Top Issues for Tweens
The tween years are full of challenges, but parents can lessen or avoid many health issues with knowledge. Candid health information allows tweens to make wise decisions about their bodies.
"During preteen years parents and physicians begin to teach the child that their health is their responsibility and things they do now can affect their health later in life," says Dr. Kathy Franchek-Roa, community pediatrician for Texas Children's Hospital and assistant professor of pediatrics at Baylor College of Medicine. Parents can create a healthy legacy with family discussions about good health.
Trim the Fat
Dr. Franchek-Roa warns that obesity and obesity complications, including diabetes and heart disease, are no longer adult-only problems. Indeed, the Surgeon General reports 61 percent of adult Americans were overweight or obese in 1999, and 13 percent of children and adolescents were overweight.
"Obesity is the most common nutritional disorder in American children today, and overweight and obese children are more likely to be overweight and obese adults," says Dr. Franchek-Roa. Fortunately, a healthy diet can prevent and reverse medical problems associated with obesity.
For more information on healthy eating consult your pediatrician or visit your local library. And use your knowledge to teach your children to make healthy choices during meals at school and at home.
In addition to eating well, kids need exercise for good health. Dr. Franchek-Roa suggests biking, hiking or playing in the park with your family instead of watching TV. Exercising together teaches kids about quality family time and instills a value of exercise children take into adulthood.
Single mom Jill Simonson, of Newport Beach, Calif., hated watching her overweight 11-year-old twin girls come home from school sad because they were teased. And the girls weren't happy with their plump appearance and lack of energy.
After sitting down for a frank discussion about weight and health, the Simonsons decided to try exercise videos and healthy eating. "We started working out two to three times a week, and we replaced after-school chips and cookies with veggies and low-fat dip or fresh fruit," she says. "We also drink mostly water instead of sodas or juice." On weekends the family rewards healthy behavior with a movie or fun outing. "We've been doing this for six months and it's paid off: The girls have lost weight and we're all in great shape," says Simonson.
Violence is another important health issue that impacts tweens. "Witnessing violence between parents can have long-lasting, devastating effects on children," says Dr. Franchek-Roa. It's essential to discuss any violent episode a child witnessed, or was involved in, with a pediatrician so that community services can be accessed if needed.
"Not addressing violence with children is teaching them that it is OK to hurt other people," says Dr. Franchek-Roa. "We need to instill in our children that 'abuse is not OK.'" For more information call the National Violence Domestic Hotline at 1-800-799-SAFE.
Bullying also affects preteen health. Bullying often starts as teasing but it can escalate into violence and psychological problems for both the bully and the victim.
"Teaching your child early on to understand people's feelings and to not take advantage of others is a very important lesson that should be instilled early in life and then further advanced when children move away from egocentric thinking," says Dr. Franchek-Roa. "Parents are an important motivating force that can keep their children's schools safe."
Kathy Anderson of Park City, Utah, discusses bullying and hurt feelings with her 10-year-old daughter. "Rachel has really learned how to empathize with her classmates," says Anderson. "When she sees bullying at recess she makes a special effort to be a friend to the bullied child."
Feed the Brain
During tween years kids develop important problem-solving and logical reasoning skills. Unfortunately, an undiagnosed learning disability or attention problem can hamper skill development. "The sooner these problems are identified and treated, the sooner the child will be able to perform at their best ability," says Dr. Franchek-Roa. "This is important because it aids in their development of self-esteem and self-worth."
Parents can demonstrate the value of learning by helping with homework, getting involved in school activities and participating in school-sponsored events. "School is a primary influence in your child becoming a successful adult," says Dr. Franchek-Roa.
According to the Centers for Disease Control and Prevention (CDC) accidents are the No. 1 cause of death for children ages 9 to 12. "Preteens are at risk for injury because they have difficulty pre-thinking about the consequences of an action," says Dr. Franchek-Roa. "They are still impulsive; for example, they can react without thinking."
Stuart Mills, a Boulder, Colo., father to 10-year-old Jessica, rushed his daughter to the emergency room for a broken leg after she and her friends used an icy roof as a slide. "The kids climbed our fence, got on top of our sloping gazebo and slid down into a snow bank," says Mills. "I was shocked when I heard what they'd done – they could have broken their necks or backs." While driving home from the hospital he asked Jessica what she had been thinking. "Jessica sighed and said, 'Sorry Dad, it seemed like a good idea then,'" he says.
Some injuries, like Jessica's, may be hard to avoid since parents don't think like tweens, but Dr. Franchek-Roa says many impulsive-based injuries can be thwarted with safety rules. For example, CDC data shows that motor vehicle accidents account for more than half of accidental deaths among tweens, but you can reduce the chance of this. Use a car booster seat until the seatbelt fits your child properly and never allow a child under 12 to sit in the front seat, especially with an airbag.
Dr. Franchek-Roa's other suggestions for accident reduction include: keeping guns locked in a cabinet, storing gun ammunition separately, teaching rules for walking or riding a bike across streets and having children wear the proper protective gear while playing sports.
Tough Talk: Sex and Drugs
Parents don't look forward to frank conversations about sex and drugs with tweens, but straight talk is essential. "Illicit drugs are readily available to our youth in America," says Dr. Franchek-Roa. "Talking to your children about drugs at a younger age enables them to be prepared in a situation where they may experience peer pressure to do something that they do not want to do."
Dr. Franchek-Roa recommends talking through different scenarios and asking your child how situations could be handled. "Preteens are still concrete thinkers and do not have the ability to abstract generalized rules to specific situations," she says.
Shannon Tilley, a Gilbert, Ariz., mom of six (including 9-year-old Jayce and 12-year-old Braden) discusses "what if..." situations with her kids. "We get really specific, and after the kids respond, we add to the story to make it more challenging," she says.
For example Tilley might ask her kids, "What if your friend tries to get you to smoke or try drugs at school?" The kids respond with, "I would say no." Tilley then asks, "What if someone offered you money to try something? What if your friend said he wouldn't tell anyone? What if he said once wouldn't hurt and if you did it he would stop bugging you?"
Discussions about sex and body changes are also important. Yes, school curriculum covers puberty and sex, but your child needs frank conversations with you now to feel comfortable discussing questions and issues later.
"As preteen bodies mature, so does a child's ability to make mature decisions if properly nurtured," says Dr. Franchek-Roa. "However, in many cases bodies mature at a faster rate than children's minds do. It is important for children to know what is and is not OK."
Finally, don't be surprised if a physician wants to talk with your child alone. High-risk behavior can impact teen health, and it's important for tweens and physicians to talk openly.