When it comes to parenting tweens or teens, parents often have unanswered questions in their minds like “why does adolescence seem so adventurous?” Or “how do I navigate this stage with my child?” Adolescence is defined as the transition between childhood and adulthood. According to Psychology Today, it typically describes the years between the ages of 13 and 19. However, the physiologic changes that occur during adolescence begin to show as early as the pre-teen and tween years – between 9 and 12 years of age.
There is a continuing lack of resources around adolescent care in Nigeria which is shocking. Especially since adolescents account for almost one-fifth of our population. This is why many parents are concerned and struggling with understanding and managing teenage behaviour.
Reasons for the lack of adolescent health care in Nigeria.
• Lack of training programs:
In Nigeria, there have been no targeted adolescent health training programs for postgraduate doctors. This contributes to the reasons why adolescents might be cared for by either Pediatricians or adult Physicians; rather than a health care professional specifically meant for them.
• Lack of perceived need
Typically, once children have “survived” the first five years of their life, we all seem to breathe a collective sigh of relief. They do not see a Doctor or healthcare provider routinely unless they are ill or it is one of the entrance requirements for a secondary school or University.
Why the Need for adolescent health care?
Adolescents are a vulnerable group, not only because of the physiologic changes they are facing but also because they begin to question norms, traditions and even family values. They are at an age where their peers’ opinions matter a lot. The usual response of “he will grow out of it” and “it is a phase she is passing through” will not address the fears, questions and extreme vulnerability adolescents pass through.
As a result of the increasing connectivity of the world, a lot of things which were not an option for parents when they were adolescents are an option for their children. Some of these examples are suicide, hard drugs – narcotics, international trafficking and sex-slave trade among others. Many parents do not have the tools to deal with these influences or to help teens navigate these rough waters. The increased connectivity allows our children to have access to a wealth of information which is a two-edged sword that must be intentionally dealt with.
Adolescence is a time of great physical and emotional change. At puberty, the body undergoes physiologic changes. For most girls, it manifests as the development of breasts, increasing curves to their bodies, a height spurt and the onset of menstruation. Boys have a height spurt, their voices break, and they experience an increasing appearance of secondary sexual characteristics. These are only physical manifestations which usually occur after emotional and psychological changes. We need to anticipate this period for appropriate guidance.
For these reasons, there is a need for education, balance and objectivity around the growth and development of adolescents. Specialized adolescent health care providers can diagnose and help children as they navigate this stage in the event of an unhealthy pattern or challenge.
Common problems adolescents face: why adolescence is a critical period:
• Life altering changes:
Adolescence, for many, coincides with the transition from elementary to secondary school. A lot of the time, this means leaving behind old friends and trying to establish new relationships. It also includes new roles and routines in new environments. For those who have never been away from home, it involves moving to a different city, boarding school or the home of a guardian who they are not familiar with. Once they get into secondary school, adolescents begin to have a new set of influencers. Depending on how they get to school, that can start from the new school bus, the new ride shares/carpool and for those who start to go to school unaccompanied, it’s a new route on public transport.
For many adolescents, this is the time they begin to challenge family values, traditions and faith. All new friends and external influences contribute to these identity probes. They meet new friends who are also exploring, asking questions and trading stories.
As parents we need to recognize this stage; the opportunities and challenges they may represent and the widening of interests.
• The Influence of social media:
This generation has social media as their companion. The internet and social media exposure represent a new major influencer in our children’s lives. It is important to be aware of the set of influences and values it presents to our children. Social media is the way the world communicates today and children are known to follow and gravitate towards trends.
It has bad aspects such as being a tool to share gossip and fake news. It also has good aspects which include the ability to start useful movements such as gathering support for disaster victims in and around the West African continent. The internet is also fantastic because children can get content at their fingertips and learn anything they want. While our teens explore with all this, they still need to be guided and monitored to ensure that they do not fall into the wrong hands.
Importance of mental health and sexual reproductive health care
Adolescents have two major areas of need that have a dire lack of resources to address them in our environment. They are mental health and sexual/reproductive health care. In this part of the world, we recognize the need for expert care but lack the necessary expertise for meeting most of our children’s complex mental health needs. There remains a lot of stigma around accessing mental health services in Nigeria. Due to cultural restraints, conflicting cultural expectations and realities within Nigeria, there is a significant limitation on the extent to which sexual and reproductive health services are provided to adolescents.
Teenage pregnancy rate ranges from 8-36% in Nigeria and babies born to adolescents have a 50% higher risk of being stillborn or dying within the first few weeks of birth. They are also more likely to be born with low birth weights and long-term risks of cognitive and developmental issues. The lack of proper education on sexual health sometimes leaves teenagers at risk of many side effects.
Some teenagers resort to other means of engaging in sexual behaviour that does not involve intercourse, so they can “remain virgins”. This includes anal intercourse and oral sex to avoid penetration because they believe that these will prevent them from contracting sexually transmitted infections. It is clear that there is an unmet need for contraception and a need for proper sex education. At this ages, the interest and desire to explore is natural. However, what they need is to be armed with the right information to help them make informed decisions.
How to help your child transition to and through adolescence
1. Communicate with them and share personal experiences
Every one of these concerns is an opportunity for a conversation with our children. Sharing our personal experiences is particularly useful. They need to know that there is nothing wrong with them. Their thoughts and struggles are normal. Therefore, it is a good idea to be honest and open with the adolescents in your life. It is also important to know your child, so you can gauge what they are ready for and what they are not ready to hear or experience. There is no one-size-fits-all approach because children are different, and they may mature differently. Hence, we should approach them based on what suits them best.
2. Get books that will help
One way to help is to identify books that have helped other people understand and address these changes. It is also a good idea to read and share conversations with other parents.
An older friend once shared on Facebook how a book she read with her daughter helped them navigate this period of so much change. It is a good idea to read any book before suggesting it to your child, perhaps even better to read it together. For tips on useful books to read in general as your children approach adolescence click here
3. Help them know what to expect
As this period approaches, it is important to share – in age-appropriate detail – what the changes are and how these will represent the maturity of the body and the mind. It is also important to give them skills that encompass physical maturity, spiritual maturity and life in general.
This is a good time to teach boys to respect girls and to teach girls how to protect themselves from unsafe situations resulting from being alone with strangers or even people they know who might prey upon their vulnerability.
4. Digital Responsibility
It is useful to communicate with children before they get on social media about what is appropriate and what is not. Agree on written rules of engagement and let the kids write them themselves. This will serve as an agreement that they abide by. They need to know how anything they share online can form part of their permanent records and influence school as well as employer’s decisions. It is also useful to share examples of how social media can be a force for good or for evil.
5. Spiritual guidance
Most importantly, we need spiritual guidance in everything that concerns our children. As parents, we need to be clear in our communication with our children that our faith is pivotal for us. Children will thrive when there is certainty, and this is true whether they are young or old. It is important to ensure that they know what to expect and where to turn when they are alone. They can also grow in faith by example and teaching.