Educating Adolescents about Puberty: Are We Missing Something?

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of males and 2% of females) reported that no one spoke to them prior or during pube1ty about pube1tal development or sexuality issues. Teens receiving some form of puberty/sexuality education did so at a median age of 13 for girls and 15 for boys. More than one source of information was the most common (49%) followed by mother only (20%). 85% of parents reported talking to their teens about pubertal development and sexuality. There were several differences between areas reported covered by parents but not by teens, for example 72% of parents reported talking to their teens about gender differences in growth but only 31% of teens reported being spoken to about that. Areas that are ve1y poorly covered are breast development in boys and sexual assault/date rape in girls at 5% and respectively. In summary, it appears that we continue to do a relatively poor job in educating our kids about their development and sexuality and we do it late. Boys are even less likely than girls to be talked to about many areas of pubertal development and sexuality and when that is done, it is done at a later age

Youth Suicide Prevention in Rural Kentucky

Youth suicide continues to be one of the leading causes of death in the United States. Nation wide it is the third leading cause of death in the 10-24 year old age group. The rate of suicide varies somewhat from state to state. In the state of Kentucky, youth suicide is the second leading cause of death. This article describes a grass roots, community based program for youth suicide prevention and its impact on the community. The Stop Youth Suicide Campaign was launched in 2000 and included more than 30 local agencies. This program worked through public education, education of medical care providers, schoolteachers, school counselors, youth service center personnel and many other entities that deal with adolescents. This program utilized face-to-face encounters, website, video and other forms of media education. Over a four-year period, the program has provided several conferences and many lectures and workshops to the community. The program has responded to many e-mails and phone calls from teens and/or their parents asking for help. During these years, many of these children that were seeking help ended up receiving appropriate help that contributed to changing their lives and helping them stay alive and also utilizing them to help others in that period. Simple grass roots programs are able to help and are needed in the community to combat this epidemic that is causing significant mortality and morbidity

What We Are Not Talking About

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of males and 2% of females) reported that no one spoke to them prior or during puberty about pubertal development or sexuality issues. Teens receiving some form of puberty/sexuality education did so at a median age of 13 for girls and 15 for boys. More than one source of information was the most common (49%) followed by mother only (20%). 85% of parents reported talking to their teens about pubertal development and sexuality. There were several differences between areas reported covered by parents but not by teens, for example 72% of parents reported talking to their teens about gender differences in growth but only 31% of teens reported being spoken to about that. Areas that are very poorly covered are breast development in boys and sexual assault/date rape in girls at 5% and 26% respectively. In summary, it appears that we continue to do a relatively poor job in educating our kids about their development and sexuality and we do it late. Boys are even less likely than girls to be talked to about many areas of pubertal development and sexuality and when that is done, it is done at a later age

Adolescent Violence as Viewed by High School Students

On April 20th, 1999 two high school students from Columbine High School in Littleton, Colorado armed with a variety of firearms managed to kill 15 persons and injure many others in their school. Following this incident, a wave of bomb threats to schools throughout the country erupted and several adolescents and adults were arrested. Ten days following the incident we surveyed a total of 412 students from urban area high schools. All students have heard of the shooting, 80% felt sad about the incident, 90% felt hate for the shooters and sad for the victims. 3% felt indifferent and 3% liked or admired the shooters. 60% thought the shooters had help from others. In response to why did the shooters do it, the top factors included loneliness, family problems and desire for attention. Virtually all participants thought that access to fire arms is what made it possible for these teens to commit their shooting. Other factors included poor school security, help from others and inattention from other students and teachers. The survey also included questions regarding suicide, carrying weapons and access to firearms. Adolescent violence continues to increase in the USA and other countries. Major contributing factors, at least from the adolescent point of view, are access to guns, family problems, lack of friends and poor communication with teachers

Final Thoughts

The work to establish the Stop Youth Suicide Campaign (SYS) has resulted in contact with many young adults. We realized that the most important thing for the kids was finding a caring person they can trust and talk to. This project has been a learning process for all involved. I learned that I can help and so can everyone else. This community and grassroots approach showed tangible results. It needs caring and dedication and most importantly desire to make a difference. It is hard work, but well worth it. Many people, including myself, are afraid of failure. I suffered every time I thought about someone who died from suicide, but found that I will suffer even more if more kids die. I found that even if I succeed some of the time, it is much better than none of the time

Starting Off

This book is really a reflection of the past 15 years of work with teens and suicide prevention in the state of Kentucky. The work to establish the Stop Youth Suicide Campaign (SYS) has resulted in contact with many young adults and we have found that the most important thing for all of them, was finding a caring person they trust and can talk to. Because of the constant need, the SYS went from a goal of one year awareness campaign to a major community resource, to work with the state and local governments and state legislators to add as many resources as possible. We have witnessed for the 1st time a drop of youth suicide rates below the national average according to the 2013 Youth Risk Behavior Surveillance done biannually by the Center for Disease Control. In this book we will tackle various topics and specific populations in relation to suicide written by people who work with teens and care about them

A Model Program for Youth Suicide Prevention

Youth suicide continues to be one of the leading causes of death in the United States. Nation wide it is the third leading cause of death in the 10-24 year old age group. The rate of suicide varies somewhat from state to state. In the state of Kentucky, youth suicide is the second leading cause of death. This article describes a grass root, community-based program for youth suicide prevention and its impact on the community. The Stop Youth Suicide Campaign was launched in October 2000 and included more than 30 local agencies. This program worked. through public education, education of medical care providers, schoolteachers, school counselors, youth service center personnel and many other entities that deal with adolescents. This program utilized face-to-face encounters, website, video and other forms of media education. Over a four-year period, the program has provided several conferences and many lectures and workshops to the community. The program has responded to many e-mails and phone calls from teens and/or their parents asking for help. During these years, many of these children that were seeking help ended up receiving appropriate help that contributed to changing their lives and helping them stay alive and also utilizing them to help others in that period. Simple grass roots programs are able to help and are needed in the community to combat this epidemic that is causing significant mortality and morbidity

Youth Suicide Prevention in Rural Kentucky

Youth suicide continues to be one of the leading causes of death in the United States. Nation wide it is the third leading cause of death in the 10-24 year old age group. The rate of suicide varies somewhat from state to state. In the state of Kentucky, youth suicide is the second leading cause of death. This article describes a grass roots, community based program for youth suicide prevention and its impact on the community. The Stop Youth Suicide Campaign was launched in 2000 and included more than 30 local agencies. This program worked through public education, education of medical care providers, schoolteachers, school counselors, youth service center personnel and many other entities that deal with adolescents. This program utilized face-to-face encounters, website, video and other forms of media education. Over a four-year period, the program has provided several conferences and many lectures and workshops to the community. The program has responded to many e-mails and phone calls from teens and/or their parents asking for help. During these years, many of these children that were seeking help ended up receiving appropriate help that contributed to changing their lives and helping them stay alive and also utilizing them to help others in that period. Simple grass roots programs are able to help and are needed in the community to combat this epidemic that is causing significant mortality and morbidity

Mysterious Rectal Bleeding in a Female Adolescent

A 15-year-old female referred to our adolescent clinic for further evaluation of rectal bleeding was seen a week earlier in the acute care clinic with a two-day history of bright red rectal bleeding. The physical examination at that time was reportedly normal, including the rectal exam. The blood count with differential, liver function tests, ESR, and barium enema were all within normal limits. The patient, however, continued to complain of rectal bleeding and this led to the referral. She was known in the adolescent clinic as having a history of learning disability and mild mental retardation. She was started on depot medroxy-progesterone acetate one month earlier and had been sexually active since age 13. Additional history with specific questions revealed that the “heavy” bleeding always happened with bowel movements. Physical examination and pelvic ultrasound showed a slightly enlarged uterus and thickened endometrium. Sonohysterogram was done and two posterior polyps were identified. The patient underwent endometrial ablation without complications, and no further bleeding was reported on follow-up for three months. Endometrial polyps are rare m adolescents, but should be in the differential diagnosis of vaginal bleeding

Labial Adhesion as a Complication of Primary Genital Herpes in Young Women

Genital herpes is a common sexually transmitted disease in adolescents. It may be associated with significant morbidity if not diagnosed on time or not properly treated. The objective of this study was to determine the incidence of labial adhesion secondary to primary herpes in young women and the possible predisposing factors for this complication. The method was analysis of clinical data regarding primary genital herpes in young women seen in an adolescent outpatient clinic at a university hospital. Cases of primary genital herpes seen between December 1st 1998 and November 30th 1999 were included. A total of 34 female adolescents with age range 12 - 19 years were diagnosed with primary genital herpes during this time period. Seven patient (20.6%) were found to have severe labial adhesion at time of diagnosis. All seven patients were seen by other providers prior to their evaluation in the adolescent clinic, and four were correctly diagnosed. All seven patients were given antiviral therapy, but none were given local treatment. At time of diagnosis all seven patients had urinary retention for more than 24 hours and sever pain and discomfort. Three patients had diabetes mellitus (one of these was also pregnant), and one patient had asthma (on steroid therapy). The age range for these seven patients was 13 - 17 years. Treatment with local anesthetics helped resolve the adhesion in five patients, and surgical treatment was needed in the remaining two patients. it is concluded that labial adhesion is a severe complication of primary genital herpes in young women. Chronic medical conditions, incorrect diagnosis, and lack of topical treatment may be associated with the development of this complication. Use of topical therapy should be an integral part of the comprehensive treatment for primary genital herpes in female adolescents to alleviate discomfort and prevent urinary retention and labial adhesion