Well-child visits in adolescence (ages 13-17 years) are intended to assess growth and development, promote emotional well-being, and counsel patients and their families on safe behaviors at a time when youth are increasingly making independent choices that affect their health. All adolescents should be offered time alone with their physician for discussion of confidential health concerns, including but not limited to sexual health, mental health, substance use, and peer relationships. Minor consent laws vary by state. Adolescents who are sexually active should be provided with behavioral counseling on sexually transmitted infection prevention as well as offered screening for sexually transmitted infections. Sexually active adolescents who could become pregnant should be counseled on the range of contraceptive options, including long-acting reversible contraception. Vaccines should be offered and completed on time. Adolescents should be screened for depression and anxiety and offered treatment, including cognitive behavior therapy and pharmacotherapy. Adolescents should be counseled on getting 1 hour/day of physical activity and 8 to 12 hours/night of sleep, and setting goals for healthy media use, including having media-free times and spaces, including the bedroom.

Case 4. MS is a 15-year-old patient who is brought to your office for a school physical by his visibly worried father. MS did well socially and academically in middle school, but since he started high school, his grades have dropped, and he has become increasingly withdrawn. His father says that he asked MS about bullying and drug use, but MS refused to discuss it with him.