do not like a teen’s boyfriend/girlfriend
  • Begin by trying to understand why.
  • Do not flatly forbid relationships of which you do not approve. It seldom works
    and cuts off communication with the teen.
  • Talk to your teen about why you think the relationship is unhealthy. Be specific.
  • Make certain your child is knowledgeable about the consequences and
    responsibilities of a dating relationship. Provide information about:
    - Sexuality.
    - Pregnancy and prevention.
    - Sexually transmitted infections and prevention.
  Be prepared to deal with “broken hearts.” At any age, a broken relationship is
  difficult. But in the teen years, the emotional roller coaster makes a breakup even
  more shattering. Your teen may seek comfort and reassurance.

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   Death and dying
              details
  For most teens, normal grief is mixed with the added
  shock of experiencing the finality of death, often for the      Be honest.
  first time. This new point of view can turn the death of
  a teenage friend, even a casual friend, into a major
                                                                  Honesty is the
  event.                                                          foundation of
  It is not surprising to find that teens deal with grief in      trust and can
  some ways that are uniquely their own:                          help your
  • Teens may test their mortality by taking part in risky,       teenager build
    life-threatening actions. They also may become extra          healthy coping
    careful as their view of mortality changes with the
                                                                  skills.
    death of someone with whom they identify. Often
    teens will look for differences between themselves and
    the friend who died.
  • Withdrawing is common among grieving teens. A teen may pull away from
    family and friends and seek more time alone.
  • Guilt causes teens to play the “what if” game. They may wonder about actions
    they could have taken to prevent the death.
  What can parents do?
  • Parents would like to protect their children from pain, but with grief this cannot
    be done. Grief is a part of life that helps shape young adults. Loss may help
    them to prioritize what is important to them.
  • Watch for change in your teen – either positive or negative – as a barometer for
    your teen’s need for help.
  • Acknowledge that parents and children try to protect each other.
  • Be honest. Honesty is the foundation of trust and can help your teenager build
    healthy coping skills.
  • Offer to talk about the death. Bring emotions out into the open. Instead of
    asking your teen to talk about his or her emotions, share some of your feelings.
    This may encourage your teen to talk about his or her feelings or will help him
    or her know the feelings are normal. Help your teen realize his or her
    reactions are normal; labeling emotions (loneliness, anger, disbelief, confusion)
    helps guide the grieving process.
  • Expect a normal, short-term drop in attention and grades. If problems linger,
    consider talking with teachers or a school psychologist. Also be alert if your
    teen’s grades suddenly improve. This doesn’t often draw attention, but also can
    be a sign of his or her needs.
  • Offer outside help. Teachers, guidance counselors and clergy can help, as can
    therapists who work with grief issues.


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   Death and dying
              details
  • Recognize teenagers may want to do something as part of their grieving process.
    Examples of appropriate activities include: writing a poem about the loved one,
    planting a tree in the loved one’s honor, volunteering at an organization the
    loved one embraced and advocating for special causes related to the death. Your
    teen might be interested in joining a Students Against Drunk Driving chapter or
    other groups related to the death.
  • Give your teen opportunities to remember friends or family members who have
    died:
    - Do not shun the subject in everyday family discussions.
    - Take the family along to funerals.
    - Encourage remembrances. Leave flowers or mementos at a grave site, display
      keepsakes and remember birthdays.
  Some teenagers suffer unfairly when death comes to an immediate family
  member. The unfairness comes when teens are forced to play both child and
  adult roles in the family’s grieving process.
  • Do not expect a teen to take a deceased parent’s place.
  • Recognize that your teen may not choose to confide in you.
  • Encourage healthy friendships as an outlet for your teen’s emotions.
  • Break the “I must be strong” chain by letting your feelings show.
  • Allow teens to be part of the funeral service.
  For additional information, turn to the chapter about suicide on Pages 77 and 78.
  Book suggestions
  “Fire in My Heart, Ice in My Veins,” Enid Traisman, Centering Corporation.
  “The Next Place,” Warren Hanson, Waldman House Press.
  “Straight Talk about Death for Teenagers,” Earl A. Grollman, Beacon Press.
  “Talking with Children about Loss,” Maria Trozzi, Berkeley Publishing Group.
  “Healing Your Grieving Heart for Teens: 100 Practical Ideas,” by Allen
       Wolfelt, PhD, Companion Press.
  “When a Friend Dies,” by Marilyn Gootman, Free Spirit Publishing.
  Web site suggestions
  The Compassionate Friends (books and resources also available in Spanish),
      www.compassionatefriends.org.
  The Dougy Center for Grieving Children and Teens, www.grievingchild.org.
  The Sibling Connection, www.counselingstlouis.net.
  Additional resources
  Children’s Hospital of Wisconsin bereavement resources, (414) 266-2995.


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   Dental care details

  If your teenager does not have a dentist, now is the time
  to get one. Teens have more cavities than any other age          Insist on
  group, for several reasons:
  • Poor diet. Teens eat more cavity-causing
                                                                   proper daily
    carbohydrates, such as sweets, candy, sugared                  care and form
    cereals and soda.                                              a working
  • Infrequent dentist visits. The teen years are busy,            partnership
    which leads to less time for dental appointments. A            with a dentist
    dental exam and cleaning should be performed every
    six months.
                                                                   by scheduling
  • Poor dental care. Most parents no longer supervise             regular
    brushing and flossing. Teens need this responsibility,         checkups.
    and lapses can be part of the learning process.
  As a result of the above issues, it is important to watch
  for signs of future dental problems.
  Periodontal (gum) disease
  • Puberty affects the soft tissues of the mouth, making teens more likely to
    develop gum problems.
  • If your teen fails to properly brush and floss daily, periodontal disease can get a
    foothold.
  TMJ dysfunction
  • Symptoms of this painful dysfunction of the jaw joint often begin during the
    teen years.
  • Chronic pain develops in the joint and/or facial muscles.
  • Pain often is worse in the morning from nighttime stress-related teeth grinding.
  • Even minor symptoms should be checked out by a dentist.
  Crooked teeth
  • Malocclusion (a faulty meshing of the upper and lower teeth) is common
    among teenagers.
  • If you have not already done so, consider scheduling an orthodontic exam in the
    early teen years to treat physical problems or to correct cosmetic problems that
    affect appearance.
  Teeth are meant to last a lifetime. Parents can play a part in keeping them strong.
  Insist on proper daily care and form a working partnership with a dentist by
  scheduling regular checkups.




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   Dental care details

  Sports-related tooth trauma
  Sports have become more competitive, and some contact sports can result in
  tooth injuries. Teens should use a custom-fit mouth guard when participating in
  any contact sport like football, soccer or baseball. If an injury occurs, see a dentist
  immediately. If a tooth is broken or knocked out, place the tooth in water or milk
  and see a dentist immediately. Report any mouth injury to your teen’s dentist.
  Oral piercings
  Your teen may see piercing his or her
  tongue, lips or cheeks as a fashion
  statement. This fashion can have
  serious health risks. The piercing can
  chip teeth by rubbing against them.
  Rubbing also can cause gum disease.
  A serious infection is a possibility any
  time the skin is broken. Damage to
  nerves and blood vessels also is
  possible, especially when the piercing
  is done by an amateur. Injuries to the
  mouth can cause permanent speech
  difficulties.
  Smokeless tobacco
  Even occasional use of smokeless (chewing) tobacco can cause changes in the
  tissue of the mouth and precancerous lesions. Prolonged use can lead to cancer
  of the mouth. Teens should chew sugarless gum instead.




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   Divorce details
  Experts agree divorce is
  emotionally trying for children
  of any age, and teenagers are
  no exception. The normal
  stresses of growing through the
  teen years can be compounded
  by a family breakup or by the
  presence of stepparents.
  Sensitivity to a teenager’s emo-
  tional needs is an especially
  important trait for a divorced
  parent or stepparent. Even the
  most amicable divorce tugs at
  the foundations of parent/child
  relationships. With loving care
  those relationships can
  become stronger.
  The suggestions below touch on
  only a few of many ways family
  members can support a teen
  during and following divorce.
  Relationships following divorce
  • Learn to tolerate a reasonable level of anger and disagreement. Divorce often is
    a source of added anger and frustration.
  • Avoid speaking ill of your former spouse in front of your children.
  • Maintain the best possible relationship with your former spouse. A child’s
    adjustment to divorce is directly related to the intensity and length of
    parental conflict.
  • If children spend time with both parents, consider living relatively near one
    another. Stay in the same school district, if possible. Regardless of whether
    parents are divorced, social activities with parents and family are a second
    choice for teens. A parent living away from “the action” is likely to have a bigger
    battle for family time than a parent living nearby.
  Dating and remarriage
  • Maintain a child-oriented focus, even in the midst of forming new romantic
    relationships. Don’t introduce new relationships to your teen until the
    relationship seems to be solid. Keep in mind that each person who becomes


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   Divorce details
    involved with your teen and then leaves will cause a
    loss for him or her. Your teen still needs stability, not a
                                                                   The more
    swinging door of new partners coming and going in his
    or her life. See new partners during the time your chil-       respect you
    dren are with their other parent until you are sure this       show for your
    relationship is going somewhere, then introduce the            former spouse,
    new partner into your children’s lives slowly.                 the more
  • Be aware that teens quickly pick up on “do as I say,
                                                                   respect you
    not as I do” messages. Teenagers will note if you
    advise them not to have sex before marriage, but then          can gain for
    see you have a dating partner spend the night. If your         a present
    former spouse begins living with a new partner outside         or future
    of marriage, explain to your teen that you and your for-       stepparent.
    mer spouse do not agree on everything, and that is
    OK. Talk to your teen about what should be present in a relationship if it is
    going to be a sexual one. It will give your teen the information needed to make
    responsible decisions.
  • Do not cast stepparents as a replacement for natural parents. Do not insist on
    expressions of affection if they are not sincere. Do not force the use of “dad”
    or “mom” for a stepparent unless the teen is comfortable using the terms.
  • The more respect you show for your former spouse, the more respect you can
    gain for a present or future stepparent, as well as yourself.




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   Driving details
  It is easy to understand the attraction driving has for teenagers. To a teen, a
  driver’s license is a ticket to independence and mobility. It is a symbol of maturity.
  Dating, school activities, shopping and work all take on new meaning when a teen
  can drive.
  However, the benefits of driving bring an awesome responsibility – the safety of
  the driver, passengers, pedestrians and other motorists.
  Teens are more likely to be in a motor vehicle crash than any other age group.
  Nationally, teens make up about 7 percent of the driving population but
  represent 14 percent of motor vehicle deaths. In fact, motor vehicle crashes are
  the leading cause of death for 15- to 20-year-olds, accounting for 35 percent of
  all deaths in this age group, according to the National Highway Traffic Safety
  Administration.
  While the number of teen crashes is higher during the day, crash severity tends to
  be greater at night. Young drivers who have at least one passenger are at a much
  greater risk of having an accident than those who drive alone.
  To help reduce the risks associated with teen driving and to make sure your son
  or daughter understands all the responsibilities that come with a vehicle, consider
  the following:
  • Learning to drive – Parents play an important role in helping teens learn to
    drive. Once your teen begins lessons and has an instruction permit, he or she
    will be able to drive the family vehicle under your supervision. When you allow
    your teen behind the wheel, make certain you are in a patient mood. Displays
    of impatience or anger will erode your teen’s self-confidence and make learning
    more difficult. You could map out a route to drive before you leave the house. If
    you’re giving directions along the way, make sure to note each change in course
    far enough in advance. Use a calm tone. Instead of yelling “You’re speeding!”
    you might calmly ask, “What’s the speed limit on this road?” Let your teen know
    when he or she does something right or drives well. Pay close attention to your
    own driving skills, because your teen will be modeling his or her driving habits
    on yours.
  • Establishing rules – Make sure your teen follows the restrictions state law
    places on the different types of licenses, whether an instruction permit,
    probationary license or regular driver’s license. In addition, you should
    establish and enforce your own set of driving rules for your teen. Be specific
    about when and where your teen can drive. Be clear about how many
    passengers your teen can have and who the passengers can be. Determine
    which of your teen’s friends, if any, are allowed to ride when your son
    or daughter is driving. Do not allow your teen to drive other people’s cars
    or let friends drive your family’s vehicle.
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   Driving details
  • Safety first – Let your teen know you expect him or her to obey speed limits
    and other traffic laws and to drive defensively at all times. Make sure your teen
    always uses a seat belt and requires passengers do the same. If your teen
    baby-sits, talk about the importance of only transporting children when they are
    properly restrained in car seats. Discuss the dangers of driving when tired.
    Make rules about distractions such as talking on cell phones or changing the
    radio station. Until your teen gains more experience, you may want to limit
    driving on crowded expressways, at night or in bad weather. Help your teen
    practice driving in these conditions. Teach your teen the importance of auto
    maintenance. Keep emergency equipment in your vehicles and make sure your
    teen knows how to use it. Show your teen how to change a tire. Remind your
    teen to lock valuables out of sight and check the back seat before getting into
    the vehicle.
  • Alcohol – Drinking and driving do not mix. Many states (including Wisconsin)
    have zero tolerance for teens who drink. This means a teen with even a trace
    of alcohol in his or her blood can lose driving privileges. You must make it clear
    to your teen that you will not tolerate drinking and driving.
  • Insurance – Before your teen ever gets behind the wheel, notify your auto
    insurance agent that your teen will be driving. While this will cause your
    rates to increase, it is a necessary step to guarantee insurance protection.
    Most insurers offer discounts for students who have completed state-
    approved driver’s education programs. Some grant discounts for students
    with good grades.
  • Cost of driving – Driving is expensive. You may want to have your teen shoulder
    some of the cost, such as paying for gasoline and keeping the car clean inside
    and out. Many parents require teens to pay for all or a portion of the additional
    insurance cost associated with a teen driver.
  • Tickets and accidents – Let your teen know that he or she must suffer all the
    consequences of receiving a traffic violation or being at fault in a traffic
    accident. This includes paying fines, damages and increases in insurance costs
    as well as loss of driving privileges.
  • A car for your teen – This issue can be a divisive one for families, and there is
    no universally correct answer. Begin by determining costs, including the price of
    the car and insurance, operating and maintenance costs. Who will pay these
    expenses? Can you or your teen really afford these costs? Carefully consider if
    your teen truly needs a car. Make sure your teen is mature enough to handle
    other responsibilities – such as schoolwork – along with car ownership.




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   Drugs   details
  When parents hear about drug abuse by teens, they often think of marijuana or
  cocaine. These drugs are only two of many. Some of the most dangerous and
  most frequently abused drugs are legal and found in nearly every home.
  Abusing household chemicals
  Teens have learned that the fumes from a wide variety of household products can
  cause a high. In fact, by the eighth grade, 1 in 5 young people has abused an
  inhalant to get high, at the risk of brain damage and death.
  Young people can get high on more than 1,000 legal, everyday products. Most are
  commonly used products parents never would suspect.
  What kinds of chemicals are being abused (inhaled or
  ingested)?
  • Correction fluid, such as Liquid Paper® or Wite•Out®.
  • Gasoline.
  • Solvents, such as paint thinner.
  • Aerosols.
  • Cough and cold medications.
  Why don’t teens see the dangers?
  • Many teens would never think these “innocent” products could kill.
  • Teens have been taught “bad” means illegal, so legal inhalants do not seem
    harmful.
  • Most teens know a single puff on a marijuana cigarette will not kill. They do
    not realize it is entirely possible to die the first time inhalants are used.
  What are the dangers?
  • One episode of inhaling fumes or “huffing” can kill.
  • Inhalants make the body more sensitive to the hormone epinephrine. That
    means:
    - Any stress to the heart can cause the heart muscle to beat irregularly or stop
      beating.
    - A person in cardiac arrest is much harder to resuscitate.
  • There is no way for health care providers to know an inhalant is causing the
    problem.
  • Chemicals in solvents are damaging to brain tissue.
  • Dextromethorphan is a sedative used to control cough. When taken in large
    amounts it can give a person a “high” or cause hallucinations. It also causes
    sleepiness and can lead to a coma.



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   Drugs   details
  • Combination cough and cold medications contain multiple ingredients,
    including decongestants, which can raise blood pressure and lead to stroke.
  • Antihistamines can cause fast heart rate, abnormal heart rhythm, coma and
    seizures.
  • Acetaminophen, a pain reliever, can cause liver damage or liver failure if
    misused.
  What do parents need to know?
  • Know your child well enough to spot changes:
    - Slurred speech.
    - Frequent headaches – a delayed side effect due to inadequate levels of oxygen
      to the brain.
    - A strong chemical smell on the clothing or breath.
  Do you suspect inhalant abuse?
  • Before acting, talk over plans for the discussion with someone who knows your
    teen and understands the problem.
  • Approach the teen and express concern.
  • Educate yourself and your teen about the danger.
  • Keep your anger in check and the lines of communication open.
  • If the teen does not believe the parent and appears to have inhaled something,
    stay calm and call 1-800-222-1222. This toll-free number will connect you to
    the Wisconsin Poison Center, a program of Children’s Hospital of Wisconsin, or
    your local poison control center.
  Understanding illegal drugs
  Illegal drugs fall into three categories:
  • Depressants: alcohol, marijuana and barbiturates.
  • Stimulants: amphetamines, cocaine or crack cocaine.
  • Hallucinogens: LSD, mushrooms and large doses of cough and cold
     preparations.
  Depressants act on the central nervous system. They:
  • Slow people down, leading to longer reaction time in an emergency.
  • Make driving risky.
  • Make suicidal urges worse.
  • Make people less able to judge the risks of their behavior – including
    overdosing.




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   Drugs   details
  Stimulants also impair judgment and add other effects of their own. They:
  • Cloud judgment and reduce emotional control, which leads to making bad
    decisions.
  • Make people less shy or reserved and more impulsive.
  • Speed up reaction time, allowing less time for logical thought before acting.
  Hallucinogens cause an even greater lack of judgment. A person using them is
  out of touch with reality. These drugs:
  • Create hallucinations – seeing or hearing things that are not there.
  • Some have long-term effects, such as flashbacks or permanent emotional scars.
  All these drugs are illegal. Buying drugs means breaking the law. Using them can
  lead to other negative behaviors, such as:
  • Stealing to afford the high cost of drugs.
  • Hanging out with people who live outside the law.
  Using drugs to blunt emotional problems also can mean trouble:
  • Avoiding a problem may make it worse.
  • Drugs can aggravate problems such as depression.
  • Teens who use drugs to solve problems are “short circuiting” the process of
    dealing with problems.
  Parent prevention tips
  • Think about your family. Do other members of your family abuse drugs?
  • Be open about the subject. Help a teen plan a response to being offered drugs.
    Talk about the results of drug use.
  • Have a family policy on drug abuse. Set consequences and be consistent in
    enforcing them.
  For additional information, see the chapter about alcohol on Page 2.




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   Eating disorders
               details
  Teens and young adults have a wide range of normal
  eating behaviors. Some of their habits can be unhealthy         By paying
  without being diagnosed as an eating disorder. A visit
  with your health care provider can help to determine
                                                                  attention to
  whether your teen has an eating disorder.                       your teen’s
                                                                  physical condi-
  What is the difference between
                                                                  tion and eating
  anorexia and bulimia?                                           habits, these
  Anorexia nervosa is marked by serious weight loss, fear
  of fatness, poor self-image, eating rituals, overactivity       eating disorders
  and a desire to continue losing weight. Teens with this         can be spotted
  disorder may feel fat even though they are extremely            early.
  thin. Bulimia nervosa most often involves bingeing –
  eating great quantities of food in a short time. Purging usually follows bingeing
  and may include vomiting, using diuretics or laxatives, excessive exercise or
  restricting food.
  You should talk to a health care provider if you notice any of the following
  behaviors:
  • Eating tiny portions.
  • Refusing to eat.
  • Not being hungry.
  • Avoiding a specific food group, such as fat, sugar or meat.
  • Unusual food choices or cravings.
  • Unusual eating habits.
  • Intense fear of being or becoming fat.
  • Exercising too much.
  • Disappearing after eating, often to go
    to the bathroom.
  • Eating secretly or hiding food.
  • Obsessing about appearance and body.
  • Withdrawing from family or friends.
  • Irregular or stopped menstrual cycles.
  • Feeling cold much of the time.
  • Stomach pain or bloating.
  • Weight loss or frequent weight
    fluctuations.




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   Eating disorders
               details
  Eating disorders most commonly begin between the ages of 14 and 17, but they
  may occur earlier or later. Girls and women are affected most often, but boys and
  men also can have eating disorders.
  What should parents do?
  Treatment is usually more successful when begun early in the disease. If you sus-
  pect your teen has an eating disorder, a visit to the family doctor is the best place
  to start. Your doctor is a good judge of the physical symptoms of eating disorders
  and can recommend specialists to help treat this serious disease. Hospitalization
  and/or counseling may be needed.
  What can you do to help prevent eating disorders?
  • Think about your thoughts, attitudes and behaviors toward your own body and
    your child’s.
  • Try to have positive, healthy attitudes and behaviors. Children learn from the
    things you say and do.
  • Teach your teen about the genetic reasons for different body shapes and sizes.
  • Teach your teen to avoid prejudice, including weight discrimination.
  • Help your teen learn to see the ways TV, movies and magazines display images
    of people and imply that “thinner is better.”
  • Encourage teens to be active and to enjoy what their bodies can do and feel.
  • Do not put your teen on a diet, unless it is recommended and monitored by a
    health care professional.
  • Try to model good habits for sensible eating, exercise and self-acceptance.
  For more information, call the Children’s Hospital of Wisconsin Adolescent
  Health and Medicine Program at (414) 266-2754.




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   Employmentdetails

  Many teenagers work while attending school. A parent can help a teen see the
  advantages and disadvantages of part-time employment.
  Are teen jobs positive or negative?
  • Jobs can help shape a teen’s future:
    - Employment can be a wonderful introduction to adult responsibility.
    - Adult supervisors can serve as mentors. They can offer advice about career
      options and future education requirements.
  • Jobs also can do some harm:
    - Teens may make money more important than school or social activities.
      Students should limit employment to less than 14 hours per week.
    - A bad experience can affect the teen’s lifelong attitude toward work.
  Some questions for parents to consider
  • Must your teen work for financial reasons?
  • Can your teen work and maintain grades?
  • Can money come from parents as an allowance or payment for chores?
  • Does the teen know the value of a dollar? Will the job help teach this?
  • Is there a career goal involved?
  • Should working be limited to the summer?
  • What are your state’s rules for employees under the age of 18?
  Consider volunteer work
  • A teen can learn about real jobs in many fields.
  • The habit of volunteering can last a lifetime.
  Think about job-related injuries
  • Teens sometimes are asked to do things for which they are not trained.
  • They are not experienced enough to recognize danger.
  • Know what your teen’s job duties are. Will there be job training?
  • Point out your concerns. Talk to the employer if necessary.
  • If the work is hazardous, steer your teen to a safer job.




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   Extracurricular activities
                details
  Educators say children who take part in extracurricular activities tend to do better
  in school. Some teens seek out after-school activities on their own. Others need
  encouragement. It is up to parents to take a role in searching out activities for
  their teens and urging them to take part, but forcing a teen to take part in an
  activity may lead to resentment or resistance. Parents must be careful not to live
  vicariously through their children by forcing them to take up an activity to fulfill
  the parent’s own desires.
  Parents can make extracurricular activities more attractive to teens in
  several ways:
  • Give the teen choices. Present several options, such as basketball, choral
    or instrumental performances, computer club or volunteer work, and let the
    teen choose. It will give him or her a feeling of having some control.
  • Find out what other teens are doing. Peers are important at this age.
    If other teens are taking part in an activity, the resistant teen may be
    more willing to try it.
  • Once teens take part in activities, it is important that parents show an interest,
    too. They can do so by attending their teen’s athletic event, concert, play or
    science fair or helping in the classroom. As much as teens complain and say
    they do not want their parents involved, they really do.
  Summertime can be a difficult time to find activities. Preteen and early teen
  children may have a particularly tough time finding interesting activities, since
  they are too old for some activities, such as playground games, and too young for
  others, such as finding jobs.
  In addition to schools, find out about activities offered by local recreation
  departments, the YMCA or YWCA, scouting and 4-H organizations, your church
  or the library.
  Make certain after-school activities do not interfere with homework or job
  responsibilities.




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   Eye care details
  Many people get their first eyeglasses as teenagers. Nearsightedness (a difficulty
  in seeing things at a distance) often comes with the surges of growth before and
  during the teen years.
  Along with this growth comes a need to feel attractive to others. A child may even
  choose to walk around in a world of blurry vision instead of wearing glasses
  friends may see as “uncool.”
  Here are some simple tips for dealing with a teen who should wear glasses,
  but refuses:
  • Have regular vision tests. An eye care professional’s advice may influence
    a teen when a parent cannot.
  • Set safety rules. Some activities, such as driving or operating machinery,
    demand the use of glasses. Make it clear that eyeglasses must be worn at
    these times.
  • Consider contacts carefully. Contact lenses may look better but require more
    care. Teens who want contacts should try eyeglasses first and keep a pair of
    glasses as a backup in case a contact lens is lost or damaged.
  • Dismiss vision surgery. In recent years, eye surgeons have begun offering
    surgery such as LASIK, which may correct nearsightedness in some people.
    However, surgery is not an option for people younger than 18.
  • Offer sunglasses. Wearing prescription sunglasses protects the eyes from the
    harmful ultraviolet rays of the sun. It also is fashionable. A cool pair of
    sunglasses can do wonders for an uneasy teen’s self-image.




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   Eye emergencies
              details
  If your teen suffers an eye injury, seek emergency care for the following
  symptoms:
  • Blurred vision that does not clear with blinking.
  • A loss of peripheral (side) vision.
  • A decreased ability to move an eye.
  • Double vision.
  • Moderate to severe pain.
  • A different pupil size in each eye or an irregular pupil.
  • A torn eyelid.
  • An eyeball that appears to be cut.
  • A feeling there is something in the eye.
  If any of these symptoms are present, do not put anything in the eye or rub the
  eye. Seek immediate medical help.
  For a chemical burn of the eye, wash the eye under a faucet or by using a clean
  container of water for about 15 minutes. Cool or lukewarm water is the most
  comfortable on the eye. Then seek emergency medical care.




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   Family relationships
                details
  Tips for building strong family
  relationships                                                  Children
  • Build a channel for communication. Every teen needs          imitate their
    someone to rely on. A parent can be that person by           parents’
    listening without judging and offering positive feed-        actions. Even
    back. Talking things over is far better than acting out.
                                                                 in the teen
  • Be aware of how your son or daughter normally                years, actions
    behaves. Sudden changes in feelings and actions are
    part of a normal teen’s life. Still, changes that come       speak louder
    big and fast can be a warning signal. Watch for              than words.
    changes in friends, grades or mood.
  • Make a family contract that sets clear rules. Teens like the freedom to choose
    within a set of simple and secure rules. Discuss and write down a family
    constitution. Focus future disagreements on the rules instead of people. This
    document should be updated as needed.
  • Teach the link between an action and its consequences. Teens can learn from
    their mistakes. Parents can help by allowing teens to experience the outcome of
    their actions. Experiencing small mistakes now could mean avoiding big ones
    later.
  • Wavering is normal. Even “model” teens break rules now and then. Learn to
    look at patterns of behavior. Overreacting to a rare slipup can damage the trust
    between parent and teen.
  • Walk your talk. Children imitate their parents’ actions, even in the teen years.
    A good way to convince a teen not to do something is to quit doing it yourself.
    Actions speak louder than words.
  • Accept the fact that a teen’s life is not always in a parent’s hands. As children
    develop, they gain the ability to take care of themselves. Parents must recognize
    this fact and be ready to let go.




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   Family time details

  The last thing teenagers may want is to spend time, or even be seen, with their
  parents.
  Teens often prefer to spend time with peers or at school activities. That attitude
  may make it difficult to spend “quality time” with your teen and to talk about his
  or her life and yours.
  By offering a variety of activities and insisting on participation, you can encourage
  your teen to become a willing participant in family activities.
  Here are activities in which to include teenagers:
  • Family events. Insist they attend important family activities, such as graduations
    and birthdays for relatives.
  • Restaurant dining. If possible, go out for the occasional “fancy” dinner. It will
    expose teens to the etiquette involved in fine dining.
  • Movies. Offer a list of acceptable films and let family members vote on
    their choices.
  • Bowling. It’s an activity that can be done year-round.
  • Sporting events. Professional ball games are an option, as are college and high
    school games. Teens may wish to join their friends during high school events,
    but insist the family touch base at least once during the game, perhaps to get
    refreshments at half-time.
  • Theater and concerts. This may be your teen’s only exposure to classical music
    and time-honored plays. One parent says her teenage daughter complained
    mightily about having to go to the opera. Now that the daughter is attending
    college away from home, she looks forward to visits home and family activities,
    such as going to the opera. If you and your teen enjoy a musical group or
    performer, whether it is a popular artist or classical artist, suggest going to a
    concert together.
  • Shopping or working on a joint project, such as fixing a car. These are activities
    that parents and teens can enjoy equally.
  • Parks. Family activities need not be expensive. Hikes through parks promote
    fitness and offer adventure.
  • Board games. Just because your teens have outgrown Candyland™ doesn’t
    mean they won’t enjoy games geared to their age group such as Monopoly™,
    Guesstures™ or Cranium™. Split the family into two teams: parents versus
    kids or males versus females, for example. Mix up the teams from time to time.
  • Entertainment. Check entertainment listings in local newspapers and other
    publications for more ideas for family activities.
  • Travel. Invite your teen to join the family as you explore new places or return to
    favorite vacation sites.


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   Firearm safety
               details
  Firearms, particularly handguns, pose a serious health
  threat to teens. Each year, an alarmingly high number           Store firearms
  of teenagers are wounded or killed by firearms, through
  accident, suicide or deliberate attacks.
                                                                  in a locked
                                                                  and secure
  Further, the presence of firearms on our streets and in
  our homes may have a harmful psychological impact on            cabinet,
  young adults.                                                   drawer or safe.
  What can you do?
  The best thing you can do is never keep firearms in your home. However, if you
  do have firearms in your home, take the following steps:
  • Fit each firearm with a trigger lock. These are inexpensive – generally $7
    to $10 each – and readily available at gun shops, sporting goods stores and
    many hardware stores. Keep keys to trigger locks in a safe place far away
    from the guns.
  • Make certain every gun in your house is unloaded.
  • Never point a loaded or unloaded gun at another person.
  • Store firearms in a locked and secure cabinet, drawer or safe.
  • Never store ammunition with your firearms. Ammunition should be stored away
    from firearms in a locked and secure drawer or safe.
  Other safety measures
  • Teach all family members that guns and other weapons are not toys. Caution
    your children never to pick up a gun or play with a gun.
  • Recognize that firearms, conflict and alcohol can be a deadly combination.
  • If you are a hunter and want your child to learn how to hunt, do not try to teach
    your child on your own. Rather, enroll your child in a course that teaches both
    firearm safety and firearm proficiency. And while you are at it, enroll yourself in
    a course – you will be surprised at what you will learn.
  • Immediately report any unlawful use of a gun to your local police department or
    sheriff’s office.
  • Know and obey local, state and federal firearm laws. These laws are designed to
    protect your entire family.




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   Gangs   details
  Many parents’ response to gang activity is, “My kid
  would never get involved in a gang.” Unfortunately, every       Do not give up.
  day parents find out their children are involved in gang
  life with all the violence and lawbreaking it brings.
                                                                  Deep down
                                                                  inside, your
  Who is attracted to gangs?                                      teen hopes you
  • Teens from all backgrounds – inner city, suburban and
    rural.
                                                                  will not.
  • All teens share common needs that gangs can meet:
    - Acceptance.
    - A chance to “try out” different roles in life.
  What can parents do to keep a teen from joining
  a gang?
  • Surround the teen with positive people who offer love and attention.
  • Do family activities on a regular basis from early on, so teens feel they “belong.”
    Include friends in family activities. This will give you a chance to become better
    acquainted with your teen’s friends and casually communicate your rules and
    expectations.




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   Gangs   details
  • Find wholesome opportunities for recreation or employment. Busy kids are less
    at risk.
  • Do not force teens into adult responsibilities or opportunities too soon.
  • Keep the lines of communication open.
  • Know what is going on in your teenager’s life. For example, ask:
    - Who are your closest friends?
    - Are these friends much older than you?
    - Have you seen your friends do things you know are illegal?
    - What do you and your friends do with your time?
  • Set firm limits:
    - Make the rules of behavior clear.
    - Be consistent in discipline.
  Warning signs of gang involvement
  • Dropping friends, adopting new ones, especially ones older than your child.
  • Interest in violent films, television shows, games or books or obsession
    with guns.
  • Wearing gang-favored clothing, colors or tattoos.
  • Suddenly gaining money or expensive possessions.
  If your teen is in a gang
  • Get help from community resources:
    - Police department gang unit.
    - Social service agencies.
    - Church, for healthy teen activities.
    - Support groups.
  • Seek family therapy from a trained professional, not individual therapy for the
    teen.
  Do not give up. Deep down inside, your teen hopes you will not.




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   Health care details

  The teen years generally are a time of vibrant good
  health. All parents wish to keep it that way. Doctors         Teens should
  agree and suggest a good way to do so is to develop a
  continuing relationship with a pediatrician or specialist
                                                                have regular
  in adolescent medicine.                                       checkups.
  Teens should have regular checkups, for several reasons:
  • It is healthy to have an annual physical.
  • Teenagers need some important immunizations and booster shots.
  • Vision and hearing screenings are important in the teen years.
  • Many schools suggest or require a sports exam before joining an athletic team.
  • The teen years are the best time to establish a lifelong pattern of regular
    medical care.
  Your health care provider is trained to screen for mental health problems and
  other situations that may affect your teen’s health and wellness, including:
  • Psychological health, such as feelings of anxiety or depression.
  • Social problems such as difficulty with friends, dating or sexual identity/
    orientation.
  • Substance abuse problems
    such as drinking, smoking
    or abusing drugs.
  • Physical concerns such as
    bodily changes during
    puberty, menstrual
    problems, eating disorders
    or physical conditioning
    for sports.
  If a teen ever needs mental
  health treatment, a pediatri-
  cian or other health care
  provider is a good first
  resource. He or she can rule
  out physical causes for the
  problem and has a wide
  network of resources par-
  ents may turn to for further
  help. Many teens feel
  comfortable trusting a
  health care professional who


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   Health care details

  keeps a promise of strict confidentiality (except in cases where bodily harm to the
  child or others is a serious possibility). Your teen’s doctor is a valuable ally. The
  doctor’s goal is the same as yours: leading your teen into a healthy future.
  The Adolescent Health and Medicine Program at Children’s Hospital of
  Wisconsin provides comprehensive, coordinated care to teens with a variety
  of general health needs. For more information about the program, call
  (414) 266-2754 or visit www.chw.org/adolescent.
  In addition, the following school-based clinics for teens are available in the
  Milwaukee area:
  Custer/Lady Pitts School Based Health Center
  5075 N. Sherman Blvd.
  Milwaukee, WI 53209
  (414) 393-4919
  Downtown Health Center/Adolescent Clinic
  1020 N. 12th St.
  Milwaukee, WI 53233
  (414) 277-8900
  South Division Cardinal Clinic
  1515 W. Lapham Blvd.
  Milwaukee, WI 53204
  (414) 902-8338




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   Home alone details

  When is a preteen or teenager ready to stay home alone?
  The answer depends upon your child. Most youngsters             Encourage your
  will show signs of readiness for this milestone.
                                                                  son or daughter
  Signs of readiness                                              to tell you
  • A reliable ability to follow reasonable guidelines.           about any fears
  • An interest in independence and a lack of reluctance
    and fear.
                                                                  or concerns
  • An ability to handle unexpected situations in a               about staying
    positive way.                                                 home alone.
  • An ability to amuse himself or herself without
    supervision.
  Staying alone after school
  If you decide your teen is ready to stay alone after school, set up the situation
  for success:
  • Look into other options, such as after-school daycare, before deciding.
  • Make clear, firm rules about the behavior you expect. Talk about the
    consequences of misbehaving.
  • Emphasize that safety is the No. 1 concern, not trust or mistrust of the teen.
  • Make sure your home has working smoke alarms on every level, secure dead-
    bolts and locks, a fire extinguisher, a first aid kit and emergency contact phone
    numbers posted next to the phone.
  • Make sure your teen knows to never enter your home if a window is broken,
    door is open or a light is on. Anything that is different may signify someone is in
    the home who shouldn’t be. Tell your teen to go to a neighbor’s house for help
    or to call the police.
  • Have your teen check in with you or another adult (neighbor or caregiver) as
    soon as he or she gets home.
  • Teach your teen why it is important not to reveal to anyone, either over the
    telephone or at the door, that he or she is home alone. The teen should say,
    “My mom (or dad) is not available right now. Can I have her (him) call you
    when she (he) is ready?”
  • Insist that your child lock all doors when home alone.
  • Encourage your son or daughter to tell you about any fears or concerns about
    staying home alone.
  • Make the choice to stay alone after school a family choice, not simply a
    job-related decision.




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   Home alone details

  Being home with younger siblings
  Being “old enough” is not the only measure of a teen’s readiness to care for
  younger brothers or sisters alone. A teen caregiver also needs:
  • An understanding of younger children. Teens should realize small children do
    not have an adult’s ability to reason.
  • Emergency training, including basic first aid and CPR. Baby-sitting training is
    an excellent source for these skills. For more information, see the chapter about
    baby-sitting on Page 5.
  • Telephone numbers of those who can help in an emergency.
  Dealing with friends and weekends
  Parents who are able to control their children may be unable to control their
  children’s friends. This especially is true when leaving a teen home alone for a
  weekend or longer. Be sure to have the following tips in mind before deciding to
  leave your son or daughter alone for an extended period of time:
  • Make and enforce clear rules.
  • How many friends may visit? Which ones?
  • What are they allowed and not allowed to do?
  • What are the consequences of breaking rules?
  • It may be wise to have a trusted adult check on the teen daily.
  If your teen is not ready to stay home alone, here are some alternatives to
  consider:
  • Area daycare centers may offer care before and after school or summer
    programs.
  • Another parent may be able to share care. You can watch his or her child at one
    time, and he or she can take yours at another time.
  • Day camps are offered by YMCAs and other local organizations.




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   Immunizations
              details
  Check your teen’s records to make sure that he or she has received all recom-
  mended childhood vaccines. If you do not have a complete immunization record
  for your teen, your doctor may recommend booster shots to make sure your teen
  is fully immunized.
  In addition, Children’s Hospital of Wisconsin experts recommend the following
  vaccines specifically for teens:
  Gardasil: the human papilloma virus (HPV) vaccine. The vaccine is given in a
  three-dose series over six months. This vaccine is an effective way to prevent
  infection by the four varieties of HPV, which increase the risk of cervical cancer.
  This vaccine is recommended for girls and women 11 to 26 years old.
  Hepatitis A: a two-dose series delivered six months apart. This vaccine prevents
  a liver disease caused by a virus. Hepatitis A can be transmitted when an infected
  person does not wash his or her hands before handling food.
  Hepatitis B: a three-dose vaccine given over six months. This vaccine prevents a
  liver disease caused by a virus. Hepatitis B is caused by contact with an infected
  person’s blood.
  Influenza: an annual vaccine for those who have a chronic illness or who live
  with a household member at high risk. The high-risk category includes those with
  a chronic illness and children 1 to 5 months old.
  Meningococcal: a one-time vaccine. This vaccine prevents meningitis, a bacterial
  infection of the brain and spine, which could lead to brain damage, seizures,
  pneumonia and even death.
  Pneumococcal: given every 5 years to those who have a chronic illness. This
  vaccine prevents pneumonia.
  Tdap: given every 10 years. This vaccine prevents tetanus, diphtheria and
  pertussis (whooping cough).
  Varicella: a two-dose vaccine given four weeks apart after age 13. This vaccine
  prevents chickenpox for those who never have had the disease. This vaccine is
  highly recommended if your teen never has received it or never has had chicken-
  pox.




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   Injuries details
  “If a disease were killing our children in the proportions that injuries are,” former
  Surgeon General C. Everett Koop, MD, said, “people would be outraged and
  demand that this killer be stopped.”
  Studies show that for every teen who dies of cancer or other diseases, more than
  10 die from injuries.
  Injuries are not “accidents.” They can be prevented if parents and teens work
  together to steer clear of the things that are likely to cause injury.
  Teens often believe they are invincible. Parents can help keep them safe by
  talking about potential dangers and rules of safety.
  Motor vehicle, bicycle and pedestrian safety
  • Insist on good driver education and plenty of driving practice before getting
    a license.
  • Teach your teen never to drive after consuming alcohol. Nearly half of all
    adolescent motor vehicle deaths involve alcohol, according to a recent National
    Highway Traffic Safety Administration study.
  • Urge your teen to call home instead of driving drunk or riding with an intoxicat-
    ed driver. Talk about the incident the next morning.
  • Teach teens to refuse a ride in a car driven by someone who has been drinking.
  • If possible, limit late night outings. Most accidents occur on weekends, after
    midnight.
  • Teach teens to always wear safety belts. Set a positive example by wearing a
    seat belt whenever you drive.
  • Stress the dangers of playing “chicken” and driving or standing in the path of an
    oncoming vehicle, bicycle or train. Every year, many teens are seriously injured
    or killed when they misjudge the speed or distance of an oncoming vehicle.
  • Stress the need for bicyclists and pedestrians to follow safety rules. Urge
    bicyclists and motorcycle drivers and passengers to wear helmets.
  For additional information, see the chapters about bike safety on Page 7 and
  driving on Pages 24 and 25.
  Firearm safety
  Be sensitive to the need for firearm safety:
  • Limit access to firearms. Keep guns safely under lock and key or consider
    having a gun-free household.
  • If teens use guns for hunting or target shooting, provide proper training in
    handling, cleaning and storage.




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   Injuries details
  • Insist that guns never be used as a plaything or in games.
  • Do not ignore anger, rage or suicidal thoughts.
  For additional information, see the chapter about firearm safety on Page 37.
  All-terrain vehicle and snowmobile safety
  • Insist on a driver’s safety course.
  • Do not use three-wheeled ATVs. They are unsafe and no longer manufactured.
  • Riders under the age of 16 should not ride full-size ATVs.
  • Insist on safety equipment: helmet, eye protection, non-skid shoes or boots,
    long pants and long-sleeved shirts.
  • Even older teens should be supervised.
  • Never carry passengers. ATVs are designed for one rider.
  • Do not use ATVs on roadways or after dark.
  • Never operate an ATV under the influence of drugs or alcohol.
  For additional information, see the chapter about all-terrain vehicles on Page 4.
  Other injury risks
  • Consider the risks of sports injuries before taking up a sport.
  • Be certain teens are educated on the use of illegal and legal drugs, such as
    inhalants.
  • Educate teens on water safety, and ask that a safe boating course be completed
    before a boat is used without adult supervision.
  • Provide lessons in swimming and water safety for all family members.
  • Consider trying family activities that involve risk (such as rafting or rock
    climbing) and focus on doing them safely.




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   Internet use details

  Teens are spending more time on the Internet than ever before. The World Wide
  Web can put information at your child’s fingertips, help with homework, improve
  computer skills and provide entertainment. The Internet also can lead children to
  inappropriate material and dangerous situations.
  Even if you don’t have a computer in your home, your child will be exposed to the
  Internet somewhere – at school, the public library or a friend’s house. While
  these places may have guidelines and procedures to protect children, it is
  important to talk to your child about the Internet and to set rules of your own.
  Your teen needs your guidance when using this tool and as he or she continues to
  explore its resources.
  Here are a number of tips to keep your teen’s Internet experience safe,
  educational and fun:
  • Make sure your son or daughter understands what types of Web sites you
    consider appropriate and what categories of sites are off-limits. Establish clear
    rules, post them near the computer and enforce them.
  • Set limits on the amount of time your teen can spend online each day or week.
    Do not let surfing the Internet take the place of homework, playing with friends
    or other activities. Use an alarm clock or timer to keep your child from losing
    track of time while using the computer.
  • Participate in your teen’s online time. Stay involved and monitor what your child
    is doing. Keep your home computer in a common area such as the kitchen or
    family room. If your child has a computer in his or her bedroom, make sure the
    door to the room stays open at all times.
  • Polish your own computer skills. If you are not comfortable using a computer or
    the Internet, consider taking a class or doing some reading. Your child will need
    your help to use this resource effectively, and it is important for you to
    understand what your teen is doing (and what he or she is capable of doing).
  • Consider buying filtering software that prevents your teen from visiting
    inappropriate sites and helps you monitor the files he or she downloads. Keep
    in mind that even the best filter may accidentally give your child access to
    materials you don’t approve of, and many children are smart enough to find
    ways around these blocks.
  • Ask your teen about how he or she uses computers outside your home and talk
    about the kinds of information online. Encourage your child to discuss
    anything that makes him or her feel uncomfortable.
  • Talk to your son or daughter about how easy it is for people to misrepresent
    themselves on the Internet. Explain that strangers in chat rooms should be
    treated with the same caution as strangers on the street. Teach your child not to
    open e-mail from someone he or she doesn’t know.

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   Internet use details

  • Tell your teen never to arrange to meet in person anyone he or she has met
    online. Get to know your teen’s online friends just as you would his or her other
    friends. Ask the same kinds of questions you ask before your teen goes out with
    friends. Find out where he or she is going online and with whom.
  • Explain why your child should never provide any personal information to
    someone on the Internet. This includes name, address, phone number, age,
    school, school location, names of friends, credit card numbers, passwords and
    vacation plans. Your child should not exchange pictures online. Make sure
    your teen chooses usernames and e-mail addresses that have no identifying
    information such as name, age or city.
  • Decide whether you want your teen to participate in unmoderated chat rooms
    where he or she may be exposed to bad language and personal questions. In
    moderated chat rooms designed for children, inappropriate messages are edited.
  • Never give your teen your
    credit card for online pur-
    chases. If you want to allow
    your child to buy items on
    the Internet, insist on being
    involved in all orders.
  • Discuss unsolicited
    commercial e-mail, called
    spam, with your child. These
    offers often are scams. Teach
    your child to delete these
    messages. If your child is
    placed on an unwanted
    e-mail distribution list,
    show him or her how
    to be removed.
  • Ask about the Internet use
    policy at your local library
    and at your teen’s school.
    If your teen’s friends have
    computers at home, talk to
    their parents to determine
    whether their rules and
    monitoring practices are
    consistent with your own.



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   Lawn mower safety
            details
  Almost 10,000 children are injured in lawnmower accidents each year. These
  accidents often result in the amputation of a limb. Furthermore, the driver of the
  mower is almost always a relative of the victim. This not only means the injured
  child experiences great physical pain, but it often psychologically damages the
  driver who feels responsible for the accident.
  Children younger than 15 years of age have the most mower accidents of any age
  group. Most of these injuries are caused by the unsafe use of power lawn mowers
  rather than a mechanical problem. Only properly trained children 12 years or
  older should be allowed to mow the lawn alone.
  Follow these guidelines for safe mowing:
  Always:
  • Read the owner’s manual before mowing.
  • Make certain teens who mow the lawn understand safety guidelines.
  • Wear steel-toe shoes, protective eyewear and long pants.
  • Be sure people – especially children – and pets are out of the yard
    while mowing.
  • Make sure the grass is dry.
  • Clear the yard of sticks, stones and other debris that may be ejected at high
    speed while mowing.
  • Use a power mower that has a device that stops it from moving forward when
    the handle is released and a riding mower that will not cut when in reverse.
  • Turn off the blades when crossing a sidewalk or driveway.
  • Let the engine cool 10 minutes before refueling. Gas spilled on a hot engine
    could cause a flash fire.
  • Disconnect the spark plug before performing maintenance work on a mower.
  • Stay clear of a hot engine. Mufflers can reach up to 1,200 degrees Fahrenheit.
  • Mow across an incline with a walk-behind mower.
  • Mow up and down an incline with a riding mower.
  Never:
  • Override the mower’s safety functions.
  • Mow at dusk or at night.
  • Allow passengers on a riding mower.
  • Adjust the mower height, clean or remove the grass chute with the
    engine running.
  • Drink alcohol before or during mowing.
  • Smoke when filling the gas tank.
  • Leave the mower unattended while the engine is running.


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   Nutrition details

  Teens have special nutritional needs. These years are a time of rapid physical
  growth, especially in the long bones of the arms and legs, which add height and
  body strength. A natural growth in appetite comes along with these changes. The
  teen years also are a time to make food choices that set the habits of a lifetime.
  Helping teens make good food choices
  • Parents should model good eating habits.
  • Try to eat meals as a family as often as possible. This also is a great time to
    share news about school and friends. Try to avoid arguments during meal times.
  • Include all food groups in meals (dairy, vegetables, fruits, meats and grains),
    even when eating fast food.
  • Never skip meals. Encourage a three-meals-a-day eating pattern.
  • Choose healthy snacks that include servings from two food groups.
  • Do not eat in front of the TV, while working at the computer or while playing
    video games.
  Creating a healthier teen
  If your teen is overweight, start by developing healthier eating, activity and
  communication habits.
  • Short-term diets aimed at rapid weight loss are unhealthy and should be
    avoided.
  • Focus on decreasing high-fat, high-sugar foods, sweetened beverages and
    portion sizes.
  • Focus on physical activity to increase fitness, improve body tone and boost
    self-esteem.
  • Avoid negative comments about your teen’s weight.
  • If your teen is eating for emotional reasons, such as stress, boredom, sadness or
    loneliness, address these issues. Consider assistance from a counselor.
  • Decrease watching TV, playing computer or video games and talking on the
    phone. Instead, encourage more physical activities like walking or playing a
    team game with friends.
  • If your teen wants advice on attaining a healthier weight, have him or her talk
    with a health care provider about how to improve lifestyle habits.
  Understanding overweight
  Overweight is extra stored energy. There are many things that contribute to being
  overweight. Some of them include:
  • Energy imbalance. This means your teen consumes more food than his or her
    body needs.
  • Genetics. If there are other members of your family who are overweight, there
    is an increased chance of your teen being overweight.

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   Nutrition details

  • Lifestyle. Leading an inactive lifestyle and not being physically active on a
    regular basis contributes to being overweight.
  There are two major eating disorders, which may be combined: anorexia
  nervosa (self-starvation) and bulimia (binge eating, followed by forced vomiting or
  other purging methods).
  Signs of an eating disorder
  • Becoming very finicky about food or skipping meals.
  • Refusing to eat certain foods, especially meat, desserts, milk or foods with fat.
  • Becoming very thin, wearing baggy clothing, being cold even in warm weather
    or ceasing menstruation.
  • Battling over food. Mealtime becoming unpleasant.
  • Exercising for several hours every day.
  • Denying there is a problem.
  See a doctor about any possible eating disorders. These are serious illnesses that
  call for treatment by health care professionals. See the chapter about eating
  disorders on Page 29 for more information.
  Nutrition guide: school-aged children and teenagers
  Use MyPyramid.gov when preparing meals for school-age children, teenagers and
  yourself.
  MyPyramid.gov provides an outline
  of what should be eaten daily. It
  recommends a range of servings from
  each of the five food groups. It also
  recommends that fats, oils and sweets
  be eaten sparingly.
  The number of overweight children and
  teens has dramatically increased over
  the last 10 years. About 16 percent of
  children and adolescents aged 6 to 19
  years are considered to be overweight.
  Being overweight puts teens at a higher
  risk for premature death, Type 2 diabetes, hypertension, dyslipidemia,
  cardiovascular disease, stroke, gallbladder disease, respiratory dysfunction, gout,
  osteoarthritis and certain kinds of cancers. In order to reverse this trend, many
  Americans need to eat and drink fewer calories, be more active and make wiser
  food choices.


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   Nutrition details

  If your teen is overweight, your goal should be to reduce the rate of weight gain
  while allowing healthy growth. Always consult a health care provider before
  placing your child on a weight-loss diet, especially if your child has a chronic
  disease and/or is on medication.
  In 2003, 38 percent of students in grades 9 to 12 watched at least three hours of
  television each day. Children and adolescents should have at least 60 minutes of
  physical activity on most, preferably all, days of the week. Resistance exercise,
  such as weight training, using weight machines and resistance band workouts,
  increases strength and endurance and maintains or increases muscle mass.
  Weight-bearing exercise may help girls reduce the risk of osteoporosis by increas-
  ing bone mass while bones are growing.
  To maintain a healthy weight, balance calories from foods and beverages with
  calories spent. To prevent or reduce gradual weight gain over time, make small
  decreases in food and beverage calories and increase physical activity. For
  example, eliminating one soda each day will make a noticeable difference over
  time.
  General guidelines for healthy eating habits
  The following recommendations are based on a diet of 2,000 calories a day. The
  Dietary Guidelines for Americans recommends a 2,000 calorie diet for moderately
  active girls ages 14 to 18 and a 2,400 to 2,800 calorie diet for moderately active
  boys ages 14 to 18.
  • Add more dark green vegetables, orange vegetables, legumes, fruits, whole
    grains and low-fat milk and milk products.
  • Eat less refined grains, fats (especially cholesterol, saturated and trans fats),
    added sugars and calories.
  • Fruit group: Eat four servings per day. One serving is equal to one-half cup of
    frozen or canned fruit, one medium fruit, one-fourth cup of dried fruit or one-
    half cup of fruit juice.
  • Vegetable group: Consume five servings per day. One serving is equal to one-
    half cup of cut-up raw or cooked vegetables, one cup raw leafy vegetables or
    one-half cup of vegetable juice.
  • Grain group: Eat six servings per day. One serving is equal to one slice of bread,
    one cup of cereal or one-half cup of cooked rice, pasta or cereal.
  • Meat and beans group: Eat five to six servings per day. A serving could include
    one ounce of cooked lean meats, poultry or fish; one egg; one-fourth cup
    cooked dry beans or tofu; one tablespoon of peanut butter or one-half ounce of
    nuts or seeds.


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   Nutrition details

  • Dairy group: Include three servings per day. A serving is equal to one cup of
    low-fat or fat-free milk or yogurt, one-and-one-half ounces of low-fat or fat-free
    natural cheese or two ounces of low-fat or fat-free processed cheese. Dairy
    foods contain calcium, which is especially important during adolescence.
    Studies show that drinking milk and eating other products containing calcium
    affects the density of bones. Teens should not avoid milk or dairy foods because
    of concerns about weight gain.
  • Oils: Use less than six teaspoons per day. Oils include soft margarine, low-fat
    mayonnaise, salad dressing and vegetable oil. Sources of healthy fats include
    soybean, corn, canola and safflower oils; walnuts and flaxseed; and fish such as
    salmon, trout and herring.
  Nutrition information provided by the United States Department of Agriculture.
  For additional information, see www.mypyramid.gov.
  Recommended reading
  “Caring for Your Adolescent, Ages 12-21, the Complete and Authoritative Guide,”
      Ruth Bell, Vintage Books.
  “You and Your Adolescent, A Parent’s Guide for Ages 10-20,” Laurence
      Steinberg, PhD, and Ann Levine, Harper and Row.
  “Sports Nutrition for the Child Athlete,” American Dietitic Association.




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   Parenting resources
               details
  Many parents reach a moment when parenting seems too much to handle alone.
  At such times, it is important to know that free and confidential help from a
  professional counselor is available. Accepting outside help often is the first step
  toward making things better. For more information, call Rogers Memorial
  Hospital at (800) 767-4411 or Children’s Service Society of Wisconsin at
  (800) 653-2779.
  When a teen does not want help
  • Resisting help, especially from professionals, is a common problem.
  • Be aware that a child older than 14 can refuse treatment.
  • Do not assume your teen’s friends will help solve the problem. Friends cannot
    take the place of adult professionals.
  Where to find help
  • Begin with the family doctor:
    - He or she will know both parent and teen.
    - Doctors can call on a wide range of local resources.
    - The doctor will be able to screen for physical causes behind emotional
      problems.
    - If necessary, the doctor can refer the teen to a mental health counselor
      or facility.
  • If possible, talk the matter through with other parents who have successfully
    handled similar problems.
  • School and church may provide additional resources.
  • Many employers offer employee assistance programs that may provide free
    parenting information and counseling.
  Most importantly, do not give up. Resources are available, and bringing a teen
  back to healthy patterns is worth the search for help.
  Confidential parent help lines in Wisconsin
  Dodge County
  Human Services, (920) 386-3750
  Jefferson County
  Human Services, (920) 674-3105
  Kenosha County
  Kenosha Crisis Center, (262) 657-7188
  Milwaukee County
  Community Information Line, 211
  Mobile Urgent Treatment Team, (414) 257-7621 between 9 a.m. and 10 p.m.
  The Parent Helpline, (414) 671-0566

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   Parenting resources
               details
  Ozaukee County
  COPE, (262) 377-2673
  Racine County
  Information and Referral, (262) 637-9557
  Community Information Line, 211
  Sheboygan County
  REACH, (920) 457-1111
  Washington County:
  Mobile Crisis Team, (262) 365-6565 or (866) 906-6565
  Resource Center, (262) 306-2222 or (877) 306-3030
  Waukesha County
  First Call for Help, (262) 547-3388
  Suggested reading
  “Caring for Your Adolescent, Ages 12-21, the Complete and Authoritative Guide,”
      Ruth Bell, Vintage Books.
  “Facts About Sex (or When Living Hurts or The Teenage Survival Book, or
      Raising a Child Conservatively in a Sexually Permissive World),” Sol Gordon,
      Ed-U-Press.
  “Sports Nutrition for the Child Athlete,” American Dietetic Association.
  “Sportswise: An Essential Guide for Young Athletes, Parents and Coaches,”
      Lyle Micheli, MD, and Mark Jenkins, Houghton Mifflin.
  “You and Your Adolescent: A Parent’s Guide for Ages 10-20,” Laurence
      Steinberg, PhD, and Ann Levine, Harper and Row.




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   Peers   details
  The teen years are a time when friends can rival parents in importance. Parents
  may be frustrated and fearful of the values a child’s peers may hold. The wisest
  response is to know your teen’s friends and their values. This is not prying. It is
  an honest concern for your teen’s safety and well-being.
  • Know your teen’s friends personally. Meet their parents.
  • Are the peer group’s values the same as your family’s? If not, discuss this with
    your teen.
  • Include the friends in family activities. This will give you a chance to get to
    know the friends. It also will give you a chance to casually talk about your rules
    and expectations.
  • Teach teens the key to choosing friends is not to become popular. Friends
    should support your teen, enjoy many of the same things and contribute
    positively to your teen’s life.
  Know what to do when you do not approve. Following are some tips for handling
  this situation:
  • Examine your feelings. Is there a logical reason to dislike a friend of your child?
  • Do not flatly forbid friendships of which you do not approve. It seldom works
    and strains communication with your teen.
  • Talk to the teen about why a particular friend or group is not healthy. Be
    specific.
  • Encourage your teen to seek healthy friendships outside his or her clique.
    Remind your teen that truly popular people are those who accept and build
    friendships with everyone.
  • Know when to compromise and when to fight. A wild hairstyle will pass, but
    tattoos, teen pregnancies and drug addictions have lifelong consequences.
  The best way to help your teen make good decisions about friends is to provide
  plenty of love, support and encouragement. Teens need to have enough
  self-esteem to form their own opinions and not simply follow a group of friends.
  Standing up for beliefs is an important part of maturity. Teens with healthy
  self-esteem are less likely to cave in to the peer pressures of smoking, drinking,
  taking drugs or having sex.
  The bottom line is that cliques are a part of every teen’s life. With the right
  guidance, your child’s teen years can be a smooth transition into adulthood with
  good friends and positive experiences.




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   Pregnancy details

  The majority of teen pregnancies are unplanned.
  Because most adolescents lack the ability to connect          It may be
  present actions with future outcomes, they often do not       helpful to
  take steps to prevent pregnancy.
                                                                offer a more
  It may be helpful to offer a more accurate picture of         accurate
  parenting to sexually active teens. Ask your teen to
  consider the following questions.
                                                                picture of
  • What about success in school? It is tough doing             parenting to
    homework when a baby is crying or participating in          sexually active
    school activities when there is an infant at home to        teens.
    feed. Dreams of college and a career become more
    remote for teen parents.
  • What about money? Babies need diapers, formula, clothes, daycare and dozens
    of other things. This means money will be tighter and continuing an education
    may be too expensive. Lack of education means a low-paying job and less of a
    chance for a better life. Many teen moms assume parents will help and are
    surprised if they refuse.
  • Have you thought of friends and social life? Teen parents are busy with babies,
    which means less time for fun with friends. Having a baby often brings an end
    to spur-of-the-moment activities. Friends may call less often, thanks to the
    lifestyle changes parenthood brings. Having a baby is not an end to loneliness.
  Often the teen mom’s parents become the caretakers for their grandchild, so
  parents have a reason to be sure their children know the impact of pregnancy.
  What can parents do?
  • Encourage your teen to wait until adulthood to engage in adult activities.
  • Clearly explain the human body, sexual functioning and birth control, including
    where family planning materials can be obtained.
  • Spell out a pregnant teen’s options and discuss the advantages and
    disadvantages of each:
    - Keeping the baby; the reality of teen parenting.
    - Adoption.
    - Abortion.
  • Inform your teenager about sexually transmitted infections, such as
    herpes, gonorrhea and AIDS. Talk about ways to prevent these infections.
  • Impart your values to your children.




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   Pregnancy details

  • Talk about the sometimes unrealistic approach to sexuality presented in movies,
    television and books. Limit your teen’s exposure to such materials or talk about
    the programs or written materials with your teen.
  • Practice refusal skills. Teach your teen to say “no” to people who are asking for
    something that differs from your family’s values.
  • Work on your teen’s self-image. Stress that your teen is a great individual. Help
    your teen to realize his or her goals through fun activities like creating a
    time line. Encourage your teen to use creativity and draw symbols and dates to
    show when they plan to graduate high school and college, begin a career, travel
    and begin a family. Refer to the time line, encourage your teen’s progress and
    discuss how premature parenting can impact the projected goals.
  • Keep your teen involved in activities that promote healthy lifestyles, such as
    extracurricular activities, sports, faith-based activities and organized clubs.




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   Puberty details
  The period most people think of as adolescence really begins at puberty, the time
  when boys and girls begin the body changes needed to become men and women.
  These changes, and the emotions they bring, are the source of many questions.
  When does puberty begin?
  This varies from person to person. A girl may have her first menstrual period
  before the age of 10, although the average age is 12 1⁄2. Boys often enter puberty at
  11 or 12, though some begin earlier or later. If body changes do not begin by 13
  (for girls) or 14 (for boys), talk to a doctor.
  How does the body change in puberty?
  Every child’s body goes through puberty differently, though most people can
  expect the following:
  • A growth in height, plus gender-based body changes (boys’ shoulders broaden,
    girls’ hips widen and waists narrow).
  • Body hair grows under arms and in the pubic area. Boys may start to grow
    facial hair.
  • Skin and hair gets oily. Acne may begin.
  • Sweat glands develop, and sweat may have an odor.
  • Breasts in boys and girls may feel tender and sore. Boys may develop a small
    amount of breast tissue on one or both breasts that eventually goes away.
  • Feet may grow rapidly, making the child feel clumsy.
  • Girls begin having menstrual periods, develop breasts and gain the ability to
    bear children.
  • Boys’ testicles and penises grow. The ability to father children begins.
    Nocturnal emissions (wet dreams) may occur.
  What emotional changes come at this time?
  The hormones that bring on the physical changes of puberty affect emotions as
  well. The changes differ from child to child, though some are common to most:
  • Swings in mood.
  • A loss of concentration.
  • Sexual feelings.
  • A “mixed up” feeling. Sometimes the adolescent behaves like an adult,
    and other times, like a small child.




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   Puberty details
  What can a parent do to help?
  Begin by making sure your child knows puberty is coming and discuss ahead of
  time some of the body changes that are to be expected. Be reassuring and stress
  that everyone goes through this phase sooner or later.
  How can a parent cope with the challenges of
  puberty?
  • Reassure your child that everything is normal.
  • Keep your sense of humor.
  • Remember your own swirling emotions at that age.
  • Schedule a visit with your health care provider.
  Who else can help a child through puberty?
  Your health care provider or doctor can help both children and parents move
  through puberty. As part of a routine visit your health care provider can screen
  your child for normal development, answer questions and provide guidance to
  both parents and youth on what emotional and physical changes are to be
  expected during puberty and adolescence.
  Does a girl need a gynecologic evaluation when her
  menstrual periods begin?
  This usually is not necessary unless your child is sexually active or having
  menstrual problems. If you have any concerns, ask your child’s health care
  provider for more detailed information.
  For additional information, see the chapter about sexuality on Page 66.




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   Rape    details
  All women, including teenage girls, need to protect themselves against rape.
  Boys need to protect themselves as well, although male rape is less frequently
  reported. In recent years, the subject of rape, especially date rape (forced sex
  between people who are seeing each other socially), has come into the open.
  One of the best things parents can do is discuss the subject within the family.
  Talk about prevention, starting with the ideas below:
  • Create an atmosphere of openness between parent and teen. Do not deny the
    things a teen says, even if rape or incest are involved.
  • Share concerns about teen girls and boys being home alone together. Set rules
    and enforce consequences.
  • Teach daughters and sons some practical prevention tips:
    - Do not walk alone. Take along another person you trust.
    - Stay in supervised areas.
    - If trouble occurs, go to a well-lighted area with other people, such as a gas
      station, for help.
    - Lock doors.
    - Be wary when getting into cars.
    - Trust your instincts. If a situation is uncomfortable, find a way to leave.
  • Teach teens that sex is not a payback for a date, even if money was spent.
  • Allow only group or double dating for younger teens; encourage it for
    older ones.
  • Remind teens that alcohol is involved in a high percentage of rapes. Alcohol
    can lead to a lack of emotional control and poor judgment. Teach your teen to
    never leave any drink unattended.
  • Encourage teens to decide ahead of time what level of physical affection they
    want to share with their boyfriend or girlfriend.
  • Help your teen develop a plan to ensure they maintain the level of affection
    they choose.
  • Teach teens how to say “no.”
  • Role-play different situations. Try different ways to say “no:” humor, repetition
    and leaving.
  • Teach children that using sex to barter is wrong, especially if it is with an
    authority figure such as a teacher or boss.
  • Teach your children to tell a parent, a trusted teacher or a counselor if anyone
    touches them in a way that is uncomfortable.
  • Teach your teens that rape is a violent crime.




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   Religious issues
                details
  It is perfectly natural for parents with religious faith to
  seek to pass it on to their children. It is just as natural     Parents can
  for some teenage children to question it.
                                                                  reinforce the
  The teen years are a time when all values are under             value of
  question. Religious faith is no exception, even for
  children who have displayed strong faith during
                                                                  personal faith
  childhood. This questioning may even lead to rejection          by allowing a
  of some values learned through a lifetime of family             teen free
  modeling and religious instruction. Eventually, however,        choice to
  the freedom to question can help a young person come            participate
  to a deeper, more personal faith that can last a lifetime.
                                                                  or not.
  Parents with religious faith can help in this process by
  providing a firm foundation in the family for faith to grow.
  Begin by making religious observance a family rule. For many families, this means
  regular attendance by all family members at a house of worship of the parents’
  choice. The regularity and reassurance of this approach will be a valuable
  cornerstone on which to build an adult spiritual life.
  Teens look to parents as role models, which makes living the faith you preach
  important. Be open in the practice of spiritual disciplines at home, and make a
  point of discussing faith issues in a personal, nonjudgmental way.
  Respect a teen’s views with the same respect given to a fellow adult. Answer
  questions honestly, and do not be afraid to admit you do not know some answers.
  Take these moments as an opportunity to learn more together.
  When it comes to coming-of-age events, give teens a choice. Rituals such as
  baptism and confirmation (in the Christian faith) and bar or bat mitzvah (in the
  Jewish faith) are first steps toward spiritual adulthood. Parents can reinforce the
  value of personal faith by allowing a teen free choice to participate or not.




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   Risky behavior
               details
  Teens often are risk takers. They believe they are invincible, that nothing bad
  happens to young people. They may not see the possible results of their actions.
  Drugs and alcohol pose the greatest threat to teenagers. Seventy percent of
  injuries to teens are associated with the use of drugs or alcohol. For additional
  information, see the chapter about alcohol on Pages 2 and 3 and the chapter
  about drugs on Pages 26 to 28.
  Peer pressure is strong, and teens tend to rebel. By talking regularly with teens,
  parents have a better chance of influencing their activities. Good habits taught to
  young children are carried into the teen years.
  The leading causes of death for teens include:
  • Motor vehicle crashes, when not wearing seat belts.
  • Homicide.
  • Suicide.
  • Bicycle and motorcycle accidents when riding without a helmet.
  • Drowning in pools after climbing fences.
  • Drowning or diving injuries when swimming in unfamiliar water.
  • Pedestrians hit by motor vehicles.
  • Accidents from guns and explosives.
  • Assault with blunt objects.
  • Assault with cutting objects.
  • Sports injuries.
  Advice about tobacco
  Cigarette use among teens steadily has increased in recent years. Smokeless
  tobacco (chewing tobacco and snuff) has become popular among teenage boys.
  Make certain your teenager understands the health risks associated with tobacco.
  These dangers include lung disease and cancer.
  One of the best predictors of teen smoking is parent smoking. If you want your
  teen to be smoke free, consider quitting yourself before your child is at risk. For
  additional information, see the chapter about tobacco on Page 83.




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   School issues
               details
  To a teenager, school may seem like the center of the universe. It can be a source
  of achievement, self-esteem, friendship and fun, or it can be pure misery.
  Sometimes it is all of those things on the same day. This natural swing in mood is
  heightened by many pressures on today’s teens.
  A number of things can cause problems in a teen’s school world, such as:
  • The natural increase in a teen’s social life in high school may temporarily affect
    schoolwork.
  • Other changes in the teen’s life, like family problems and physical changes, also
    can affect schoolwork.
  • A sudden, extreme change could be a warning of drug or alcohol use.
  • Parents who expect too much can put excessive pressure on a teen. For
    example:
    - Parents need to adjust standards as a child grows older (a child who is ranked
      No. 1 in grade school may be No. 20 in a larger high school).
    - Parents should be able to accept the fact that a teen may have to repeat a
      course.
    - Parents should be sure they are responding to what is good for the child, not
      what makes them feel good as parents.
  Tips for working out school solutions include:
  • Work with the school, taking advantage of the staff’s expertise, but do not
    expect educators to solve problems.
  • School psychologists are a good place to start. They generally are willing and
    able to help.
  • Do not be afraid to seek other outside help. Some school psychologists are only
    trained in psychological testing, not in therapy.
  • A psychologist can give an assessment of emotional factors.
  • Independent academic testing can give a picture of progress and/or problems in
    schoolwork.
  In the end, most children are average students. The goal of the school and the
  student should be the same: to build the foundation for a fulfilling, productive
  adult life.




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   Self-esteem details

  Self-esteem is not winning a gold star or making the basket that wins the game.
  Positive feelings come from a much deeper source. Self-esteem is having respect
  for oneself, one’s character and one’s conduct. Well-adjusted self-esteem is a
  reliable, built-in feeling, not something handed out by peers or parents. A teen’s
  self-esteem can be nurtured or damaged by peers, parents and other trusted
  adults. If this reservoir of self-respect is not filled throughout childhood, it
  becomes much harder to fill later. You can help your teen’s self-esteem by setting
  up situations in which he or she can be successful through his or her own efforts.
  Tips for building a teen’s self-esteem
  • Notice when your teen does something good and offer appropriate praise.
  • Never stop offering encouragement. Teens never tire of feeling special and
    loved. Don’t worry that legitimate praise will make your teen arrogant.
  • Firm boundaries build self-esteem. A set of clear rules and consequences make
    a teen feel secure. Security promotes a positive self-image.
  • Tell your teen that you love him or her and give hugs just for being who he or
    she is. If you only praise teens for doing things, they will think they are only
    lovable if they are achieving goals.
  • Always compliment them in public and correct them in private.




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   Sexuality details

  In many families, the spur to discuss “the birds and the bees” comes from
  outside. A pediatrician may suggest it as part of a regular exam. A child’s school
  may offer classes in human growth and development.
  These events are a good invitation to sit down for a talk about the basic facts of
  sex. A doctor can help by offering literature or advice. Schools may lay the
  groundwork by talking about how babies are conceived. A parent often is most
  able to cover the full subject, including the moral issues and answering specific
  questions.
  There are as many ways to discuss the facts about sexuality as there are parents
  and children to discuss them. The points offered below are simply broad guide-
  lines, designed to lead to a healthy, helpful parent/teen talk.
  • Start early. Ideally, honest answers to sexual questions will have been the family
    rule since the child was a toddler. Arrange the time for a complete talk during
    puberty or just before. A full discussion, held early, can counter the wrong
    information peers may spread.
  • Ask what pressure your teen is feeling and what he or she considers normal
    sexual behavor. Ask your teen questions to find out what he or she knows. You
    may be surprised by what your teen already knows.
  • Always use the correct names for sex organs, sexual behaviors and sexual
    orientation.
  • Avoid scare tactics as a way of preventing your teen from having sex.
  • Talk to teachers. A child’s teacher can share what is being taught on sexual
    development in school and offer helpful tips from teaching experience.
  • Recognize embarrassment. Do not cover up shy feelings on this delicate
    subject or use jokes. Listen supportively as your child shares awkward feelings.
  • Share your views and family rules about sexual activity. Be clear about your
    values and why they are important to you. Let your teen know that others may
    have different values that should be respected. Offer unbiased information to
    lay the groundwork for wise personal choices.
  • Give full and honest answers. Admit when you don’t have all the answers.
    Use other sources, such as outside professionals or books, for information that
    cannot be supplied at home.
  • Listen to your child’s concerns about the changes he or she is experiencing. Let
    your teen know that you’re available to listen or to talk.
  • Keep in mind that your teen may explor a sexual orientation other than opposite
    sex behavior or affiliation.
  • Ensure a safe place at home for your teen to talk about sexually topics openly.
    Not talking about it or ignoring the subject will not make it go away.


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   Sexually transmitted infections
                details
  Anyone who is sexually active can get a sexually transmitted infection. That
  includes teenagers.
  These infections are spread from person to person during close sexual contact.
  This includes sexual intercourse, oral sex and anal sex. Infections also can be
  transmitted during very close genital contact without vaginal, oral or anal sex.
  Sexually transmitted infections include:
  • AIDS (Acquired Immune Deficiency Syndrome): An infection that destroys the
    body’s immune system and is caused by the human immunodeficiency virus
    (HIV). There is no known cure for HIV/AIDS. Most people eventually die from
    this infection.
  • Chlamydia: A curable, very common infection among teens and the No. 1
    cause of female infertility. Seventy-five percent of females and 25 to 50 percent
    of males will have no symptoms when infected.
  • Genital warts: An infection caused by human papilloma virus that is not
    curable. It is the leading cause of cervical cancer in females. The majority of
    infected males and females do not have visible warts yet still are contagious.
  • Gonorrhea: A curable infection that affects both males and females and is very
    common among teens. If untreated, it can cause problems in the joints, heart
    and other body systems.
  • Hepatitis B: An infection that affects the liver and is passed along during sex
    with an infected person or from exposure to infected blood. All adults and
    children should receive a series of three vaccinations to be protected from this
    infection.
  • Herpes: Caused by herpes simplex virus. There is no known cure for herpes.
    Infection causes painful, recurring genital ulcers. It also can be transmitted in
    the absence of visible sores.
  • Pubic lice or “crabs:” Small, light brown, flat, pinhead insects that infest pubic
    hair and cause small, red sores and itching in the pubic area. This can be
    transmitted by very close physical contact with an infested person. Lice usually
    are killed and symptoms cleared after about one week of proper treatment.
  • Syphilis: A curable infection that causes a painless sore on the genitals. If not
    detected and treated, it can cause more permanent health problems.
  • Trichomonas: A curable infection causing yellow-green, frothy vaginal discharge,
    itching and bad odor in females. Males may have no symptoms but may be
    carriers.




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   Sexually transmitted infections
                details
  Although a person could have a sexually transmitted
  infection and look and feel healthy, general symptoms of       Many
  these infections may include:
                                                                 physicians’
  Females:
                                                                 offices, clinics
  • A feeling of burning or itching around the vagina.
  • An unusual discharge or smell from the vagina.               and public
  • Bleeding from the vagina other than during the regular       health depart-
    menstrual cycle.                                             ments offer
  • Lower abdominal pain or cramping.                            information
  • Pain deep inside the vagina during sex.
                                                                 about how to
  Males:                                                         talk to your
  • A drip or discharge from the penis or unusual staining
    of the underwear.
                                                                 teen about
  • Tingling sensation inside the penis.                         sexually
  Both males and females:                                        transmitted
  • Swelling in the groin in the area around the sex             infections.
    organs.
  • Sores, bumps or blisters near the sex organs or mouth.
  • Burning or pain when urinating or during a bowel movement.
  • Flu-like feelings, with fever, chills and aches.
  Often, there are no symptoms of an infection.
  Treatment of sexually transmitted infections
  Infections caused by bacteria, such as chlamydia, gonorrhea, syphilis and
  trichomonas, can be treated with antibiotics and cured. Other infections caused
  by viruses, such as HIV, herpes, genital warts and hepatitis, cannot be cured with
  antibiotics. Some treatments can be used to aid in symptom relief for infections
  that cannot be permanently cured.
  It is important to know that with the exception of the syphilis lesion, the
  symptoms of even curable infections will not go away without treatment. If they
  are not treated, there can be lifelong problems.
  It also is important to know there may be no symptoms for some infections.
  If your teen is sexually active, he or she should be tested for gonorrhea and
  chlamydia every six months and annually for most other infections.
  Many communities have clinics for the testing and treatment of infections. Most
  health care providers know how to treat these infections and will maintain your
  teen’s confidentiality. Your teenager’s privacy will be protected, no matter where
  you get treatment.

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   Sexually transmitted infections
                details
  If your teen has a sexually transmitted infection, his or her sexual partner(s)
  must be told about the infection. These persons also must receive treatment
  right away so they do not spread it to others or re-infect someone who has
  received treatment.
  The teen should not have sex again until the infection is gone and his or her
  partner also has been treated.
  If sexually transmitted infections are not treated:
  • They may be passed on to others during sexual contact.
  • They may be passed on to infants in the womb, during childbirth or when
    breast-feeding.
  • Reproductive organs may be damaged. Males and females may not be able to
    have children.
  • It may cause more serious infections and symptoms.
  Prevention of sexually transmitted infections
  The best way to avoid sexually transmitted infections is to completely abstain
  from sexual contact.
  If your teen is sexually active, offer the following tips:
  • If you notice your sexual partner has a rash, sore, redness or discharge, do not
    have sex.
  • Use a condom (rubber) every time you have sex. If used correctly, a condom
    will protect you from infections much of time; however, they are less effective
    in preventing infections from herpes, syphilis and genital warts. Make certain
    your teenagers know the proper way to use a condom. Females should not rely
                                                           on the male to carry con-
                                                           doms. Sexually active
                                                           females also should carry
                                                           condoms.
                                                        Many physicians’ offices,
                                                        clinics and public health
                                                        departments offer informa-
                                                        tion about sexually transmit-
                                                        ted infections and how to
                                                        talk to your children about
                                                        these issues. Teens can be
                                                        evaluated and treated for
                                                        infections without their
                                                        parents, if necessary.


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   Sexually transmitted infections
                details
  In Milwaukee, contact:
  Custer/Lady Pitts School Based Health Center
  5075 N. Sherman Blvd.
  Milwaukee, WI 53204
  (414) 393-4919
  Downtown Health Center/Adolescent Clinic
  1020 N. 12th St.
  Milwaukee, WI 53233
  (414) 277-8900
  South Division Cardinal Clinic
  1515 W. Lapham Blvd.
  Milwaukee, WI 53204
  (414) 902-8338
  Contact any Planned Parenthood of Wisconsin location for more information
  about preventing and treating sexually transmitted infections.
  Additional Resources
  “Caring for your Adolescent, Ages 12-21, the Complete and Authoritative Guide,”
      Ruth Bell, Vintage Books.
  “You and Your Adolescent: A Parent’s Guide for Ages 10-20,” Laurence
      Steinberg, PhD, and Ann Levine, Harper and Row.
  “Facts about Sex (or When Living Hurts or The Teenage Survival Book, or Raising
      a Child Conservatively in a Sexually Permissive World),” Sol Gordon,
      Ed-U-Press.




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   Skin problems
               details
  Where skin is concerned, many teenagers seek a pimple-free, richly tanned
  appearance. Doctors usually are able to effectively treat acne and are urging
  parents to focus on the damaging effects suntanning can have on a young
  person’s skin.
  What causes acne?
  Acne is a common reaction in teens, caused by hormones acting on the oil glands
  in the skin. The glands become plugged and sometimes rupture, causing a red,
  puffy pimple to form.
  Acne is not caused by the things past generations believed:
  • By not washing often enough.
  • By foods such as chocolate or french fries.
  • By emotional stress (although stress can make it worse).
  How is acne treated?
  Over-the-counter acne medicines may help a mild case of acne. Scrubbing the
  face with loofahs or coarse “puffs” actually may make acne worse.
  Speak with your child’s physician about acne medication options.
  What are the results of not treating acne?
  The treatment for acne may seem unpleasant for awhile, but this pales when
  compared to the long-term effects of untreated acne.
  • Facial scarring is possible. This can be difficult for plastic surgeons to
    remove later.
  • Emotional scars. Studies show that even a few pimples may affect self-esteem
    and mood.
  Should teens limit their sun exposure?
  Teens love the sun. A rich suntan enhances their image to others. It also
  enhances the likelihood that skin will show age prematurely.
  A teen who wishes to keep a youthful appearance throughout life should avoid
  unnecessary sun exposure. This especially is true if the teen is using a
  prescription acne medication.
  • Long-term effects could include wrinkling, dryness and loss of elasticity.
  • The effects of sun exposure cannot be undone.
  • Exposure in a tanning booth has an effect similar to direct sunlight.
  If a teen must be exposed to sunlight, encourage a visored hat, cool yet protective
  clothing and an effective sunblock with a minimum sun protection factor (SPF)
  of 15. Just one blistering sunburn increases the chances of developing skin
  cancer.

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   Sleep   details
  Parents of teens often feel frustration about their
  children’s sleeping habits. Teens are stereotyped as           Your teen will
  staying up to all hours of the night, then lying in bed
  late. The truth is, they often do, and it’s biologically
                                                                 be more rested
  important.                                                     by going to
  Many people believe that as children get older, they           sleep and
  need less sleep. However, studies indicate that the            getting up at
  teenage brain needs about nine hours of sleep each             about the same
  night for optimal functioning and development. When            time each day,
  you take into consideration that a typical teenager’s
                                                                 including
  schedule includes school, athletic practices, homework
  and an after-school job, it is no surprise that most teens     weekends.
  average only six to seven hours of sleep.
  Brain development during the teenage years almost is as explosive as during
  infancy, especially in the areas that control thinking and reasoning. Extra sleep
  helps develop new neural connections that increase intelligence, self-awareness
  and performance.




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   Sleep   details
  Sleep deprivation in teens can affect their moods and ability to think, perform
  and react appropriately. Teenagers who lack sleep can become irritable. Their
  inability to concentrate may cause academic performance to slip. It is important
  to work with your teen to ensure he or she is getting enough sleep to achieve
  optimal growth and development.
  What parents can do
  • Learn to recognize signs of sleep deprivation. Using several alarm clocks,
    needing help to awaken or falling asleep during the day are simple signs.
  • Establish a sleeping routine. Your teen will be more rested by going to sleep and
    getting up at about the same time each day, including weekends.
  • Avoid taking long naps during the day. If a nap is needed, limit it to 20 to 30
    minutes.
  • Encourage your teen to schedule less difficult classes in the morning when
    concentration may be limited.
  • Encourage learning. For brains to grow, they need proper stimulation. Limit
    computer games, Internet surfing and television.
  • Don’t allow your teen to “cram” for exams with late-night study sessions.
  • Help your teen find balance. Teens need a variety of activities and experiences
    for their brains to grow, but they also need time to relax and rejuvenate.
  • Exercise in the morning may help your teen wake up, but avoid exercise right
    before bed.
  • Avoid caffeine in the afternoon and evening.
  • Schedule some time to relax and unwind before trying to fall asleep.
  • Be patient, and understand that your teenager’s sleep needs are different
    than yours.
  Disrupted sleep patterns can cause depression, moodiness, poor judgment and
  memory loss. Hormone imbalances caused by lack of sleep can even increase
  acne. Help your teen develop sleep habits that will stay with him or her for life.




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   Sports  details
  For many teens, sports activity is one of the most important and satisfying parts of
  life. The teen years can set the stage for a lifetime of sports involvement.
  A wider range of sports are available to young people than ever before.
  Opportunities for girls to participate in sports have grown significantly.
  However, taking part in sports also can mean injuries. Many teens may not
  have the maturity to spot possible hazards. Rapid physical growth can make
  movement awkward.
  Adults can guide teens in making wise choices about sports. Even a teen with a
  disability or a physical injury can find some type of healthy, character-building
  sport to enjoy. These simple guidelines will help to steer teens away from the
  dangers of sports injuries and toward a healthy pattern of sports activity that can
  last long after the teen years.
  • Know what your teen is doing. Take time to learn the coach’s philosophy, and
    consider his or her experience. Compare notes with other parents. Read books
    and articles on sports safety.
  • Make your teen responsible for safety. Teach the teen to set limits for physical
    risk-taking (such as “playing through” a potential injury or attempting a
    dangerous maneuver) and to stay within those limits even when instructed to
    exceed them by a coach. Make sure your teen knows that you’ll listen to
    concerns about his or her coach.
  • Understand the risks at a sport’s higher levels. If top-level competitors often are
    injured, consider the risk before entering the sport.
  • Remember, minor injuries are a natural part of sports. The goal of safe sports
    activity is to keep minor injuries from becoming long-term problems.
  • Consider the pluses and minuses of a chosen sport. As an example, a few
    popular sports are considered in the chart on the following pages.
  • Play by the rules. Many rules are put in place to prevent serious injuries.
  • Avoid steroids. Supplements do not improve athletic performance and do not
    increase muscle size or strength. In fact, young athletes can suffer cramping
    and dehydration after taking protein supplements. Steer your child away from
    performance-enhancing vitamins and drugs.
  • Make sure your teen has regular physical examinations. For high schoolers, this
    means an exam every two years unless specific health concerns develop.
  • Make sure your teen is getting proper nutrition.
  • See a physician promptly when you are worried about a possible injury. Some
    seemingly minor injuries can be severe. Call your doctor or go to the emergency
    room if you suspect your teen has had a concussion or other head injury, a neck
    or back injury or if there is joint pain, especially pain that causes a limp or
    weakness in an arm or leg.

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   Sports  details
  • Go to the emergency room if there is pain that does not respond to over-the-
    counter medication, severe swelling, a deep cut or if any movement causes
    severe pain.



                                                                      Safety
  Sport         Benefit                     Common injuries           equipment
  Baseball      Teaches teamwork and        Pitchers are prone to     Helmet, gloves.
                eye/hand coordination.      elbow and shoulder
                Does not require            injuries. Players also
                extensive physical          can get injured while
                conditioning.               sliding.
  Basketball    Develops eye/hand           Injuries to knees,        High-top shoes.
                coordination and            ankles and hands.
                teamwork. Lifelong,
                year-round activity.
  Bicycling     Good cardiovascular         Head injury (Low risk     Fitted helmet.
                conditioning. Lifelong      if helmet is worn).
                activity.

  Football      Builds team spirit,         Upper and lower           Helmet/gear
                physical strength and       extremity, spine and      appropriate to
                fitness. Many options       head injuries possible.   position played.
                for participation.
  Gymnastics    Teaches dedication          Injuries from falls and   Proper
                and individual              weight-bearing in the     instruction,
                achievement. Develops       upper extremities.        spotter, mats.
                coordination, flexibility   Backaches from
                and strength.               hyperextension.

  Hockey        Good cardiovascular         Most injuries are to      Helmet and gear
                conditioning. Teaches       upper extremities due     appropriate to
                teamwork, eye/hand          to checking.              position played.
                coordination.




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   Sports  details
                                                                  Safety
  Sport        Benefit                  Common injuries           equipment
  Lacrosse     Teaches teamwork and Moderate injury               Helmet/gear
               eye/hand coordination. potential.                  appropriate to
                                                                  position played.

  Roller-      Easy access and          Most common injuries Helmet, wrist
  blading      appeals to a wide age    are scrapes, bruises braces, elbow
               range and ability.       and sprains.         and knee pads.
  Skate-       Teaches individual    Most common injuries Helmet, wrist
  boarding     achievement. Develops are scrapes, bruises braces, elbow
               coordination.         and sprains.         and knee pads.


  Skiing       Appeals to a wide age    Moderate injury           Helmet, warm
               range.                   potential.                clothing.
  Soccer       Appeals to a wide age    Most injuries are to      Shin guards.
               range.                   lower extremities,
                                        especially to knees.
  Swimming     Good total-body work-    Shoulder rotator cuff     Proper safety/
               out with low stress to   pain due to unnatural     rescue equip-
               bones and joints.        arm movement.             ment at pools
                                        Swimmers’ knee from       and lakes.
                                        breast stroke.
  Tennis       Develops eye/hand        Injuries in elbow,        Well-fitting
               coordination. Year-      wrist or shoulder,        shoes.
               round activity.          occasional stress
                                        fractures in bones.
  Track        Good cardiovascular      Watch for pain with       Well-fitting
               conditioning.            activity, especially pain shoes.
                                        around joints or stress
                                        fractures in bones.

  Volleyball   Promotes communica-      Common injuries are     Knee pads.
               tion, teamwork and       to shoulders, forearms,
               eye/hand coordination.   fingers, knees, ankles
                                        and hands.

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   Suicide details
  Suicide rates among teens are alarmingly high.
  This growing problem worries parents, who are concerned every time a teen
  seems out of sorts. Counselors who work with teens suggest that parents learn
  the facts and correct the myths commonly believed about this tragic trend. For
  more information, call Rogers Memorial Hospital at (800) 767-4411, Children’s
  Service Society of Wisconsin at (800) 653-2779 or one of the confidential parent
  help lines listed on Pages 54 and 55.
  Some myths about teen suicide
  • Myth 1: Someone who talks about suicide will not do it. On the contrary,
    talking about suicide is a way of asking for help. If you are worried because your
    teen expresses such thoughts, you need to investigate it. Often, when teens talk
    about suicide, they act on their thoughts.
  • Myth 2: Talking about it just gives a teen the idea. Studies have shown that
    nearly all teens think about suicide at some time, whether parents discuss it or
    not. According to the Centers for Disease Control, 20 percent of high school
    students seriously consider suicide every year. Talking about it will help teens
    realize just how final a decision of suicide is. By talking with them, you can help
    them to see other options besides suicide and let them know that you are a
    support for them if they ever have suicidal thoughts in the future.
  • Myth 3: Only people who are mentally ill commit suicide. Some mental
    illnesses which prompt suicide, including depression, schizophrenia and
    manic-depressive illness, show up first in the teen years. Other teens who
    consider suicide have none of these illnesses. Recent losses or other problems
    that reflect poorly on the youth can lead to suicide attempts. The most common
    reason for suicide is a sense of hopelessness.
  Some common reasons for considering suicide
  • School problems.
  • Romance or friendship problems.
  • Fears about sexual identity or homosexuality.
  • Recent losses that interfere with normal living for more than four to six weeks,
    such as:
    - Loss of a family member.
    - Loss of a friend.
    - Death of a peer, even if your teen was not a close friend.
    - Death of a music star or movie star.
    - Loss of a family pet.




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   Suicide details
  Look for the warning signs
  • Talking or writing about suicide.
  • Reading books about suicide.
  • Talking about people who have taken their own lives, including friends, family
    members or celebrities.
  • Giving away prized personal possessions.
  • A sudden calm after a period of feelings of despair. The calm feeling may be
    present because the teen has made the decision to die and is content with that
    decision.
  What can a parent do?
  • Get help (see the chapter about parenting resources on Pages 54 and 55). This
    is not an issue most parents can deal with alone. Ask for help in discussing
    suicide with your teen.
  • Talk to the teen involved.
  • Be certain the teen knows of your loving concern.
  • Do not shield the teen from the real-life issues involved.
  • Urge the teen to call a suicide hotline.
  • If you feel the situation is life threatening, take the teen to a hospital emergency
    room or call 911.
  For additional information, see the chapter about death and dying on Pages 18
  and 19.




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   Summer activities
              details
  Summer vacation seems like the perfect time for teens
  to catch up on their sleep. In part, that’s true. The           You can add
  summer break is for relaxing and escaping the pressures
  of the school year. However, teens with too much time
                                                                  special projects
  on their hands may resort to irresponsible behavior or          to your teen’s
  get so used to lazy days that going back to school is           list of chores.
  tough. Therefore, it’s important that teens still have          Think of
  some structure to their days.                                   unusual tasks
  Some activities for teens                                       that might
  • Spending time with friends. Encourage your teen to            provide a
    get involved with friends in healthy activities. Day          challenge.
    trips could include hiking, water parks, museums,
    mountain biking or amusement parks. It’s important for your teen to spend time
    with friends in a positive environment.
  • Volunteering. Many teens find it fun and rewarding to volunteer at hospitals,
    senior centers, nursing homes, shelters or child care facilities. They make new
    friends and often develop a passion for helping people that stays with them
    throughout life. Also, your teen can feel like his or her time spent truly is
    worthwhile.
  • Camp. Camps offer a variety of interesting activities, such as horseback riding,
    theater, arts, sailing, canoeing and group camping. It’s a great place to meet new
    friends and spend a week or two doing new things. Teens get to be away from
    home, yet still are supervised. Older teens also may be able to participate as
    camp counselors for younger campers.
  • Classes/lessons. Many teens may not want to think about going to class during
    the summer, yet there are a lot of great opportunities in your community to
    learn fun things. Ask your teen if there’s something he or she has always wanted
    to learn. Whether it’s taking music lessons, pottery or painting classes, or
    playing sports in summer recreation programs, help your teen get excited about
    acquiring new skills.
  • Summer jobs. Earning money is a great way for your teen to learn about
    responsibility while giving him or her a sense of independence and
    accomplishment. Money management skills, such as budgeting and saving, can
    only help your teen in the future. Money isn’t everything, so urge your teen to
    find a job he or she really will enjoy. Be sure to check that the job will be safe
    for your teen. Some types of employment have legal age limits, so be sure to
    check that your teen is old enough for the job.



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   Summer activities
              details
  • Special tasks. For extra allowance or special privileges, you can add special
    projects to your teen’s list of chores. Think of unusual tasks that might provide
    a challenge. Organizing closets and cupboards, painting the basement or even
    refinishing furniture may be things you can’t find the time to do yourself. Your
    teen has time to spend on these tasks and will benefit from learning what it’s
    like to complete a big job from start to finish.
  Taking part in
  activities such as
  these will keep your
  teen mentally
  stimulated over the
  long break, thus
  more likely to do
  better in school the
  following year.
  Providing structure
  for your teen this
  summer may be
  more easily accepted
  than you think.
  Teens who have
  access to a lot of
  interesting
  summertime
  activities may end up
  having so much fun
  they don’t even
  realize they are on
  a schedule.




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   Telephone usage
              details
  Parents of teens may find this scenario familiar: Your teenager is talking on the
  phone. You check again in half an hour. The teen still is talking. Two hours slip by,
  and the teen continues chatting away. Perhaps the teen is on the phone for a
  mere half-hour, but homework still is in the teen’s backpack.
  Set and enforce telephone rules
  You do not need to make an issue out of talking on the telephone unless it is a
  problem. If it is a problem, set some guidelines.
  Time spent on the telephone should not interfere with homework. It also should
  not interfere with teens taking care of themselves, for example, getting clothes or
  lunches ready for school the next day.
  An effective way to structure time spent on the phone is to assign a block of time
  to talk on the phone each night. An hour is appropriate – perhaps from 8 p.m. to
  9 p.m. Setting a block of time for teens to talk on the phone lets them have a
  consistent time for themselves and their friends. They can tell their friends, “Call
  me between 8 and 9.” It also sets a time when parents can tell their friends or
  business associates, “Don’t bother calling us between 8 and 9.”
  Another way to structure time is to limit the amount of time per telephone call.
  Allowing phone usage for 15 to 20 minutes per call, for example, will not tie up
  the phone line for a full hour at a time.
  Keeping in touch
  Often, parents find their best time to talk on the phone is when the teens are
  out socializing, but they also want their teens to be able to reach them if an
  emergency arises.
  Many parents of teenagers choose to get a “call waiting” feature on their
  telephone. With call waiting, teens who are out with the family car or socializing
  with friends can easily reach you during an emergency, even if you or your other
  children are using the phone.
  Some parents also find an answering machine can help screen calls when their
  teens are out socializing. The answering machine can take messages from the
  friends trying to reach your teen, while you can relax with a favorite video or book.
  Cellular phones
  Cell phones are very popular with teens. If you are thinking about a cellular
  phone plan for your family, you should consider the following questions:
  • What is the basic monthly charge?
  • How many unrestricted minutes are included?



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   Telephone usage
              details
  • How many free night and weekend minutes are included?
  • What is the per minute airtime rate if included minutes are exceeded?
  • What is the long distance charge?
  • Are there roaming charges when you are outside your local area? If so, what
    is the charge per minute?
  • What is the schedule for peak versus off-peak minutes?
  • What is the charge for text messages?
  • What is the charge for Internet access if the phone has it?
  • How long is the initial contract period?
  • Can changes to the plan be made during the contract period?
  • What is the cost of termination during the contract period?
  You should discuss who will be responsible for the following charges with
  your teen:
  • The basic charge for the phone.
  • Any minutes over your basic plan.
  • Text messages.
  • Internet access.
  • Replacing the phone if it is lost.
  You also should discuss responsible use of cell phones.
  • Sending threatening messages or intimidating others using a cell phone
    is illegal.
  • Using a cell phone to cheat in school is wrong.
  • Using a cell phone camera to secretly take pictures or capture video clips is
    wrong and in some cases illegal.
  • The same rules that apply to Internet chat rooms also apply to cell phones. Do
    not give out your address, cell phone number or other personal information.
  • Do not talk on the phone while driving. University of Utah researchers found
    that teenagers and young adults who used a cell phone while driving reacted as
    slowly as elderly drivers who were not using a phone. It’s much safer to pull
    over to use the phone. Your state or community may even have laws that restrict
    this privilege. Check with your local police department for regulations and
    penalties.
  Consider making a contract with your teen that defines how the phone will be
  used and the consequences of failing to use the phone appropriately.




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   Tobacco details
  The best way for a teen to quit smoking cigarettes is not to start. Unfortunately,
  this message comes too late for an alarming number of teenagers. Each year, 1.5
  million teenagers start to smoke. Most American smokers begin their habit before
  the age of 20. Teens also make the mistake of assuming they can quit later. They
  believe only old people get sick from smoking.
  Parents of teens who smoke can do much to bring the downside of smoking into
  focus. Make certain your teenager understands the health risks associated with
  tobacco. These dangers include lung disease and cancer. You also should be aware
  that selling or giving cigarettes to anyone younger than 18 is illegal in Wisconsin.
  Forcing a teen to quit usually is not effective, since much of teen smoking goes
  on behind a parent’s back.
  Below are steps to try to help teens come to terms with tobacco use:
  • Make your own feelings clear on the subject. State your concern about your
    teen’s health and about your concern for smoking’s effects. Nobody has a right
    to nag, but it is your privilege as a family member to state your beliefs.
  • Examine your own tobacco use. If you smoke or chew tobacco, you may be
    modeling behavior for your teen. Consider quitting.
  • Educate teens on smoking and smokeless tobacco dangers. Offer literature or a
    chance to attend programs on the topic. A teen may know smoking is generally
    dangerous but may have overlooked the distressing specific evidence.
  • Set consequences for using tobacco. Begin by forbidding tobacco in your home
    or when other family members are present. You also may consider withholding
    privileges as a response to continued smoking, but be aware that punishment
    will not force a smoker to stop.
  • Point out the short-term consequences of smoking. It can reduce endurance for
    those involved in athletics. It can stain teeth and fingers. The smell lingers in
    hair and clothing.
  Despite all your efforts, your teen may continue to smoke. Smoking in teens is
  hard to stamp out. Staying mad or endlessly nagging will not change the behavior,
  and it will take an emotional toll on you.
  Virtually all teen smokers know smoking is harmful. They need help to quit this
  highly addictive habit. Let them know you are willing to help. Literature on
  quitting is available from the American Lung Association. Your health care
  provider has various medications that can help you or your teen quit smoking.




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   Violence details

  Some people think of violence as a social problem that doesn’t directly affect their
  family. Others know violence as a daily, personal reality. Both groups feel power-
  less to stop it.
  Experts agree the best place to begin the fight against violence is within the
  family. There are many practical steps a parent can take to create a less violent
  family. A calm home atmosphere can make your teens less likely to act violently
  and less likely to be the victim of violence.
  Now is the best time to begin taking anti-violence steps such as those listed
  below.
  • Create a less violent home environment. Family members who witness or
    experience domestic, sexual or child abuse in the home are more likely to be
    violent in the community.
  • Watch for the symptoms of post-traumatic stress disorder resulting from wit-
    nessing or being a victim of violence. If untreated, post-traumatic stress disorder
    may lead to future violence. Symptoms include:
    - Irritability or crankiness.
    - Nightmares or flashbacks.
    - A desire for isolation.
  • Limit access to violent television and movies. View questionable programs
    together and talk afterward. Express your concern through letters or calls to
    news media outlets.
  • Cut off the fuel of violence: alcohol and drugs. The mind-altering effects of
    these substances are linked to a substantial number of violent and suicidal acts.
  • Maintain a gun-free home. Suicide is seven times more likely if there is a gun
    in the home. If firearms must be available, limit teen access. See the chapter
    about firearm safety on Page 37 for more information.
  • Fight violence with healthy activity. Find ways to keep teens at home or busy in
    places away from violent activities.
  • Discuss ways to handle violent situations:
    - Get out as quickly as possible.
    - Teach methods for calming an angry peer.
    - Seek out community violence prevention programs. Learn additional
      prevention tips and join in communitywide efforts. For more information,
      contact Project Ujima at (414) 266-2557.
  Violence touches us all, and we all can play a part in curbing it.




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   Water safetydetails

  The following water safety rules can help you keep your teen safe and healthy
  during the summer months and throughout the year.
  Never
  • Swim or go boating when you have been drinking alcoholic beverages or allow
    your teenagers to do so. Remember, your life and the lives of your family
    members depend on it. Often, children drown in the presence of adults who
    have been drinking.
  • Allow running or pushing in pool areas.
  • Allow playing or swimming in rivers or other unfamiliar waters. There may be
    dangerous currents, hidden rocks or unknown depths. River currents can cause
    drowning even among the strongest of swimmers. Polluted water may be a
    health hazard.
  • Allow more than one person at a time on a diving board. Do not dive headfirst
    into a pool or unknown waters.
  Always
  • Apply sunscreen with a rating of SPF 30 or higher to skin every two hours.
  • Use the buddy system when swimming, regardless of age or ability.
  • Wear approved personal flotation devices when in a boat or riding personal
    watercraft, such as a jet ski.
  • Swim in the designated swimming areas of a lake.
  Education is important
  • No one younger than 16 years of age should operate a boat or a personal
    watercraft.
  • Participate in a safe boater course.
  • Families, especially those with backyard pools, should know how to perform
    cardiopulmonary resuscitation. Classes are offered by many hospitals and the
    American Heart Association.
  • Be aware of water hazards in the winter. Never go on a pond or lake unless you
    are certain it is solidly frozen. Many drownings occur in winter months when
    adults or children fall through the ice.




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   Winter safety
               details
  Wintertime fun should not be life threatening, yet often it is. Cold and
  recreational activities can result in serious injuries and even death.
  Consider the following tips to protect your teens from winter’s chill:
  • Avoid prolonged exposure to extremely cold weather.
  • Insist on adequate layers of protective, waterproof clothing. Be sure to cover all
    exposed areas (head, ears, hands, neck). The head and neck lose heat more
    quickly than other parts of the body.
  • Use mittens, which offer more warmth and protection than gloves.
  • Use waterproof boots and wool socks.
  • Teens should be told that drinking alcohol will reduce their body temperatures.
    When exposed to cold weather, this can cause mild hypothermia.
  Hypothermia
  Hypothermia (colder than normal body temperature) and frostbite can happen to
  anyone who is not properly protected from the cold. Hypothermia occurs when
  the body temperature falls below 95 degrees Fahrenheit. The normal body
  temperature is 98.6 degrees Fahrenheit. In the early stages, this may cause
  memory loss, confusion and shivering. Eventually, a low body temperature may
  cause cardiac arrest and death.
  Signs of hypothermia include slurred speech, reduced coordination, shivering and
  poor judgment. The best way to prevent hypothermia is to drink fluids and
  protect the body from the cold.
  Frostbite
  Frostbite also is a danger in the winter months. When exposed to extreme cold,
  the body tissue freezes. This affects the body like a burn. The hands, feet, ears,
  cheeks and nose are the most commonly affected areas.
  Signs of mild frostbite include yellow or gray patches on the skin. After the skin is
  warmed, it becomes red and flaky. In more severe cases, a blister or sore, swelling
  and pain may develop.
  If mild frostbite is suspected, come indoors and remove wet clothing. Gently dry
  the affected area. Do not rub the area, as this may cause more damage. Warm the
  affected area by immersing it in warm water (104 to 108 degrees Fahrenheit) for
  15 to 20 minutes or until the color returns.
  Transport the frostbitten family member to an emergency room if there is pain,
  blistering or swelling.




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   Winter safety
               details
  Deep frostbite, often affecting the feet and hands, can be very dangerous. It can
  lead to infection, severe pain and swelling, nerve and tissue damage, and
  amputation. Symptoms include cold, waxy and pale skin. When it thaws, the
  affected area turns blue or purple. Large blisters appear, followed by peeling or
  gangrene (dark, swollen tissue caused by decay).
  Sledding
  Sledding, although fun and popular, can cause serious neck and back injuries and
  even death. Teach your teens to consider the following tips for safe sledding or
  tobogganing:
  • Encourage sledders to wear helmets.
  • Inspect the sledding course for hazards. Trees, fences, rocks and telephone
    poles can cause injuries. Hay bales are not always effective protection from
    hazards.
  • Make sure the run at the bottom of the hill is long enough for the sled to safely
    stop on its own.
  • Avoid hills with very steep inclines.
  • Never sled near roads, parking lots, rivers or other bodies of water.
  • Sled only during daylight hours.
  • Sleds and toboggans should not be used on the same hills. Toboggans, which
    may be more difficult to control than sleds, should only be used on designated
    toboggan runs.
  • Do not sled on icy hills. The hills must be snow-covered.
  • Do not ride headfirst or on the stomach. Ride in a sitting position or feetfirst
    while lying on your back. Support your body with your elbows.
  • Avoid sledding over snow bumps.
  • Stay alert, keep your eyes open and use common sense.
  • When going back up the hill, walk along the edge of the sledding course away
    from sleds.
  • To find out where sled and toboggan hills are located and the hours they are
    open, call your local park system.




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   Additional resources
                details
  Books
  “Caring for Your Adolescent, Ages 12-21, the Complete and Authoritative Guide,”
       Ruth Bell, Vintage Books.
  “Facts about Sex (or When Living Hurts or The Teenage Survival Book, or Raising
       a Child Conservatively in a Sexually Permissive World),” Sol Gordon,
       Ed-U-Press.
  “Fire in My Heart, Ice in My Veins,” Enid Traisman, Centering Corporation.
  “Healing Your Grieving Heart for Teens: 100 Practical Ideas,” Allen Wolfelt, PhD,
       Companion Press.
  “The Next Place,” Warren Hanson, Waldman House Press.
  “Sports Nutrition for the Child Athlete,” American Dietetic Association.
  “Sportswise: An Essential Guide for Young Athletes, Parents and Coaches,”
       Lyle Micheli, MD, and Mark Jenkins, Houghton Mifflin.
  “Straight Talk about Death for Teenagers,” Earl A. Grollman, Beacon Press.
  “Talking with Children about Loss,” Maria Trozzi, Berkeley Publishing Group.
  “When a Friend Dies,” Marilyn Gootman, Free Spirit Publishing.
  “You and Your Adolescent: A Parent’s Guide for Ages 10-20,” Laurence Steinberg,
       PhD, and Ann Levine, Harper and Row.
  Web sites
  Children’s Health Education Center, www.BlueKids.org.
  Children’s Hospital of Wisconsin, www.chw.org.
  The Compassionate Friends (books and resources also available in Spanish),
      www.compassionatefriends.org.
  The Dougy Center for Grieving Children and Teens, www.grievingchild.org.
  The Sibling Connection, www.counselingstlouis.net.
  United States Department of Agriculture Food Pyramid, www.mypyramid.gov.
  Phone numbers
  Children’s Health Education Center, (414) 765-9355
  Children’s Hospital of Wisconsin, (414) 266-2000
  Children’s Hospital of Wisconsin bereavement resources, (414) 266-2995
  Children’s Service Society of Wisconsin, (800) 653-2779
  Milwaukee County Mobile Urgent Treatment Team, (414) 257-7621
  Project Ujima, (414) 266-2557
  Rogers Memorial Hospital, (800) 767-4411
  Wisconsin Poison Center, (800) 222-1222




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