Adolescent Medicine by Gail B. Slap, MD, MS (Auth.)

By Gail B. Slap, MD, MS (Auth.)

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At-risk groups, such as those with kidney failure, diabetes mellitus, asthma, and other pulmonary conditions, should receive an influenza immunization each fall. Those who are immunocompromised should not receive live vaccines, such as measles-mumpsrubella (MMR) or varicella. Promoting Self-Efficacy The development of self-management skills is a critical task for all adolescents, regardless of health status. Box 6-4 outlines factors that support these skills, such as patient and parent training in problem solving.

The federal Indivi­ duals with Disabilities Education Act (IDEA) requires a public school to maintain a written Individualized Educational Plan (IEP) for a student with an eligible learning disability. The IEP should be developed and annually reviewed by parents, student, and school personnel and must include a transitional plan from age 14 years to high school graduation. Section 504 of the Rehabilitation Act requires a written individual health plan (IHP) for students with functional limitations due to physical or mental health conditions.

The prevalence of these conditions during the adolescent years does not diminish their chronicity and the adverse effects they can have on psychosocial function. Monitoring Growth and Development Chronic conditions may alter the timing and tempo of growth and pubertal development. For example, spina bifida and McCune-Albright syndrome are associated with the early onset of puberty. More often, chronic ­conditions are associated with pubertal delay (Chapter 10). This may occur as a consequence of poor disease control, as in diabetes mellitus; malnutrition, as in inflammatory bowel disease or cystic fibrosis; or hypogonadotropic hypogonadism due to chronic physiological stress.

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