How can I tell -- and what can I do -- if my child is having a serious problem?

Most youngsters from 10 through 14 are not as troubled as their stereotype suggests. They manage the bumps of adolescence successfully. Still, you need to be on guard. According to one study, 28 percent of America's eighth-graders have experimented with drugs, although a much smaller percentage go on to develop serious drug problems. Some young teens develop eating disorders. Others suffer from depression and other emotional problems. In some cases, emotional problems are linked to learning disabilities that have not been diagnosed or treated.

Some factors that can place a young teen at greater risk for developing problems include:

  • growing up in poverty;
  • living in a single-parent home;
  • being male;
  • growing up in a neighborhood with few social supports;
  • lacking adequate adult supervision;
  • having poor relationships with their parents or other adults who are important to them;
  • possessing low self-esteem;
  • poor-quality schools; or
  • experiencing physical abuse, sexual abuse or neglect.

Don't assume that being "at-risk" automatically means trouble for a child. Some young teens with many risk factors avoid major problems. And some with few risk factors stumble.

We know that certain things increase the chances that children will avoid major problems. Having warm, supportive parents who also draw clear rules and monitor sufficiently is key. In addition, a child with an easy-going temperament, good social skills and a sense of humor is generally able to deal with problems. A child who attends school and lives in neighborhood that provides many supports is also, on average, more able to bounce back form trouble. These supports include people who take a special interest in them-for example, teachers, coaches or neighbors.

This booklet is unable to address in detail all problems that young teen face. However, it is important to recognize the warning signs for some major problems and the Resources section lists materials organizations, Web sites and hotlines that can provide you with further direction and help.

One warning: You may have to address more than one problem at the same time, because serious problems likely appear together in one child: a 12-year-old with an eating disorder may also be depressed and a 14-year-old who uses marijuana also may be sexually active.

Alcohol or Drug Use
Because early adolescence can be a confusing and stressful time for children, it is not surprising that this is the time when many of them first try alcohol, tobacco and other drugs.

Because mood swings and unpredictable behavior are common among young teens, parents often find it hard to spot signs of alcohol and drug abuse. If your child starts to show some of the following signs, drugs or alcohol may be at the heart of the problem:

  • He's withdrawn, depressed, tired and careless about personal grooming.
  • She's hostile and uncooperative and often breaks curfews.
  • He has new friends (and may not want to talk about them).
  • She doesn't want to tell you where she is going and what she is going to do.
  • His grades slip.
  • She's lost interest in hobbies, sports and other activities that were once favorites.
  • His eating or sleeping patterns have changed; he's up late at night and sleeps during the day.
  • Her relationship with family members has worsened and she refuses to discuss school, activities, friends or other important subjects.
  • He has trouble concentrating and seems forgetful.
  • Her eyes are red-rimmed and/or her nose is runny when she doesn't have a cold.
  • Household money keeps disappearing.

Eating Disorders
Eating orders usually occur in females. Eating disorders in males are usually associated with athletics, especially wrestling.

The most common eating disorders are anorexia nervosa and bulimia. Anorexia is an emotional disorder that can be signaled by severe weight loss or failure to gain weight. About 90 percent of the people who have this disorder are females. Studies suggest that one in 250 young women may suffer from anorexia, with symptoms most often first appearing in early to middle adolescence. Bulimia can be signaled by episodes of binge eating followed by self-induced vomiting, fasting or strenuous exercise. Bulimia tends to develop among older adolescents, many of whom have also been anorexic.

Many physical disorders are associated with eating disorders, such as kidney problems, irregular heart rhythms, irritation and tears in the esophagus, dizziness or fainting and stomach and intestinal problems. The death rate is from 5 to 15 percent, but it is lower if sufferers receive treatment.

Take your worries to an expert if your child:

  • loses a large amount of weight for no medical reason;
  • reduces the amount of food she eats and/or stops eating high carbohydrate and fatty foods;
  • exercises excessively despite weakness and fatigue;
  • possesses an intense fear of gaining weight;
  • stops menstruating;
  • binges on foods that are high in calories; or
  • tries to control her weight by vomiting or using laxatives or diuretics.

Depression and Suicide
An increase in suicides among young adolescents makes it vital for parents to recognize the causes and symptoms. Many factors can contribute to serious depression that can lead to suicide. If a parent suffers from extreme depression, a child is more likely to experience it, too. But situations such as broken or unhappy families, the loss of parent through divorce or death, sexual abuse or drug or alcohol abuse may also contribute to depression. Other stressful situations may also play a role: for example, losing a relative, being ignored by friends or serious concerns about sexuality.

Some warning signs of depression and possible suicidal tendencies include:

  • Change in sleeping patterns (either sleeping too much or too little);
  • Change in behavior (can't concentrate on school, work or routine tasks, slipping grades);
  • Change in personality (seems sad, withdrawn, irritable, anxious, tired, indecisive, apathetic);
  • Change in eating habits (loss of appetite and weight or overeating);
  • Physical changes, (including a lack of energy, sudden weight gain or loss, lack of interest in appearance);
  • A major loss or life change (through death, divorce, separation, broken relationship);
  • Decreased interest in friends, school or activities;
  • Low self-esteem (feeling worthless, overwhelming guilt, self-hatred);
  • No hope for the future (believes things will never get better, that nothing will ever change);
  • Preoccupation with music, art and personal writing about death;
  • Giving away prized possessions and otherwise "getting affairs in order;" and
  • Direct suicide threats or comments such as, "I wish I was dead!" "My family would be better off without me." or "I don't have anything to live for." These threats should always be taken seriously.

Learning Disabilities
The National Institutes of Health estimate that 15 percent of the U.S. population has some type of learning disability (LD). Learning-disabled students have a neurological disorder that creates difficulty in how they store, use or produce information. They are as intelligent as anyone else and they often do very well in art, music or sports. But a gap may exist between their ability and their performance and they may have trouble with reading, writing, speaking or mathematics, as well as with social relationships. Most often, learning-disabled students must work harder to make up for their learning problems. This can leave them open to depression and cause a lack of confidence, particularly if the disability goes untreated.

Look for these warning signs of learning disabilities. One or two of these signs in your child is not reason for concern, but the presence of several can signal the need for help:

  • Often reverses letters in writing, such as writing felt for left.
  • Has trouble learning spelling strategies, such as using information from prefixes, suffixes and root words.
  • Avoids reading aloud.
  • Avoids writing compositions.
  • Has trouble with handwriting or avoids it altogether.
  • Grips a pencil awkwardly.
  • Has trouble recalling facts.

Attention Deficit Disorder (ADD) or ADHD (which includes hyperactivity), is not a learning disability, although about one fifth of ADD students have learning disabilities. These students are extremely easily distracted and have a hard time staying focused.

If you believe your young teen has a learning disability, talk to your pediatrician, your child's teachers and the school counselor, who can guide you to a proper evaluation. By law, children with learning disabilities are entitled to their own learning curriculum called an Individualized Education Program (IEP).

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