American Academy of Pediatrics Recommendations for a 15-Year-Old Well-Child Visit
The American Academy of Pediatrics (AAP) recommends that all adolescents have an annual comprehensive preventive health care visit that includes disease detection and prevention, health promotion, and anticipatory guidance addressing physical growth and development, social and academic competence, emotional well-being, risk reduction, and violence and injury prevention. 1
Physical Assessment Components
- Height, weight, and BMI measurement with plotting on appropriate growth charts
- Blood pressure screening and classification as normal, elevated, or stage 1/2 hypertension
- Complete physical examination with special attention to:
- Pubertal development (Tanner staging)
- Skin examination (acne, suspicious moles)
- Spine examination for scoliosis
- Evaluation for sports participation if applicable
Screening Recommendations
- Vision screening
- Hearing screening
- Depression screening (recommended for adolescents)
- Substance use screening
- Dyslipidemia screening once between ages 9-11 and again between 17-21
- Screening for hypertension
Immunization Review and Update
- Review immunization status and administer any needed vaccines according to CDC schedule
- Common vaccines needed at this age:
- Meningococcal conjugate (MenACWY)
- Tdap booster if not previously given
- HPV vaccine series if not completed
- Annual influenza vaccine
Confidentiality and Psychosocial Assessment
- Provide confidential time with the adolescent separate from parents
- The AAP emphasizes the importance of confidentiality in adolescent care to encourage honest discussion about sensitive topics 1
- Screen for:
- Mental health concerns (depression, anxiety, suicidal ideation)
- Substance use (alcohol, tobacco, vaping, marijuana, other drugs)
- Sexual activity and risk behaviors
- Social media use and screen time
- Sleep patterns
- Bullying or violence exposure
- School performance and educational goals
Anticipatory Guidance
- Safety discussions:
- Driving safety (if applicable)
- Injury prevention
- Violence prevention
- Protective equipment for sports
- Healthy lifestyle counseling:
- Nutrition and physical activity
- Sleep hygiene (8-10 hours recommended)
- Screen time limits
- Stress management
- Risk reduction counseling:
- Substance use prevention
- Sexual health education
- Healthy relationships
Reproductive Health
The AAP recommends that adolescents receive confidential counseling about sexual development, sexuality, and responsible personal decision-making 1. This should include:
- Discussion of abstinence and contraceptive options if sexually active
- STI prevention counseling
- Pregnancy prevention counseling
Common Pitfalls to Avoid
- Failing to provide confidential time: Adolescents are less likely to disclose sensitive information when parents are present.
- Skipping mental health screening: Depression and anxiety are common in this age group and should be routinely screened for.
- Focusing only on physical health: The comprehensive visit should address psychosocial development and risk behaviors.
- Inadequate time allocation: Well visits for adolescents require sufficient time to address multiple domains of health.
- Missing opportunities for immunizations: This visit is a key opportunity to ensure adolescents are up-to-date on vaccines.
Documentation and Follow-Up
- Document all components of the visit
- Provide appropriate referrals for identified concerns
- Schedule next annual preventive visit
- Consider more frequent follow-up for identified health concerns
The AAP emphasizes that these comprehensive visits are crucial for adolescent health and should not be replaced by brief sports physicals or acute care visits 1.