For Health Care Providers

Adolescence is not “one size fits all.” There are 3 recognized developmental stages. A teen’s physical, intellectual, and social maturity may not match up at all stages.


The stages of adolescence are early adolescence, mid-adolescence, and late adolescence. Each stage has unique characteristics.

• Growth spurt
• Signs of physical growth
• Concrete thinking but without the skills to process consequences of actions
• Initial development of abstract thought

• Physical changes stabilizing
• Growing sense of identity
• Progress in developing reflective thought
• Peer relationships and risk-taking more frequent

• Adult physical form
• Set sense of identity
• More mature relationships
• Transition to living away from family

In the change from being a child to being an adult, adolescents develop new health needs and concerns. At the same time, they are gaining independence from their parents. They start to take part in their health to being the key partner in medical decisions. Building a strong bond with young people can help them take control of health decisions. Parents will not give up control of medical decisions to their children fast. They are an important part of this process. The process must be set up within current consent and confidentiality laws.


Decision makers change during the transition from childhood to adulthood.

  • Parent and Doctor make decisions in the early adolescence stage.
  • Parent, Patient, and Doctor make decisions in the mid-adolescence stage.
  • Patient and Doctor make decisions in the late adolescence stage.

Texas Health Steps’ Adolescent Health: A Guide for Providers has more information. This guide will help:

  • medical providers,
  • social workers,
  • counselors,
  • teachers, and,
  • other professionals.

Adults who provide services and support to young people can use this guide. It offers tips on health and related legal issues in the adolescent years. For concerns or questions on laws, ask your legal counsel, licensing board, local schools, or other state agencies.  

Visit the Texas Health Steps webpage for a current version of the Guide for Providers.   


Below are some tips you can use when talking to adolescent patients:

• Spend time talking with the teen and his or her parent alone.
• Make time to visit with the parent and teen together.
• Ask teens to discuss confidential issues with their parents.
• Use the HEEADDSSS psychosocial interview format:

  • Home,
  • Education,
  • Employment,
  • Activities,
  • Depression,
  • Drugs,
  • Safety,
  • Sexuality, and,
  • Suicidality. 

• Ask patients about their friends’ involvements in risky behavior. For example, “Do any of your friends’ smoke or drink alcohol?” 
• Ask adolescents what they know about a proposed treatment before giving them information.
• Ask open-ended questions.

For more information on working with adolescents, see the Texas Health Steps Online Provider Education modules, especially:

  • Promoting Adolescent Health
  • Teen Consent and Confidentiality
  • Culturally Effective Health Care  
  • Motivational Interviewing
  • Building a Comprehensive and Effective Medical Home
  • Overcoming Barriers to medical Home Implementation
  • Transition Services for Children and Youth with Special Health Care Needs
  • Identifying and Treating Young People with High-Risk Behaviors
  • Assessing Teens Mental Health
  • Childhood and Adolescent Depression
  • Adolescent Substance Use

Each module has CEs available. There are case studies and quick courses available too.

Helpful Web Sites for Preventive Services Guidelines for Adolescents:

American Academy of Pediatrics

Bright Futures

External links to other sites are intended to be informational and do not have the endorsement of the Department of State Health Services. These sites may also not be accessible to persons with disabilities.

Helpful Handouts

The following attachments must be viewed/printed with Adobe® Acrobat® Reader. For persons with disabilities, please contact the Adolescent Health Coordinator  at 512/776-7373.

Adolescent Development Table (17K, PDF, viewing information)

Tips for Interviewing Adolescents (409K, PDF, viewing information)


Contact the State Adolescent Health Coordinator 

Last updated February 14, 2018