Age: 11-12 Years

Eleven and twelve year-olds are often referred to as ‘tweeners,’ because they are between childhood and teens. I always find it an interesting age in my well child exam. Some kids this age are completely prepubescent and some are well into puberty. Some have great relationships with their parents, while others are well on their way to strife and struggle with parents. This is a great age to educate preteens about their bodies and good healthy behaviors.

SAFETY

Substance use/abuse: This topic must be addressed. Clearly educate about the dangers and the misconceptions (e.g., many teens believe marijuana is not addictive or vape is a safe alternative to smoking). It is not unreasonable to have the expectation that your child should NOT use tobacco, drugs, alcohol, inhalants, diet pills, etc. However, kids see through double standards. Do not tell your child not to smoke if you smoke. Show him or her a good example, stop. Discuss peer pressure openly. Opening the conversation with, “Do your friends do…” rather than “Do you do…” makes it more likely to get an honest answer, and it can open the door of communication. If your child is already involved, seek help.
Car: Wear seat belts when riding in vehicles. Ride in the backseat until 12 (longer if kid is small). Educate about the dangers of texting and driving (so he/she can help police whoever may be driving whenever he/she is a passenger). Fact: Accidents are the #1 cause of death in this age group. Guess where most of them happen?
Adults: Teach rules on safety with other adults.
1. No adult should tell a child to keep secrets from parents
2. No adult (or other child for that matter) should ask to see/touch private body parts (either the child’s or the adult’s)
Smoking: Make sure your home and cars are smoke-free zones. Discuss the dangers of nicotine, both smoking and vaping. Also, check smoke alarms to ensure that they work properly, and change batteries annually.
Helmets: Wear a helmet on all things a kid can ride (e.g., bicycles, scooters, go carts, skateboards, ATVs, etc.).
Guns: Lock guns with ammunition separate and in a gun safe. (Disturbing Fact: More children are killed from guns every year than are intruders.)
Household: Reinforce home safety rules including how to use emergency numbers (e.g., 911) and what to do in case of fire or disaster.
Sports: Teach safety in sports, including using protective gear (e.g., mouth guards, helmets, knee pads).
Media: Family computers and laptops should be in an easily seen place in the home.
1. Install safety filters/safeguards to prevent inappropriate material/child predators from entering your home via your computer.
2. Teach children how to navigate the internet safely (e.g., do not give out personal information, what to do when you encounter inappropriate content, etc.)

NUTRITION

Eat 3 nutritious meals a day and healthy snacks.
Limit high fat and high sugar foods. Limit soft drinks/soda, instead encourage lots of water.
Teach the importance of eating a balanced diet. Help your child choose lots of fruits, vegetables, whole grains, and good sources of protein.
Milk should be low fat. Aim for 3 servings of dairy/day (or calcium rich foods like almond milk, dark leafy greens, etc.). If not, you may need a separate calcium and vitamin D supplement.
Eat meals as a family (around a table with no media). Not only does eating together as a family develop good nutritional habits, it has multiple lasting effects on the social support of a family.
Model good eating habits. Teach the concept of listening to our body’s hunger cues (e.g., eat when you are hungry, stop when you are satisfied).
Keep in mind it is very difficult to eat healthy when eating out (especially at fast food restaurants).
Give a multivitamin daily only if your child is not eating a balanced diet. Other supplements are not necessary unless specifically directed by your physician.

SLEEP

Most kids this age need 9-12 hours of sleep. This can be difficult with competing demands on time and early school start times. Try to stick to a routine and set bedtime.

ORAL HEALTH

Continue to brush twice daily and floss once a day
Should continue to see a dentist every 6 months.
Fluoride supplementation depends on the level of fluoride in the drinking water in the city where you live (your pediatrician or dentist can prescribe it if needed).

SEXUALITY

Have discussions (if not already done so) about sex, puberty, masturbation, pornography, development, contraception, and STI’s. It is a common misconception that discussing it is condoning it. Quite the contrary, education is empowerment. Educate your child. Tell him or her what your beliefs and expectations are.
Recognize that sexual feelings are normal, but encourage your child to delay having sex.
Learn how to “say no” to sex. Warn against feeling pressured.
Educate that abstinence, it is the only 100% effective STI and pregnancy prevention method.
Be direct and honest. Always use the correct anatomical terms.
Keep in mind, your physician is a good resource if you are uncomfortable having any of these very important conversations with your child.

OTHER

Media Exposure: Set limits (e.g., total time, content, etc.). Make a family media use plan (www.healthychildren.org/MediaUsePlan). Check ratings and choose appropriate programs.
Social Interactions: Praise your child for accomplishments. When correcting, make the clear distinction that the choices a child makes, not the child him/herself is bad. Encourage your child to talk about feelings and experiences at school and with friends. Ensure that you know your child’s friends and their families. Make a plan in case your child feels unsafe/uncomfortable at a friend’s house. Discuss bullying.
Family life: Spend time with your child both individually and together with siblings. Acknowledge conflicts between siblings. Come to a resolution without taking sides. Do not tolerate violence. Provide personal space for your child at home.
Exercise: Aim for a minimum of 60 mins of physical activity a day. Model and encourage an active lifestyle.
Discipline: Discipline is about teaching, not punishment. Set clear limits and reasonable expectations. Be consistent. Teach natural consequences for unacceptable behavior (e.g., deny a privilege until chores are done). Teach how to resolve conflicts and handle anger.
Chores: Give your child chores and household responsibilities (e.g., unload the dishwasher, keep own room clean, fold and put away laundry, etc.). Having predictable, set jobs every day help with consistency and setting expectations. Teach your child responsibility for personal belongings.
School: Emphasize the importance of school. Make sure your child is learning to be responsible for his/her own homework, course selection, attendance. Be involved as much as possible at your child’s school. Know their teachers and friends.

ILLNESS

Treat fever and minor illnesses at home as long as your child looks and acts ok. Bring your child to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your child has signs of dehydration, your child reports specific symptoms (e.g., sore throat, hurt arm, etc.), your child has difficult or labored breathing, your child is lethargic, or you are concerned.

YOUR NEXT VISIT

Your child’s next well child check is in 1 year. If Jr. High shots were not given today, they will happen at the next visit. Your child will also need blood work done (if not done today), including a screening baseline cholesterol and complete blood count (to check for anemia). It is ideal to come fasting (first morning appointments make this easier). If the idea of a blood draw is going to cause your child a lot of anxiety, please ask us for a prescription for EMLA cream prior to the visit. Apply it 30 mins prior to the appointment.

If a first HPV was given today, your child will need a second one in 6 months. Depending on the time of year, your child may also need an annual flu shot.

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