Adolescence is a time when youth make decisions, both good and bad, that have consequences for the rest of their lives. Some of these decisions put them at risk of lifelong health problems, injury, or death. The Institute of Medicine held three public workshops between 2008 and 2009 to provide a venue for researchers, health care providers, and community leaders to discuss strategies to improve adolescent health.

Adolescents obviously do not always act in ways that serve their own best interests, even as defined by them. Sometimes their perception of their own risks, even of survival to adulthood, is larger than the reality; in other cases, they underestimate the risks of particular actions or behaviors. It is possible, indeed likely, that some adolescents engage in risky behaviors because of a perception of invulnerabilityâ€"the current conventional wisdom of adults' views of adolescent behavior. Others, however, take risks because they feel vulnerable to a point approaching hopelessness. In either case, these perceptions can prompt adolescents to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. A small planning group was formed to develop a workshop on reconceptualizing adolescent risk and vulnerability. With funding from Carnegie Corporation of New York, the Workshop on Adolescent Risk and Vulnerability: Setting Priorities took place on March 13, 2001, in Washington, DC. The workshop's goal was to put into perspective the total burden of vulnerability that adolescents face, taking advantage of the growing societal concern for adolescents, the need to set priorities for meeting adolescents' needs, and the opportunity to apply decision-making perspectives to this critical area. This report summarizes the workshop.

Current policies treat adolescent risk behaviours as separate problems requiring separate solutions, ignoring the overlap of many risk behaviours. This text seeks to move beyond the fractured approach of preventing one kind of behaviour at a time and suggests more comprehensive prevention strategies.

This book covers the developmental and health problems unique to the adolescent period of life. It focuses on special needs and public health programs for adolescents. It offers deep insight into smoking, violence, teen pregnancy, HIV/AIDS, and other problems, along with intervention and prevention strategies. "Anyone serious about improving adolescent health should read this book. It spans theoretical and developmental constructs, summaries of evidence-based interventions for adolescent risk behaviors, metrics, and policy recommendations." —S. Jean Emans, MD, chief, Division of Adolescent Medicine, and Robert Masland Jr., chair, Adolescent Medicine, Children's Hospital Boston, and professor of pediatrics, Harvard Medical School "This is the one single text that students can use to study adolescent health. It includes contributions from many of the world's most accomplished researchers to provide learners with cutting edge information to make the study of adolescence understandable and applicable in practical settings." —Gary L. Hopkins, MD, DrPH, associate research professor and director, Center for Prevention Research, and director, Center for Media Impact Research, Andrews University "This textbook presents an excellent balance in weighing the evidence from the risk and the resilience literature, incorporating research in racially and ethnically diverse populations." —Renée R. Jenkins, MD, FAAP, professor, Department of Pediatrics and Child Health, Howard University College of Medicine "This is an engaging, thorough, and thought-provoking statement of our knowledge about adolescence. " —Wendy Baldwin, PhD, director, Poverty, Gender, and Youth Program, Population Council

This book focuses on the crucial role that relationships play in the lives of teenagers. The authors particularly examine the ways that healthy relationships can help teens avoid such common risk behaviors as substance abuse, dating violence, sexual assault, and unsafe sexual practices. Addressing the current lack of effective prevention programs for teens, they present new strategies for encouraging healthy choices. The book first traces differences between the “rules of relating” for boys and girls and discusses typical and atypical patterns of experimentation in teens. The authors identify the common link among risk behaviors: the relationship connection. In the second part of the book, they examine the principles of successful programs used by schools and communities to cultivate healthy adolescent development. An illuminating conclusion describes the key ingredients for engaging adolescents, their parents, teachers, and communities in the effort to promote healthy, nonviolent relationships among teens.

Adolescenceâ€"beginning with the onset of puberty and ending in the mid-20sâ€"is a critical period of development during which key areas of the brain mature and develop. These changes in brain structure, function, and connectivity mark adolescence as a period of opportunity to discover new vistas, to form relationships with peers and adults, and to explore one's developing identity. It is also a period of resilience that can ameliorate childhood setbacks and set the stage for a thriving trajectory over the life course. Because adolescents comprise nearly one-fourth of the entire U.S. population, the nation needs policies and practices that will better leverage these developmental opportunities to harness the promise of adolescenceâ€"rather than focusing myopically on containing its risks. This report examines the neurobiological and socio-behavioral science of adolescent development and outlines how this knowledge can be applied, both to promote adolescent well-being, resilience, and development, and to rectify structural barriers and inequalities in opportunity, enabling all adolescents to flourish.

Adolescence is a critical growth period in which youth develop essential skills that prepare them for adulthood. Prevention and intervention programs are designed to meet the needs of adolescents who require additional support and promote healthy behaviors and outcomes. To ensure the success of these efforts, it is essential that they include reliably identifiable techniques, strategies, or practices that have been proven effective. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century identifies key program factors that can improve health outcomes related to adolescent behavior and provides evidence-based recommendations toward effective implementation of federal programming initiatives. This study explores normative adolescent development, the current landscape of adolescent risk behavior, core components of effective programs focused on optimal health, and recommendations for research, programs, and policies.

This report constitutes one of the first activities of the Forum on Adolescence, a cross-cutting activity of the Institute of Medicine and the National Research Council of the National Academies. Established under the auspices of the Board on Children, Youth, and Families, the forum's overaching mission is to synthesize, analyze, and evaluate scientific research on critical national issues that relate to youth and their families, as well as to disseminate research and its policy and programmatic implications. The goals of the forum are to: (1) review and establish the science base on adolescent health and development and make efforts to foster this development; (2) identify new directions and support for research in this area, approaching research as a resource to be developed cumulatively over time; (3) showcase new research, programs, and policies that have demonstrated promise in improving the health and well-being of adolescents; (4) convene and foster collaborations among individuals who represent diverse viewpoints and backgrounds, with a view to enhancing the quality of leadership in this area; and (5) disseminate research on adolescence and its policy implications to a wide array of audiences, from the scientific community to the lay public.

During the transition from childhood to adulthood, adolescents face a unique set of challenges that accompany increased independence and responsibility. This volume combines cutting-edge research in the field of adolescence and the field of motivation and self-regulation to shed new light on these challenges and the self-regulation tools that could most effectively address them. Leading scholars discuss general principles of the adolescent period across a wide variety of areas, including interpersonal relationships, health and achievement. Their interdisciplinary approach covers perspectives from history, anthropology and primatology, as well as numerous subdisciplines of psychology - developmental, educational, social, clinical, motivational, cognitive and neuropsychological. Self-Regulation in Adolescence stresses practical applications, making it a valuable resource not only for scholars, but also for adolescents and their family members, teachers, social workers and health professionals who seek to support them. It presents useful strategies that adolescents can adopt themselves and raises important questions for future research.

Adolescence is a distinct, yet transient, period of development between childhood and adulthood characterized by increased experimentation and risk-taking, a tendency to discount long-term consequences, and heightened sensitivity to peers and other social influences. A key function of adolescence is developing an integrated sense of self, including individualization, separation from parents, and personal identity. Experimentation and novelty-seeking behavior, such as alcohol and drug use, unsafe sex, and reckless driving, are thought to serve a number of adaptive functions despite their risks. Research indicates that for most youth, the period of risky experimentation does not extend beyond adolescence, ceasing as identity becomes settled with maturity. Much adolescent involvement in criminal activity is part of the normal developmental process of identity formation and most adolescents will mature out of these tendencies. Evidence of significant changes in brain structure and function during adolescence strongly suggests that these cognitive tendencies characteristic of adolescents are associated with biological immaturity of the brain and with an imbalance among developing brain systems. This imbalance model implies dual systems: one involved in cognitive and behavioral control and one involved in socio-emotional processes. Accordingly adolescents lack mature capacity for self-regulations because the brain system that influences pleasure-seeking and emotional reactivity develops more rapidly than the brain system that supports self-control. This knowledge of adolescent development has underscored important differences between adults and adolescents with direct bearing on the design and operation of the justice system, raising doubts about the core assumptions driving the criminalization of juvenile justice policy in the late decades of the 20th century. It was in this context that the Office of Juvenile Justice and Delinquency Prevention (OJJDP) asked the National Research Council to convene a committee to conduct a study of juvenile justice reform. The goal of Reforming Juvenile Justice: A Developmental Approach was to review recent advances in behavioral and neuroscience research and draw out the implications of this knowledge for juvenile justice reform, to assess the new generation of reform activities occurring in the United States, and to assess the performance of OJJDP in carrying out its statutory mission as well as its potential role in supporting scientifically based reform efforts.