Age-Based Expectations

Key Ideas

• Involve them early in decision-making and educate them gradually. Small, repeated conversations are often easier to absorb than one long explanation.
• Revisit education over time; early information can be overwhelming.
• Starting late makes skill-building harder during busy high school years.
• Independent disease management takes time, practice, mistakes, and support.

Developmental Notes

Thinking And Perspective

• Abstract Thinking Develops Gradually: long-term consequences can be hard to appreciate.
• Abstract Thinking Can Be Inconsistent: formal and abstract thinking may not show up reliably in every situation.
• Self-Focus Is Common: teens can be self-centered even as abstract thinking develops.
• Identity Development Can Be Complicated: some struggle to include their condition in identity development.

Planning, Organization, And Follow-Through

• Executive Function Is Still Maturing: planning, organization, and follow-through are still developing.
• Forgetting Can Be Developmental: Often, forgetting medication, supplies, or routines often reflects developing planning and routine-building skills. These abilities improve with practice, structure, and repetition.
• Stress Can Lower Problem-Solving Skills: under stress (for example when sick), teens may revert to simpler problem-solving.

Risk, Impulse, And Safety

• Feeling Invulnerable Can Increase Risk: many feel invulnerable, which can increase risk behaviors and “testing limits.”
• Risk Assessment And Impulse Control Are Still Developing: teens may take risks or make decisions that prioritize short-term rewards over long-term safety.

Emotions And Overwhelm

• Emotional Regulation Is Still Developing: strong reactions, sarcasm, or dramatic responses often reflect difficulty managing emotions rather than intentional disrespect. Teens are still learning how to regulate feelings, especially under stress.
• Cognitive Overload Is Common: teen brains are often overwhelmed by information, emotions, and stress. When overloaded, they may seem distracted, forgetful, or not fully responsive even when they are trying to listen.

Common Coping Strategies

• Denial: pretending not to have a condition; skipping meds/tools (can be dangerous).
• Intellectualization: learning a lot but blocking feelings (useful short-term, risky long-term).
• Regression: “childish” behavior under stress; avoiding responsibilities they handled before.
• Acting-Out: disruptive or risky behavior; may include school problems, drugs/alcohol, or refusing treatments.

Important Reminders

• Teens often live in the moment, and long-term planning develops gradually over time.
• Prioritizing can be difficult because impulse can outweigh long-term thinking.
• The challenges your teen faces will change over time across adolescence.
• Role plays may not work for every teen, so it is worth checking whether your teen finds them helpful.
• Overpreparing for doctor visits may not suit your teen unless they prefer it. Asking what they want from the visit the day before or on the way can be more effective.