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Adolescent Issues

Adolescent Issues . Lisa Samson-Fang Associate Professor University of Utah. Did Puberty Happen Appropriately?. Delayed puberty No changes by 13 years old for girls 14 years old for boys Early puberty Changes before 8 years old for girls 9 years old for boys. Revisit Toileting.

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Adolescent Issues

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  1. Adolescent Issues Lisa Samson-Fang Associate Professor University of Utah

  2. Did Puberty Happen Appropriately? • Delayed puberty • No changes by • 13 years old for girls • 14 years old for boys • Early puberty • Changes before • 8 years old for girls • 9 years old for boys

  3. Revisit Toileting • Potential for higher level skills • Need for increased privacy • New environments • Increasing size • New techniques • New adaptive equipment

  4. Bed wetting • Evaluation • Consider behavioral/medical treatment • Alarms • DDAVP • Imipramine

  5. Menses • Two years after breast buds • Sub populations • Independent in toileting: able/not able to manage menses • Not independent in toileting: acceptable/not acceptable to care providers • Medical issues: seizures, migraines, behavior, fears, focus on product

  6. Menses are Okay • Incontinent: Diaper with pads or tampons • Continent: • Pads or tampons (not diapers) • Training • Modeling in home environment • Health education at school • Infrastructure • Supplies • Support person(s) identified • Treat: excessive bleeding, pain, mood changes

  7. Menses not Okay • Medical • Depoprovera • 80% success, may need low dose estrogen • ??not great for bones • Oral contraceptives • Cycle without placebos • Less often successful, may need period 2-4 times/year (noperiod.com) • Surgery • Hysterectomy (petition court) • Uterine lining ablation (???)

  8. Self Exploration (Masturbation) • Normal/universal • Religious/cultural overlay • Teach • Social context • Distract • Avoid inadvertent reinforcement • Rare: Treat with SSRIs (Prozac, Paxil, Zoloft etc.)

  9. Sexual Victimization • Appropriate Information and health care • Foster appropriate expression of emotion • Treat body space appropriately • Establish communication • Structure all environments: • who is allowed to help with toileting, dressing, hygiene; • where is child before/after school • Know where to go for help

  10. Social Acceptance Acne Dandruff Drooling Halitosis Dental Care Nutrition Calcium Multi-vit w/ iron (girls) Obesity Healthy eating Exercise Other Adolescent Issues

  11. Questions?

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