Healthy Teen Development

During the original satellite broadcast, participants had the opportunity to send their questions to the presenters. While many questions were addressed during the program, others were not. The presenters have graciously agreed to provide responses to a portion of the questions that were not addressed.

Healthy Teen Development
October 17, 2002

Laurence Steinberg, Ph.D.
Department of Psychology
Temple University
Philadelphia, PA 19122
(215) 204-7485; 204-7321
FAX: (215) 204-5539
E-mail: LDS@TEMPLE.EDU

How do you connect the social institutions to provide the connectedness the adolescents need? For example, how does the school, other organizations in a community and family become connected? Especially with so many constraints such as time, etc.? (Pennsylvania)
I think the key is a planning process that involves all of the relevant players (school personnel, parents, community programmers, etc.) at the table from the beginning to discuss their common interests and goals, and ways to monitor things on an ongoing basis.

Stressing scholastic/academic achievement and maturity is all well and good, but with budget cuts causing art and music program to shut down all across the county, isn’t it also crucial to assist teens in a creative sense and encourage them to express themselves creatively and artistically? (state unknown)
Absolutely. I didn’t mention these specifically, but I see these as falling into the general category of “life skills.” Part of what we want our children to be able to do is to participate fully in society, and this means being able to appreciate and create art and music.

How do you feel about the middle school concept with grades 4-8 and the development practices we talked about? (New Hampshire)
I don’t think that any particular approach to age grouping is inherently superior to any other, although there is some research suggesting that young adolescents may fare better in K-8 schools and under conditions where they have fewer school charges to adapt to. What really matters is the training of the individuals who work in the schools and their commitment to facilitating positive youth development.

Can you discuss the contradiction that teens experience between advancing intellectual development and the lag of their emotional development in areas such as risk taking? (Minnesota)
New scientific information suggests that many of the emotional changes of adolescence, which may lead adolescents to seek more stimulation and value reward over risk, -- both of which would lead to more risk-taking – have their onset earlier than the development of advanced cognitive skills, involving planning and self-management. In fact, many of these advanced cognitive skills may not fully mature until very late in adolescence or early adulthood. So during early and middle adolescence, individuals may have stronger impulses than their abilities to manage them.

How do boys and girls express their needs differently in areas such as communication, intimacy and morality? And the different types of stressors they experience? (New York)
Much has been made about differences between adolescent boys and girls, but a lot of what is written in the popular press, like Reviving Ophelia, is not based on scientific information. Many scholars believe that gender differences were much more pronounced in the past than they are today. In fact, most studies show that boys and girls are much more similar than different, and that the sorts of stressors that adversely affect their mental health are remarkably similar. One area where there do seem to be differences is in intimacy, where most studies find that girls’ friendships are more intimate than boys’ friendships.

How do you advise parents to handle tough issues such as sex or drugs when firmly forbidding these activities often leads teens to sneak, lie, and pull away from parents? (Illinois)
It’s important for parents to avoid the trap of thinking that talking honestly and opening with their teens about tough issues will somehow lead teenagers to experiment more with risky behaviors. There is no research indicating that teenagers engage in these activities simply because their parents forbid them (in fact, most studies show that teenagers are more at risk for problem behavior when their parent’s do not have rules and restrictions). At the same time, studies do show that adolescents are more likely to listen to their parents when their parents really discuss these issues with them rather than simply “lay down the law.”

How can one develop expectations for behavior at school when the behaviors are not expected at home? (Iowa)
It is very difficult, but not impossible. Certainly by the time individuals have reached adolescence they have the cognitive abilities necessary to understand that different people (e.g., teachers versus parents, or one teacher versus another), and different institutions (e.g., home versus school, or school versus a job) have different standards and expectations, so there is no need for schools to think that they must lower their expectations simply because they are not matched at home. At the same time, this situation can often be avoided by schools having frequent and regular contact with parents, so that teachers’ expectations and standards can be clearly articulated.

Has research discovered any correlation between the type of music or the ways in which teens listen to music (such as loudness, length of time or going to sleep with music on) effect physical development? Should parents be concerned? (Minnesota)
I am not aware of any such research, although there is some evidence that listening to extremely loud music can cause some modest hearing loss. There is no evidence that the type of music teenagers listen to has any lasting impact on their development. Parents should worry about sleep deprivation in adolescence, however. There is increasing evidence that teenagers who do not get enough sleep (8 or 9 hours per night) are more vulnerable to depression, irritability, and poor school performance.

You mentioned about the 4 dimensions of youth development. What about the spiritual aspect? This wasn’t addressed? (Iowa)
I see spiritual development as part of moral development, which was discussed under the heading of maturity.

Can you give some specific examples of successful cross programming, as mentioned in your comments on “integration across contexts?” (New York)
The best examples are well-crafted parent involvement programs, which attempt to “cross-program” between the home and the school, but I’m sure there are other examples to be found in the realm of after-school programming as well. Unfortunately, attempts to align the different organizations that serve young people are few and far between. Communities are often organized so that different kinds of programs or services are administered by completely different agencies that rarely communicate with each other. I think it is a good idea for communities to form “Youth Boards” that encourage representatives from different agencies and institutions (as well as parents and adolescents) to meet monthly in efforts to build bridges and coordinate services and programs for adolescents.

Teen Sexuality and the Role of Communication and Decision-Making
October 24, 2002

Robert Wm. Blum, M.D., M.P.H., Ph.D.
Division of General Pediatrics and Adolescent Health
University of Minnesota
200 Oak Street, SE; Suite 260
Minneapolis, MN 55455
(612) 626-2820
Fax: (612) 626-2134
E-mail: blumx001@umn.edu

What are some of the ways or words that can be used in explaining intimacy and value issues with teens?
It is important to be very concrete and very explicit. If our language is vague and abstract teenagers aren_t going to generally understand what we are trying to say. I would suggest using the things we see around us, including newspapers, radio and music, movies, and the news to raise issues. I would share not only what I think and feel, but explore with our teenagers what they think and feel as well. It will engage them much more in a conversation then being "talked at".

At what age is the discussion about sexual activity best understood and
appreciated by teens?
To me it isn't an issue of "at what age"; rather, it is an issue of how do we have conversations with our children at all ages. Young children are sexual and are sexual beings and thus having conversations about hygiene, body parts, public and private displays of behavior are appropriate at even very young ages. As our children get older, behaviors become more complicated and they see things around them that their friends as well as other young people are doing at the age of 9, 10 and 11. I would raise questions by exploring with them what behaviors they see that 5th and 6th grade friends related to cigarette smoking, drug use, same sex and other sex relationships. At what age do your children see friends "pairing off" or forming boyfriend/girlfriend relationships. The more we ask and discuss these issues at a young age the more likely our teenagers are to tell us what they think and feel.

What hope is there for teens who have uninvolved parents that choose not to take time?
The data is very clear that even when there are uninvolved parents if there is another adult in the life of a young person that that teenager does quite well. If we see kids that don't have access to parents, it is very important to connect them through school, or community groups with other caring adults.

How do parents get across that they disapprove of their children having sex in an effective way?
The groundwork for that is having a strong relationship with one's teenager. Our research has suggested that if we don_t have that firm basis, then teenagers are not very likely to hear what we have to say. Secondly, if our admonitions are not consistent with our behaviors, then what we say will also fall on deaf ears. Teenagers "listen to the music" much more than they listen to our words; and if our music (our behavior) doesn't line up with what we are saying then we are sending out very mixed messages.

How can we communicate to parents the importance of the relationship with their teens?
It is the message that needs to be given over and over again through school, through church, through newspapers. We not only need to tell parents it's importance, but we need to help them do it by providing them skills and approaches to their teenagers.

In the Add Health study, did we ask mother's about their own age of first sexual experience?
No, we didn't.

What definition of sex was used for the purpose of the Add Health study? Did it include oral and anal sex or only vaginal intercourse?
We asked a wide-range of behaviors and thus there was not an overarching definition or question about "sex". It did ask about anal intercourse, but not about oral sex.

Knowing their parents have a large influence on teen's sex views and behaviors, what implications does this have for school-based pregnancy programs?
I would suggest to the extent that we can involve parents in that home and school as well as community and media messages all line up so much the better.

Do father's tend to talk to teens' differently about sex than mothers? How many fathers were involved in the Add Health study?
Less than 10% of all parents were fathers in this study. There is research that has been done looking at fathers and they tend to be less involved than mothers in speaking to their kids. For an excellent review, I would suggest that you look at the National Campaign to Prevent Teen Pregnancy's publication: "Parents Matter".

Besides parents, who tends to be most influential I a teen_s decision to
have sex?
There are a whole set of factors that influence those decisions including
older siblings, peer and particularly the perception of peer behaviors,
personal biology (including hormonal levels).

Can you address homosexuality? Why was this topic not addressed?
The topic was addressed in the Add Health study and there is an extensive amount of research on adolescent sexual orientation and same sex behaviors. I would refer you, for example, to the work of my colleague, Gary Remafedi.

(Additional Response from Jenny Oliphant)
In our curriculum and in general health education, we have very consciously addressed same sex relationships, in terms of orientation and gender and questioning. We have found many youth who become much more accepting of all orientations when it is addressed on an on-going basis as part of the entire sexual health discussion. Many youth eventually share that family members are GLBT or that they are after it is talked about so freely in our groups. As far as why it wasn't addressed in the show, I wish I had said something. Unfortunately, time was extremely short so not every aspect of sexual health education was mentioned.

What can be done to address the media? Could you offer any suggestions for teens who have already been negatively affected by the media?
There are many groups that are effectively working with the media and this is tremendously important area. I would suggest that you explore the work of the National Campaign to Prevent Teen Pregnancy and the Director of Communications there is Marissa Nightingale.

What influence does the media/Hollywood stars play in sexual development? How does this influence sex education programs?
I don't think it has any significant influence on sexual development. It may have a modest influence on sexual behavior, but in truth there are many more factors far closer to the individual teenager that influences her or his behavior, including parents, siblings, peers, social environments and personal biology.

(Additional Response from Jenny Oliphant)
I may go a little farther. In my view, media is very influential on sexual health education. In many cases, youth are learning about sexuality from the media without the discussion of it that I believe needs to accompany it. I would refer you to the frontline video "Merchants of Cool" as one example of how media and sexuality are sold in the us to teens. I think that we could be much more deliberate in our teaching using media as a positive health educator. One can find positive examples of this on MTV, for example. I also mentioned in the talk, I believe, the "soap opera" summit that attemped to address responsible sexuality in soaps. This is another example of a small effort that could reach many youth.

Regarding adolescent sexual activity decision-making, did this study include any questions on religious beliefs?
Yes, we looked at a range of religions and religious beliefs. Simply stated,
religion itself appears to have no impact on an adolescents' sexual behavior. Secondly, mothers' religiosity (how religious or spiritual she says she is) also has no effect on her teenagers' sexual behaviors. We have also looked at individual teenagers church attendance and that too does not appear to have a significantly positive impact.

Did teens in the survey indicate that they thought of long-term implications of pregnancy in their decision to engage in sexual activity or not?
The question about long-term implications itself was not asked in that direction. There is evidence, however, that the capacity to project one's self into the future is a developmental phenomenon that emerges in adolescence. Many adolescents don't have a long-term view of most things, nor have sense of what the long-term consequences are. That having been said, the same is true for many adults.

Even if there is a slight positive trend in the abstinence program, why isn't there more encouragement to these programs?
The federal government has invested hundreds or millions of dollars in abstinence-based education programs. The empirical evidence for these programs was never very strong. Specifically, the original work out of Atlanta, GA showed that first intercourse was delayed by approximately three months. Secondly, the original program combined abstinence with contraceptive education. The most rigorous evaluation so far of an abstinence-based program was undertaken by Jemmott and Jemmott; and their evaluation was published approximately two years ago in JAMA. That study used a randomized controlled intervention of which arm was abstinence only education. The Jemmott research did not show any positive impact of an abstinence curriculum. Until there is further data to really indicate a strong impact of these programs, one should be cautious about investing additional resources.

Jennifer Oliphant photo

Jennifer (Jenny) A. Oliphant, MPH
Community Outreach Coordinator
National Teen Pregnancy Prevention Research Center
Suite 260, Gateway Building
200 Oak Street SE
University of Minnesota
Minneapolis, MN 55455
(612) 624-1907
E-mail: oliph001@tc.umn.edu

Is peered more than other types of sex education, school clinic, etc.? (Minnesota)
I believe this question means to ask if peer education is more "effective" than... The effects of peer education are quite mixed. What seems to be more effective about peer education than other sexuality education programs are its intensity and its duration, which most prominently affect those who do the teaching (the peer educators) and not to those they reach out. In addition, because of sufficient duration and intensity, peer programs that focus on skill-building have a greater potential to be effective than short or "one-shot" health education programs. I would also argue that effective programs should allow youth to explore their own values. Many sex education programs focus so much on fact that not enough time is devoted to values clarification, decision making and integration of knowledge, values and decisions into behavior change. Prochaska's model of health behavior change, originally designed for smoking cessation, is a good theoretical model to explain how health behavior change in peer education may be effective, especially because it is (again) long enough to move youth through the stages of change.

What are some examples of sites chosen by youth for their service learning program opportunities? (Wisconsin)
Youth often interested in service that is oriented toward helping younger youth. Literacy education/tutoring is one that is popular. Each group varies greatly, as do their interests. The important part of service learning is that the youth are genuinely involved in selecting the service that is meaningful to them. Our group all does the same service. Emerging Answers has a good description of effective components of service learning. (See my reading resources handout.)

I see the SUP Program is theory - based. Is it designed as a result of Blum's study? (Minnesota) What is the relationship between Dr. Blum's research and Jenny's Peer Education Program?
It was not designed as a result of this study. However, much of the components mirror what appears to be effective. The whole premise is to get youth to reach out to others who they value and discuss healthy sexuality in a respectful, informed and empowered manner. One aspect of the curriculum is called "Show What You Know" where youth are required to reach out to an adult who is at least 21 years old or older. Most youth do these special "contacts" with mothers, fathers, aunties, teachers or grandmas. This aspect is included as a way to encourage participants to have discussions with trusted adults, a common theme in the Add Health study. Also, the curriculum is based on youth development which, again, is a common theme of the Add Health study.

Does the SUP delay first intercourse longer or affect frequency the way parent connectedness does?
We haven't compared these, so it would be unfair to say yes or no from a research perspective