Originally published in The Medical Post, VOLUME 39, NO. 29, August 12, 2003

Understanding adolescent developmental hurdles can help you explain to parents how they can meet the challenges of guiding their sons and daughters

More than 80% of adolescents do not experience the stereotypic “hellion” lifestyle and behaviour portrayed in the media. There is indeed adolescent angst, but often there is an identifiable cause: parental strife, divorce, laissez-faire approaches to discipline, lack of parental involvement and support, lax enforcement of the rules of the house, poor sense of self and depressive illness, among others. And sometimes, there is no apparent explanation.

The “adolescent toolkit” —a term I use to help me with adolescent issues—is an open-source approach that can provide a foundation for discussion between parents and their teens by acting as a neutral bridging intermediary. Physicians can introduce the concepts within the toolkit to parents to help them with the day-to-day challenges of guiding their son or daughter toward independence.

The responses to the kit’s questions and concepts are age-dependent. During the development cycle, adolescents migrate from more risky “what-were-you-thinking” behaviours to reasoned responses to problems.

Recent evidence indicates ongoing development in regions of the forebrain (responsible for abstract thought and reasoning) that continue until about the age of 20. It is not surprising to see a myriad of responses to similar events and problems. We all encounter mature teens and immature adults.

Adolescents develop different areas of interests, life and educational goals, and a sense of self through the three stages of adolescence. A parent’s response and guidance strategies must adapt to keep pace with this development cycle.

In the early stage of adolescence (girls 11 to 13, boys 12 to 14 years of age), puberty’s rapid physical changes directly influence the teens’ concerns about body image and sexual changes in comparison to their peers.

They have to adapt to new school environments and social structures. Given their stage of forebrain development, they are concrete thinkers, living for the moment with little belief in their own mortality. Their normal egocentricity leads them to think everyone is watching their every action and activity.

Their dependence upon their parents conflicts with their desire to be independent. A battle rages within them between the safety of childhood and the need to enter the new adolescent world. Often parents lament, “Steve used to go out with us on family outings, but now he wants to spend time with his friends. He can be like his old self at times and then be just impossible to deal with!”

In the middle stage (girls 13 to 16, boys 14 to 17), there is a consolidation of body image and sexual identity. Peer groups become their new family and safe haven and are a form of tribalism with all its rituals, markings and lingo. Peer pressure is the dominant behavioural influence. In their quest for independence they test their limits and compare themselves to their friends. Paradoxically, they conform to their peer group in order to be more independent.

In the late stage (17 to independence), there is a crystallization of identity. Career choices and plans for the future become important. After graduation, friends head off in their own direction. Peer groups become less important as intimate one-on-one relationships develop. Indeed, when leaving the tribe, they return to their family.

Adolescents face a myriad of challenges and experiences. Although dating and social interactions are an important element of adolescent development, for some it can become an all-consuming, romanticized process. They can become stuck in a particular stage of development, progressing no further. Drug use poses a similar threat. Some teens lose themselves within destructive relationships, ignoring friends and family. The actions and behaviour of their boyfriend/girlfriend may have a dominant influence upon their own moods and actions because of this singular focus.

So what can we do? Children must inevitably break away from their parents. The challenge is to maintain good relationships and avoid festering conflicts. Teens need and want limits with well-defined, consistent positive and negative consequences. Without these limits, they are adrift without direction. They usually test the rules of the house. Nevertheless, rules that are reasonable, age-appropriate and consistently enforced have the best chance of guiding teens through these times. They build upon this foundation on their path to adulthood.

Teens have many friends. Parents cannot be their child’s friend. Physicians can play an important role promoting this critically important concept.

We can point out that inevitably, situations will arise when the parent, adopting the friendship role, will have to switch hats. Friends do not tell friends when to go to bed. Their teen will let them know this in no uncertain terms.

If a teen is willing to accept praise, then they must be prepared to face constructive criticism for negative or poor decisions and outcomes. Angst, anger and sorrow expressed by friends and family to poor behaviour and actions are just as valid a response as elation and pride when they accomplish their goals. Welcome to the adult world.

In the next issue we will review the contents of the toolkit.