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Reviewed by the Faculty of Harvard Medical School

Frequently Asked Questions: Early Adolescence (11 Through 14 Years)

When My 14-year-old daughter is at home, she wants to spend all of her time in her room with the door closed. Is this normal?

Yes, it can be perfectly normal for a teen-ager to want her own space and privacy. There are lots of changes during this period of early adolescence, including the start of puberty (when a child's body begins to turn into an adult one) and steps toward independence. While she is trying to figure out her place in the world, it is natural for her to want some privacy and time alone, away from the watchful eyes of her parent(s). Most teens come home from school and want to talk on the phone with their friends instead of their parents, or to be alone in their room just to think, listen to music or whatever.

Do not forget, though, that your teen is still a part of a family and should make some contributions to the day-to-day activities at home. Although it can be challenging to keep the lines of communication open with your teen, it is important that you do so. She must feel comfortable coming to you with issues or problems that are important to her rather than simply avoiding things by "hiding" in her room.

Look for any chance to talk with your daughter, for example, while eating breakfast, driving in the car, or waiting in line at a store. Make sure you always listen to your daughter, hear what she is thinking, and respect her opinions, even when they differ from yours, which will happen more often than you might imagine. Let her know that you had some of the same kinds of experiences when you were her age and that you understand what she is going through. Tell her you are always available to help her work through things, and that you may even have new or different ideas to share with her that may make things easier.

While you always should respect your teen's need for some privacy, complete or prolonged isolation from family or friends is not normal and may be a sign of more serious problems. Other signs that your teen needs help include extreme weight gain or loss, sleep problems, skipping school, falling grades, alcohol or drug use, or rapid changes in her personality. If a teen ever displays any of these warning signs, talk with her pediatrician right away.

It looks like my teen-age son is growing breasts. What could be wrong?

Although this can be hard to believe, there probably is nothing wrong with your son. Breast development in boys (gynecomastia) is very common, occurring in approximately one of every three males sometime during puberty, when a child's body begins to turn into an adult one. The exact cause of this condition is not known, but it may be due to changing amounts of hormones in the body during puberty.

How much breast tissue actually develops depends on the person. Sometimes it's just a small bit of tissue behind the nipple, other times it feels or looks like more. The condition can affect one or both sides and often appears worse in boys who are overweight. Gynecomastia generally causes no physical pain, although occasionally there can be some soreness in the breast, usually from your teen touching it so much because it's new and he is concerned that something is wrong.

Reassure him that most cases of gynecomastia go away on their own over a few years without any treatment. In fact, the only proven treatment for normal teenage gynecomastia is patience and understanding. But until it goes away, gynecomastia can cause a great deal of emotional stress and embarrassment. It may help your son to visit his physician, so he can be reassured that this condition is normal and nothing to worry about. If your son is overweight, his doctor may recommend that he try to lose some weight, with a healthy diet and regular exercise.

If the breast enlargement is particularly noticeable, painful, lasting longer than might be expected, causing serious emotional problems, or there is a family history of breast cancer, you should discuss this immediately with his doctor. There are some rare diseases that cause gynecomastia, but your son's physician would be able to identify other symptoms or findings on his physical exam. There are reports of some drugs being used to treat gynecomastia, but only in very special cases because of the real possibility of serious side effects. Surgery can reduce the amount of breast tissue, although it is rarely used to treat the many normal teenage boys with gynecomastia (and almost never done before the age of 18).

My son likes to listen to loud music, often with a headset because the rest of the family complains about the noise. Will this hurt his hearing?

Yes, your son could damage his hearing by listening to loud music. For us to hear sounds, they first must be changed into nerve signals that the brain can understand. This is a complicated process, involving delicate structures and nerves inside the ear. Hearing loss can develop when any of these structures or nerves is damaged.

In particular, one type of hearing loss, sensorineural hearing loss, results from problems with how nerve signals from the inner ear, specifically from hair cells deep within the ear, move through the nerve to supply that information to the brain. It is a permanent condition that usually affects both ears. Sensorineural hearing loss can be present at birth or can develop later in life. Prolonged exposure to loud noise is a common cause of sensorineural hearing loss. Other causes include infection (for example, an infection of the coverings of the brain and spinal column such as bacterial meningitis), severe head injury, toxic medications and some rare inherited diseases.

To prevent this type of hearing loss, encourage your son to avoid or at least minimize how often he listens to loud music. Permanent damage can result from prolonged exposure to sounds not much louder than normal speech. In addition to loud music (especially pop music), such sounds can come from hair dryers, firecrackers, toy cap guns, firearms, squeaking toys (some are loud enough to cause damage with only a few minutes of exposure per day), lawn mowers and leaf blowers, snowmobiles and other recreational vehicles and farm equipment.

Teach your son to wear protective devices, such as earmuffs, form-fitting foam earplugs or pre-molded earplugs when he is unable to avoid exposure to loud noises.

Last updated February 11, 2011




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