In a pediatrician’s office, summertime is teen check-up time.

And, I love it.

Annual checkups are a time for me to catch up on the school year, brag about amazing extra-curricular accomplishments, and swoon over summer vacation plans. It is also a time for anticipatory guidance, private conversations, and facing the often sobering reality of teen life.

Throughout this past year, I have had the privilege of being involved in the lives of many wonderful teenagers. And as we spoke, often very candidly, common themes repeated themselves.

These issues are real. They are present in the kids that we know; at our school, in our carpools, and on our busses. These are the issues facing kids from all schools, private and public. And, they do not discriminate for size, shape, or bank account.

Fortunately, many of my teens are knowledgeable, smart, and confident. They have little challenge to make the right choice when these topics are presented. However, it is important to recognize that these issues are possibly effecting the families and friends with which your teen spends time.

Your teen may be the support and strength for a friend facing one of these issues head-on.

I hope you will use this link-laden post as a conversation starter for your family; and you will be able to share and discuss these things with your teen in a way that you feel is developmentally, socially, and morally appropriate for your family.

10 topics to discuss with your teen this summer

1. Marijuana. My teens ask me great questions about the physical effects of marijuana on the body. Pot seems to be the latest recreational “drug of choice”  among teen users in our area, noting that it is easier and cheaper to obtain than alcohol. With legalization arguments mounting as the Presidential election draws near, arm yourself with the facts about the risks of marijuana use  and how you can openly discuss this drug. Most importantly, be honest. Don’t lie. Don’t over-exaggerate. You want to be a trusted source worth coming back to.

2. Bullying. Stories about severe bullying are real, and sobering. Social media and cell phones have brought bullying to a new level. Most of our Kansas City area schools have bullying policies in place – encourage them to be used. There are also movements, such as Lady Gaga’s Born This Way Foundation, that are rapidly growing; showing promise that many teens are openly fighting against bullying. Encourage this in your child. Know the signs of bullying and victimization. And, act on your suspicions.

3. Recreational ADHD drug use. In my area, one Adderall XR tablet will sell for $10 during finals week. Yep, one pill. My teen abusers steal the pills from younger siblings and friends houses, or simply sell their own medication. Know the side effects of stimulant medication use. Discuss how you feel about using ADHD medications as performance-enhancing drugs, including the ethical issues surrounding this form of drug use. Most importantly, keep ADHD medications and other prescription drugs stored appropriately. And if your child is on one of these medications, prepare them. Someone will ask to buy their medication before high school ends.

4. Pornography. Sexual curiosity is a normal and natural part of growing up. An extreme consequence of this curiosity is pornography addiction. With the internet’s free and easy access to porn, addiction is happening at earlier ages. In addition, even infrequent experiences with elicit material can alter the expectation of real, intimate sexual encounters – often framing the “reality” of sex as an unobtainable fantasy. Discuss your family’s opinion of pornography with your teen, and consider parental control software if you feel appropriate.

5. Texting and driving. A recent report suggests one-third of teen drivers text or email while behind the wheel. A teen was found guilty of vehicular manslaughter after texting and driving. How can parents discourage this dangerous distraction? First, model limited cell phone use behind the wheel. Second, know the tech tools that can be used with cell phones. Finally, discuss with your teen the consequence if they are ever discovered to be texting/emailing behind the wheel.

6. Over-scheduling. Teens in our community are thriving, high-achieving, and motivated individuals. For some, the quest for “doing it all” leads to compromises in their mental and physical health. Encourage and model basic healthy habits within your family. Prioritize sleep, regularly eat together as a family, have routine tech-free time, regularly exercise, and enjoy plain-old down time. Finding balance in life and work is a life-skill worth practicing. Begin now.

7. Creative alcohol intoxication. Vodka-soaked tampons and vodka gummy bears are two ways teen are getting drunk. And, have you heard about “eyeballing?” This post from Dr. Michelle Borba sums up some uncommon ways kids are trying to get the common buzz.

8. Oral sex.  Many kids think of oral sex as “safer” sex, but kids are engaging in oral sex with little understanding of its consequences. Specifically, I get concerned when teens are unable to tell me even one sexually transmitted disease that can be spread during oral sex. Share with your teen how your family feels about intimacy and sexual activity, and the consequences of oral sex. Review how oral sex can transmit bacterial and viral infections such as herpes, gonorrhea, and HPV.

9. Cell phone abuse. Poor cell phone etiquette. Texting all through the night.Sexting. Cyberbullying. All of these things are being done from cell phones in our community. Monitor your kids cell phone, and limit use. See my cell phone rules for some starter help.

10. Depression/Anxiety – Distinguishing true teen depression from “teen angst” can be challenging. I have been frustrated, however, to see depressed teens treated for panic attacks, chronic fatigue, or ADHD; while ignoring the depression at the root cause of these issues. Know the signs of teen depression, and don’t be afraid to ask your health care provider for help.

Natasha Burgert is a pediatrician who blogs at KC Kids Doc.