My daughter became an adolescent last year and suddenly, I found myself unable to handle the many biological and behavioural changes that followed. I turned to other parents of adolescents in my community. They noticed physical, social and behavioural changes in their boys and girls too. We were surprised. We thought the storm would arrive only during the teenage years.
The average age for the onset of puberty is between 10 and 14 but today, many adolescents are starting puberty aged 9 or 10. They feel anxious about their early physical development. Plugged into social media, which further drives their insecurity, many adolescents also start comparing their physical appearances with other boys and girls.
Says Ratika Vishal, “My 11-year-old daughter suddenly started distancing herself from us. She had mood swings and her appetite suffered. She always used to do well in school but her performance started to slip and she was losing focus. She was angry, irritable and for some time, I thought she really hated us.”
Like me, if you are a confused parent of an adolescent, you will find that parenting groups on social media are helpful places to turn to for useful information. For instance, do sustainable menstrual aids exist for adolescents and teenagers? Apparently they do! Still, for many parents, the picture remains incomplete and we don’t know whom to turn to when we want advice on specific challenges.
Parents of adolescent boys in particular find themselves lacking the specific tools or information to help their sons. Sandhya Viswan, who parents two boys, aged 21 and 15, says, “My younger son plays sports, so the therapists and sports doctors explained growth and development to me. They told me what is normal among adolescents and teens but they did not give me any advice or specific information when it came to boys.”
For many of us, the primary source of information is a paediatrician, but when our children start puberty or display turbulent mood swings earlier, do we switch from a paediatrician to gynaecologist or a general practitioner?
Surprisingly, emerging science about brain development tells us something interesting about the human brain. According to research by Jay Geidd titled ‘Brain development through childhood and adolescence: A longitudinal MRI study’ published in 1999, the human brain does not reach full maturity until age 25. This has given child psychologists and social scientists a new directive - they need to look at the 0-25 range instead of the 0-18 range.
In developed countries and even in some of the low middle income countries, adolescent medicine is an integral part of the paediatric specialty and runs the gamut from general health to sexual and mental health.
In India, Dr. Preeti Galagali is an adolescent medicine expert and a Medical Director at the Bangalore Adolescent Care and Counselling Centre. She was also part of the first cohort of Indian paediatricians to be trained in adolescent medicine in 2005 at the University of Kerala. For the last 15 years, she has been training paediatricians to take on adolescent health too.
“I would recommend seeing an adolescent health specialist, especially during the pre-adolescence phase onwards, or the 10-13 age group,” she says. “This is when adolescents want to assert their independence and spend more time with their friends. This makes many parents feel that their children don’t want to connect with them but the truth is that this is normal evolutionary behaviour for that age.”
She adds that the pre-adolescence phase needs to be handled differently from teenagers or young adults.
“In India, paediatricians are closely connected with the family but they are also extremely busy people,” she says. “It is a good idea to go to an adolescent clinic or seek out a paediatrician who is specialised in adolescent medicine and can give the time needed to adolescents and their families.”
Dr. Galagali runs a teen clinic in Bengaluru and spends close to an hour with each adolescent, both individually and as a group with the adolescent’s family. Apart from the customary medical check-ups and consultations, Dr. Galagali also offers what she calls anticipatory guidance. She discusses family, friends, school, eating habits, and outdoor activities. Her team also talks about sexuality, suicide, drugs and safety. The conversations are always open-minded and honest but the idea is to anticipate conflicts and offer guidance well in advance.
Dr. Galagali believes that parents need guidance and counselling too. "They must shift from being directive to having more negotiations with their adolescents,” she says.
Dr. Aruna Muralidhar, an Obstetrician and Gynaecologist at Fortis La Femme Hospital in in Bengaluru, with an interest in adolescent gynaecology believes that parents should prepare their children for what lies ahead. “We need to start early and guide them about these changes,” she says. She recommends that parents use the analogy of trees and plants to promote body positivity among adolescents. After all, every tree or plant grows in a different and unique way.
Adolescents worry about the fallout of not fitting in with their peers but they also want to explore their own identities. Parents need to appreciate and support them through this important stage in their development.
The adolescent years can be difficult and emotionally intense but they also present many opportunities. During adolescence, the brain is surprisingly malleable. This means that we need to handle adolescents with sensitivity but we can also harness the brain’s potential for change and create remarkable learning experiences.
Shweta Sharan is a freelance education journalist who lives in Bengaluru.