Components of a Normal Well-Child Check for a 14-Year-Old Male
A comprehensive well-child check for a 14-year-old male should include vital sign measurements, complete physical examination, psychosocial assessment with private time for the adolescent, screening for high-risk behaviors, and age-appropriate anticipatory guidance. This structured approach ensures optimal health outcomes by identifying and addressing physical, developmental, and psychosocial concerns.
Vital Signs and Growth Assessment
- Measure height, weight, and calculate BMI; plot on appropriate growth charts 1
- Measure blood pressure using appropriate cuff size after 5 minutes of rest; interpret using age/sex/height-specific normative values 1, 2
- Compare measurements to previous visits to assess growth trajectory
Complete Physical Examination
- Head-to-toe examination including:
- Vision screening (recommended every 2 years at this age) 1
- Hearing assessment
- Dental examination (recommend twice-yearly dental visits) 1
- Skin assessment (acne, suspicious lesions)
- Musculoskeletal examination including spine assessment for scoliosis
- Cardiovascular and respiratory examination
- Abdominal examination
- Tanner staging for pubertal development 3
- Genital examination (assess for normal development, testicular descent, hernias) 4
- Neurological assessment
Psychosocial Assessment
- Provide private time with the healthcare provider without parents present 1
- Screen for mental health concerns including depression and anxiety 1
- Assess peer relationships and screen for bullying 1
- Screen for substance use (tobacco, electronic cigarettes, alcohol, drugs) 2
- Evaluate school performance and educational goals
- Assess family relationships and home environment 1
- Screen for high-risk behaviors
Screening
- Depression screening using validated tools 2
- Substance use screening 2
- Blood pressure screening 2
- Vision screening if not done in past 2 years 1
Immunization Review and Update
- Review immunization status and provide any needed vaccines:
- Tdap (if not previously given)
- Meningococcal conjugate vaccine
- HPV vaccine (if not completed)
- Annual influenza vaccine 1
Anticipatory Guidance
- Physical activity: Recommend 60 minutes of daily physical activity 1
- Nutrition: Discuss healthy eating habits and balanced diet
- Sleep: Counsel on adequate sleep (8-10 hours recommended for adolescents)
- Screen time: Discuss appropriate limits on recreational screen time
- Safety: Discuss seat belt use, helmet use for sports, water safety, and firearm safety if applicable 1
- Internet safety and appropriate social media use 1
- Sexual health education appropriate for age and development
- Substance use prevention
Family Assessment
- Screen for family stressors that may impact the adolescent's health
- Assess parental mental health
- Evaluate for signs of abuse or neglect
- Provide resources for family support as needed 1
Documentation and Follow-up
- Document all findings, screenings, and discussions
- Address any identified concerns with appropriate interventions or referrals
- Schedule next well-child visit (typically annual at this age)
- Provide contact information for any questions between visits
Special Considerations
- For adolescents with chronic conditions (e.g., diabetes), include condition-specific assessments 2
- Begin discussions about transition to adult care in early adolescence 2
- Consider preconception counseling for sexually active adolescents 2
Remember that establishing rapport and confidentiality with the adolescent is crucial for an effective well-child visit. The adolescent should understand that while most information will remain confidential, safety concerns may necessitate breaking confidentiality 2.