Adolescent developmental tasks and behavior

The formation of personal identity and separation from family are major developmental tasks of adolescence. Feelings of immortality and exception to the consequences of risky behavior may serve to promote independence and formation of personal identity.

Adolescents tend to identify with a peer group, and departure from group standards may result in alienation from that group. Cognitive tasks involve considering other points of view and behaving in a culturally acceptable manner.10 Health professionals can help adolescents navigate through this period by listening, providing anticipatory guidance, and screening for risks. 

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Intentional and unintentional injuries are among the leading causes of adolescent morbidity and mortality.11 Integrating preventive screening into daily practice would promote early identification of problems such as risky behavior and allow intervention and guidance.

Several tools are available for adolescent health and behavioral screening or anticipatory guidance, including but not limited to the American Medical Association’s Guidelines for Adolescent Preventive Services (GAPS),12 Rapid Assessment for Adolescent Preventive Services (RAAPS),13

Adolescent Health Review,14 and the American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care.15 Most of these tools address risk factors such as depression, suicide, sexual behavior, weapon use, and illicit alcohol, tobacco, and drug use.

Adolescents may not view other risky behaviors, such as the salt and ice challenge, as harmful, and these behaviors are not specifically addressed within the screening tools. However, health-care providers should mention these challenges or any other causes for concern during the patient’s visit.

In the case of the salt and ice challenge, the accompanying injury should be evaluated and managed according to burn guidelines16 with consideration given to the location, size, depth, and degree of the burn. Referral to a counselor or psychiatrist should be considered if low self-esteem, depression, or risk for further injury is suspected.