During the teen years, it's important to keep having yearly checkups. Your teen may be embarrassed about having a checkup. Reassure your teen that the exam is normal and needed. The doctor may ask to talk with your teen without you in the exam room.

Here are some topics you, your teen, and the doctor may want to discuss during this visit:

• School performance. How is your child doing in school? Is homework finished on time? Does your child stay organized? These are skills you can help with. Keep in mind that a drop in school performance can be a sign of other problems.
• Friendships. Do you like your child's friends? Do the friendships seem healthy? Make sure to talk with your teen about who their friends are and how they spend time together. Peer pressure can be a problem among teens.
• Life at home. How is your child's behavior? Do they get along with others in the family? Are they respectful of you, other adults, and authority? Does your child take part in family events? Or do they withdraw from other family members?
• Risky behaviors. Many teens are curious about drugs, alcohol, smoking, and sex. Talk openly about these issues. Answer your teen's questions. And don't be afraid to ask questions of your own. If you're not sure how to talk about these topics, ask your child's doctor for help.

Your teen may still be experiencing some of the changes of puberty, such as:

• Acne and body odor. Hormones that increase during puberty can cause acne (pimples) on the face and body. Hormones can also increase sweating and cause a stronger body odor.
• Body changes. The body grows and matures during puberty. Hair will grow in the pubic area and on other parts of the body. Girls grow breasts and have monthly periods (menstruate). A boy's voice changes, becoming lower and deeper. As the penis matures, erections and wet dreams will start to happen. Talk with your teen about what to expect and help them deal with these changes when possible.
• Emotional changes. Along with these physical changes, you'll likely see changes in your teen's personality. They may want to date and become “more than friends” with other teens. Also, it's normal for your teen to be moody. Try to be patient and consistent. Start conversations, even when they don't seem to want to talk. No matter how your teen acts, they still need a parent.

Your teen likely makes their own decisions about what to eat and how to spend their free time. You can't always have the final say, but you can encourage your teen to have these healthy habits:

• Get at least 60 minutes of physical activity every day. This time can be broken up throughout the day. After-school sports, dance or martial arts classes, riding a bike, or even walking to school or a friend's house counts as activity.
• Limit screen time. This includes time spent watching TV and playing video games. It also includes texting and using the computer or tablet. If your teen has a TV, computer, or video game console in their bedroom, you may want to remove it.
• Eat healthy. Eat fruits, vegetables, lean meats, and whole grains every day. Less healthy foods like french fries, candy, and chips should be eaten rarely. Some teens fall into the trap of snacking on junk food and fast food throughout the day. Make sure the kitchen is stocked with healthy choices for after-school snacks. If your teen does choose to eat junk food, consider making them buy it with their own money.
• Eat three meals a day. Many kids skip breakfast and even lunch. Not only is this unhealthy, it can also affect how they do at school. Make sure your teen eats breakfast. If your teen does not like the food served at school for lunch, have them bring their lunch.
• Have at least one family meal with you each day. Busy schedules often limit time for sitting and talking. Sitting and eating together allows for family time. It also lets you see what and how your child eats.
• Limit soda, sports drinks, and juice drinks. A small soda is okay once in a while. But make sure soda, sports drinks, and juice drinks are not substitutes for healthier drinks. Water and low-fat or nonfat milk are the best choices.

Recommendations for good hygiene include:

• Have your teen bathe or shower daily and use deodorant.
• Let the doctor know if you or your teen have questions about hygiene or acne.
• Bring your teen to the dentist at least twice a year for teeth cleaning and a checkup.
• Remind your teen to brush and floss their teeth before bed.

During the teen years, sleep patterns may change. Many teens have a hard time falling asleep. This can lead to sleeping late the next morning. Here are some tips to help your teen get the rest they need:

• Encourage your teen to keep a consistent bedtime, even on weekends. Sleeping is easier when the body follows a routine. Don't let your teen stay up too late at night or sleep in too long in the morning.
• Help your teen wake up, if needed. Go into the bedroom, open the blinds, and get your teen out of bed. Do this on the weekends and during school vacations, too.
• Being active during the day will help your teen sleep better at night.
• Discourage use of the TV, computer, or video games for at least an hour before your teen goes to bed. (This is good advice for parents, too!)
• Make a rule that cell phones must be turned off at night.

Recommendations to keep your teen safe include:

• Set rules for how your teen can spend time outside of the house. Give your teen a nighttime curfew. If your teen has a cell phone, check in regularly to ask where they are and what they are doing.
• Make sure your teen uses their cell phone safely. Help your teen know when it is dangerous to talk on the phone, text, or use headphones. This includes while they are riding a bike or walking, especially when crossing the street.
• Constant loud music can cause hearing damage, so check on your teen's music volume. Many devices let you set a limit for how loud the volume can be turned up. Check the directions for details.
• When your teen is old enough for a driver's license, talk about safe driving. Teach your teen to always wear a seat belt, drive the speed limit, and follow the rules of the road. Don't allow your teen to text or talk on a cell phone while driving. (And don't do this yourself! Remember, you set an example.)
• Set rules and limits around driving and use of the car. If your teen gets a ticket or has an accident, have consequences. Driving is a privilege that can be taken away if your teen doesn't follow the rules. Talk with your teen about the dangers of drinking and drug use with driving.
• Teach your teen to make good choices about drugs, alcohol, sex, and other risky behaviors. Work together to come up with ways for staying safe and dealing with peer pressure. Make sure your teen knows they can always come to you for help.
• Teach your teen to never touch a gun. If you own a gun, always store it unloaded and in a locked location. Lock the ammunition in a separate location.

If you have a strong family history of high cholesterol, your teen's blood cholesterol may be tested at this visit. At this visit your child may receive the following vaccines:

• Meningococcal
• Influenza (flu), annually
• COVID-19

Ask your teen's doctor which tests and vaccines are advised at this visit.

In this wired age, teens are much more “connected” with friends. They may have never met some of these friends in person. To teach your teen how to use social media responsibly:

• Set limits for the use of cell phones, tablets, and laptops. Remind your teen that you can check the web browser history and cell phone logs to know how these devices are being used. Use parental controls and passwords to block access to websites that aren't safe. Use privacy settings on websites. This way only your child's friends can view their profile.
• Talk to your teen about the dangers of giving out their information online. Ask them to check with you before they share personal details with online friends. This includes their phone number, address, and picture.
• Make sure your teen understands that things they “say” online are never private. Posts made on websites like YouTube, Instagram, and TikTok can be seen by people they weren't intended for. Posts can easily be misunderstood and can even cause trouble for you or your teen. Supervise your teen's use of social media, cell phone, and internet use.

Experts advise screening children ages 8 to 18 for anxiety. They also advise screening for depression in children ages 12 to 18 years. Your child's doctor may advise other screenings as needed. Talk with the doctor if you have any concerns about how your teen is coping.

It's common for teens to have extreme mood swings as a result of their changing hormones. It's also just a part of growing up. But sometimes a teen's mood swings are signs of a larger problem. If your teen seems depressed for more than 2 weeks, you should be concerned. Signs of depression include:

• Use of drugs or alcohol.
• Problems in school and at home.
• Frequent episodes of running away.
• Withdrawal from family and friends.
• Sudden changes in eating or sleeping habits.
• Sexual promiscuity or unplanned pregnancy.
• Hostile behavior or rage.
• Loss of pleasure in life.

Depressed teens can be helped with treatment. Talk to your child's doctor. Or check with your local mental health center, social service agency, or hospital. Assure your teen that their pain can be eased. Offer your love and support. If your teen talks about death or suicide or has plans to harm themself or others, get help now. Call or text 988. You will be connected to trained crisis counselors at the Suicide and Crisis Lifeline. An online chat is also available at www.988lifeline.org. The lifeline is free and available 24 hours a day, 7 days a week.