Well-Child Visit: 16 Years

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your teen's weight and height,calculate body mass index (BMI), and plot the measurements on a growth chart.

2. Check your teen's blood pressure and possibly hearing.

3. Ask questions, address concerns, and offer advice about your teen's:

Eating. Teens should eat 3 meals a day that include lean protein, whole grains, at least 5 servings of fruits and vegetables, and 3 servings of low-fat or nonfat dairy products or fortified soy milk.

Sleeping. Teens need about 8–10 hours of sleep per night. Poor sleep is common during the teen years and can hurt school and athletic performance. Biological changes make teens want to stay up later, but early school start times can make it hard for them to get enough sleep. Encourage your teen to follow a relaxing bedtime routine. Electronic devices, like smartphones and computers, should be turned off before bed.

Physical activity. Teens should get 60 minutes of physical activity per day. Encourage your teen to balance screen use (TV, video games, smartphones, tablets, and computers) with healthy behaviors, like spending time with others, being physically active, and getting enough sleep. Set a good example by limiting your own screen time and exercising daily.

Growth and development. By age 16, it's common for teens to:

• if female, have gotten a first period by now. If your daughter hasn't, talk to your doctor.
• if male, show signs of pubertal development (the testicles get bigger, the penis gets longer, and pubic hair grows)
• be influenced by their peer group
• explore different identities to help them determine where they fit in
• have sexual feelings. This includes an interest in dating and relationships, exploring one's sexuality, and becoming aware of sexual orientation and gender identity.
• begin to think abstractly and reflect on how to make decisions, but still be impulse-driven and not think about the consequences of their actions
• want to engage in risky behaviors

4. Do anexam. The doctor will look at the skin, listen to the heart and lungs, check the back for curvature of the spine, and check for puberty development. A chaperone should be present during the exam.

5. Update immunizations.Immunizations can protect people from serious illnesses, so it's important that your teen get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

6. Order tests. Your doctor may check for anemia, high cholesterol, tuberculosis, and sexually transmitted diseases (STDs) and order tests, if needed.

Looking Ahead

Here are some things to keep in mind until your teen's next checkup at 17 years:

School

1. Encourage your teen to participate in a variety of activities, such as music, arts, sports, after-school clubs, and other activities of interest.
2. Encourage your teen to take responsibility for schoolwork. Praise accomplishments and provide support in areas where your teen struggles.
3. Talk about future college or work plans. If your teen is having trouble in school, find out if bullying, depression, learning or attention problems are to blame.

Self

1. Spend time with your teen every day. Share mealtimes, be active together, and talk about things that are important to your teen. 
2. Praise good choices, and include your teen in decision-making.
3. Set rules and explain your expectations. Have fair consequences for rule-breaking.
4. Encourage your teen to wait until older to engage in sexual activity with others. Explain the risk of sexually transmitted diseases (STDs) and unwanted pregnancy. Discuss the importance of birth control and condom use.
5. Your teen should brush their teeth twice daily, floss once a day, and see a dentist once every 6 months.
6. Explain to your teen the dangers of smoking, vaping, alcohol, and drugs. Talk about prescription drug misuse. Praise your teen for saying no to these activities.
7. Look for signs of depression, which can include irritability, depressed mood, loss of interest in activities, poor grades, and talk of suicide.
8. Encourage your teen to take charge of medical care by learning to chedule doctor's appointments, renew prescriptions, and care for any ongoing health problems.

Safety

1. Teens should always wear a seatbelt while in a vehicle.
2. As your teen starts driving, set limits for the number of passengers allowed and what hours they may drive. Tell your teen not to text or use the phone while driving.
3. Talk about the dangers of drinking and driving and tell your teen to never get in a car with someone who has been drinking or using drugs. Instead, let your teen know to always call you for help.
4. Teens should apply sunscreen of SPF 30 at least 15 minutes before going outside and reapply about every 2 hours. They should not use tanning beds, as these increase the risk of skin cancer.
5. Make sure your teen knows about online safety, cyberbullying, and wise use of social media.
6. Prevent gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids can't get to the keys.
7. Talk to your doctor if you're concerned about your living situation. Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.