Textbook of Adolescent Health Care / Edition 1 available in Hardcover
- Pub. Date:
- American Academy of Pediatrics
Nearly 200 chapters cover physical growth and development...examination and laboratory screening...sexual development...puberty...obesity...sleep disorders...adolescent dermatology and much more.
|Publisher:||American Academy of Pediatrics|
|Product dimensions:||8.80(w) x 11.00(h) x 2.70(d)|
About the Author
Martin Fisher, MD, FAAP is Chief of the Division of Adolescent Medicine at Cohen Children’s Medical Center of Northwell Health in New Hyde Park, New York and Professor of Pediatrics in the Zucker School of Medicine in Hempstead, New York. He is Past President of the Society for Adolescent Health and Medicine and of the North American Society for Pediatric and Adolescent Gynecology, and has served as editor in chief of the Textbook of Adolescent Health Care, published by the American Academy of Pediatrics. He is editor of PREP Adolescent Medicine, an associate editor of Adolescent Medicine: State of the Art Reviewers, an associate editor of Current Problems in Pediatric Health Care and the Co-Chair of the Adolescent Panel of Bright Futures. Dr Fisher has published over 70 articles in peer-reviewed journals, over 70 chapters and reviews, and has presented over 100 abstracts and lectures in national and international meetings.
Elizabeth M. Alderman, MD, FAAP, is Professor of Clinical Pediatrics at the Albert Einstein College of Medicine of Yeshiva University and Director of the Post-doctoral Training Program in Adolescent Medicine. The current president of the North American Society for Pediatric and Adolescent Gynecology, she has also served as chair of the AAP Section on Adolescent Health and on the executive council of New York, Chapter 3 of the AAP.
Richard Kreipe, MD, FAAP, FSAM, FAED, is the founding Director of the Child and Adolescent Eating Disorder Program at the University of Rochester Medical Center, and a board-certified pediatrician and adolescentmedicine specialist, as well as a Fellow of the Academy for Eating Disorders. Dr.Kreipe is a consultant to the American Psychiatric Association regarding diagnostic criteria for eating disorders in young people, and is a past-President of the Society for Adolescent Health and Medicine.
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Textbook of Adolescent Health Care
By Martin M. Fisher, Elizabeth M. Alderman, Richard E. Kreipe, Walter D. Rosenfeld
American Academy of PediatricsCopyright © 2011 American Academy of Pediatrics
All rights reserved.
History of Adolescent Medicine and Health Care
HEATHER MUNRO PRESCOTT, PHD
HISTORY PRECEDING ORGANIZED ADOLESCENT HEALTH CARE
Interest in providing specialized health care to adolescents is a product of ideas about youth that emerged during the early 20th century. The work of developmental psychologist G. Stanley Hall was primarily responsible for establishing adolescence as a distinct developmental category. Hall was also the first to suggest establishing a branch of medicine for adolescents, writing that his book had prompted a deluge of letters from parents and relatives of young people asking for medical advice. "Had I been a physician" Hall wrote, "I might have easily worked up a lucrative practice from such cases"
Yet a new medical field dedicated to this age group did not appear until the 1950s, when adolescent medicine evolved as a subspecialty of pediatrics. This did not mean that adolescents' health care needs were ignored. Rather, the settings in which young people received health care have changed considerably over the course of history.
Prior to the early 20th century, most adolescents, as well as children and adults, received health care from female family members within the home. This was especially true in colonial America, when the number of trained physicians was much lower than in Europe. Advice for caring for sick family members was available in newspapers, almanacs, and domestic medical manuals written by physicians. When an ailment proved to be beyond the healing capabilities of a homemaker, she would rely on a midwife, who typically had training and experience not only in labor and delivery but diagnosis and treatment of illness.
Enslaved African-American youth also received most of their health care within the household or plantation. Typically, slaves received health care from older slave women, who relied on home remedies adapted from West African healing traditions. Owners of large plantations also contracted with local white physicians to provide care for slaves of all ages. After the importation of slaves was outlawed in 1808, slaveholders took special interest in protecting the fertility of young female slaves, because the only legal way to increase the slave population was through reproduction. The estimated mean age of menarche among adolescent female slaves was 15.
LATE 19TH CENTURY
Prior to the 1920s, a significant percentage of adolescents were compelled to start working for wages at an early age to help support their families. The first national labor data on youth employment, collected in 1880, indicate that 32% of all males and 12% of all females aged 10 to 19 worked for wages. These figures varied considerably according to race and ethnic background; the labor force participation rate of children aged 10 to 19 was considerably higher among black males (66%) and females (44%) than among white males (43%) and females (13%). Likewise, the rate among foreign-born children exceeded that of their counterparts born in the United States — by about 9% and 16% among males and females, respectively. These differences may be largely attributable to the higher earnings levels of white and native-born families. In addition, labor force participation among rural children exceeded urban rates by about 8%.
The poor conditions of many places of employment took a heavy toll on young persons' health. Work in crowded textile mills and sweatshops led to high rates of respiratory illnesses, especially tuberculosis, which was the leading cause of death among adolescents and young adults at the turn of the 20th century. Young workers frequently were injured by heavy machinery too large for them to operate safely. Although some factories, mines, and logging camps contracted with physicians to provide medical service to employees on a fixed per annum basis, most employers did not provide health care or health insurance for their employees. Those who were absent from work because of illness or injury typically lost their jobs.
Larger cities built general hospitals and freestanding dispensaries to provide free health care for growing numbers of poor and immigrant adolescents who needed medical attention. The first children's hospital in the United States opened in Philadelphia in 1855. Several other large cities, such as Boston, Washington, DC, Detroit, and Chicago, created children's hospitals in the late 19th century. In 1909, there were only 25 children's hospitals in the country, compared with 4,359 general hospitals. Children's hospitals seldom treated patients over the age of 12. Administrators of general hospitals recognized that young children needed to be separated from the rest of the hospital population, but they placed adolescents with adult patients. Thus, those who could afford to do so still employed private physicians and nurses to care for them within their homes.
During the 19th century, a variety of public agencies and private philanthropic organizations created institutions for sick and needy adolescents. Although not all of these were designed for health care, the rapid spread of illness among those housed in close quarters necessitated the creation of hospitals and infirmaries as auxiliaries to orphanages, almshouses, and asylums for adolescents with physical, cognitive, or sensory disabilities. Boarding schools for Native American children, started in the late 1870s to separate Native American children from their traditions and make them truly "American," proved to be breeding grounds for contagious diseases, especially tuberculosis and trachoma. White adolescents in private and public schools also were vulnerable to epidemic diseases, such as measles, whooping cough, scarlet fever, diphtheria, and tuberculosis. School boards attempted to control the spread of disease by requiring school children and adolescents to be vaccinated against smallpox, diphtheria, and other diseases prior to attending school. Then as now, a number of parents objected strongly to compulsory vaccination. Some felt that vaccination was dangerous, whereas others resented the intrusion of state officials into private family matters. To prevent the spread of disease and to protect students' health, schools began in the 1890s to hire physicians as medical inspectors. These physicians identified a set of diseases that seemed to be caused and/or exacerbated by the environment of 19th-century schools, many of which lacked adequate light, ventilation, heat, or sanitary facilities. Medical experts noted that American school rooms, especially those in urban areas, were breeding grounds for the spread of disease and called for reforms that would eliminate hazards to student health.
EARLY 20TH CENTURY
At the same time, child welfare reformers successfully lobbied for legislation to protect the nation's children and youth. Their activism led to the creation of the US Children's Bureau in 1912. This agency led efforts to improve child health and welfare, as well as movements to outlaw child labor and mandate school attendance through the age of 16. As a result of these reforms, school attendance for adolescents grew dramatically. According to US Census figures, in 1890 only 6.7% of 14- to 17-year-olds were enrolled in high school. By 1920, this figure had risen to 32.3% and by 1930 more than 50% of adolescents were enrolled in junior and senior high schools. During the Great Depression, widespread unemployment and New Deal legislation further restricting child labor pushed high school attendance rates to 75% and graduation rates to 50%.
FIRST ADOLESCENT OUTPATIENT CLINIC
The first mention of an outpatient clinic specifically for adolescents was in a 1918 article from Archives of Pediatrics. The article described a separate clinic for girls aged 11 to 16 established by San Francisco physician Amelia E. Gates, MD, as a branch of the children's clinic at the Stanford University Medical School 2 years earlier. Gates observed that malnourishment was a common problem among her patients, with a significant number recorded as underweight for their age, anemic, or having some other dietary deficiency. Postural defects and scoliosis were present in more than one-quarter of her patients. Investigation and treatment of menstrual problems formed a large part of the work of the clinic. Gates wrote it was "surprising how many girls come to us with no knowledge either of the advent or the meaning of the menstrual function," because of erroneous information gathered from other girls or lack of adequate instruction from mothers. Gates believed that one of her main objectives was to make up for this lack of information. Diseases of the teeth and gums were the most common of all, but Gates lacked sufficient facilities for even the most basic dental work.
Gates observed that when the clinic started, she was concerned mainly with medical issues, but she soon found that given her clientele, who came predominantly from working-class families in the Bay area, she and her staff "could hardly confine ourselves to medical work alone" but that the "psychical phenomenon" of the adolescent period was central to their functions as well. A number of the girls in her clinic were referred from associated charities and under the care of foster mothers. The staff also had to deal with other problems in the home, mental overstrain in school, worries about finding employment after graduation, and "the various social maladjustments of our modern life." The clinic "assumed the character of a girls club," providing after-school activities and "wholesome amusement" for the girls' leisure hours. According to Gates, many of the girls looked forward to coming to the clinic, "knowing they can bring their small troubles and worries and feeling sure of a sympathetic understanding and an attempt at effective help." Gates wrote that even after finding jobs, former patients still "hold their allegiance to the clinic and return to us from time to time," usually because of physical disability caused by work-related injuries.
RELATIONSHIP AMONG HEALTH, ACADEMIC SUCCESS, AND ACCESS TO CARE
During the late 1910s and 1920s, the educational psychologist Lewis Terman argued that public schools also should treat physical illnesses and defects that hindered a student's academic success. He proposed that schools hire nurses, who would not only examine students at school but follow up on cases by visiting the students' homes to ensure that medical treatment was being followed. He also realized that many families, especially immigrant, urban, and rural poor, could not afford medical care on their own. Therefore, he argued that the second essential step in promoting the health of students was to create medical clinics in the nation's schools. These suggestions met with fierce opposition from the American Medical Association (AMA) and other medical organizations, who saw this as the first step toward "socialized medicine." Terman replied that free medical and dental clinics for the nation's children and youth were no different from universal public school education supported by taxpayer dollars. Nevertheless, opposition from the AMA led public schools to abandon school medical clinics as a health care strategy. Instead, they limited their role to providing health education and ensuring that students were properly vaccinated and in sufficiently good health to attend school.
Instead, traditional fee-for-service practice remained the primary model for adolescent health care delivery for decades. Access to these services depended heavily on one's ability to pay. The shortcomings of this system became painfully apparent during the Great Depression of the 1930s, as millions of Americans lost their jobs and could no longer afford physicians' fees. Among the most destitute were the nation's rural farm families, who had the lowest per capita income in the nation and experienced the highest rates of preventable illnesses such as pellagra, hookworm, syphilis, tuberculosis, malaria, and typhoid fever. To address the plight of the nation's farm families, Franklin D. Roosevelt and Congress created the Farm Security Administration (FSA). In addition to providing low-interest loans and other financial benefits to impoverished farmers, the FSA also created a network of prepaid medical cooperative plans that at the agency's peak enrolled more than 650,000 poor rural farmers and their families. Because the FSA targeted those who had few resources to pay for medical care and was a voluntary program that allowed for free choice of physician, the program did not encounter the same attacks from medical organizations about the "socialization of medicine" as did other state-funded health care programs. Although the FSA was disbanded during World War II, the agency's medical program served as a model for the growth of third-party insurance in the postwar period.
LATE 20TH CENTURY
World War II and its aftermath led to increased attention on the health of adolescents, especially of the nation's young men. Data collected by the Selective Service indicated that 25% of the 18- and 19-year-old registrants who reported for the draft were rejected for military service. Despite the efforts of the FSA, rejection rates were higher for farmers (41%) than for other occupational groups. Racial discrimination and unequal access to health care also led to higher rates of rejection among blacks than among white registrants. These observations led William M. Schmidt, MD, regional medical consultant for the US Children's Bureau, to call once again for the creation of medical clinics in the nation's schools, as well as reforms in medical education that would better equip pediatricians and general practitioners to care for adolescents.
FIRST HOSPITAL-BASED ADOLESCENT UNIT AND THE SOCIETY FOR ADOLESCENT MEDICINE
The mainstream medical profession continued to oppose school-based medical care, as well as President Truman's efforts to establish national health insurance. However, these calls for increased attention to the health of adolescents led to the emergence of adolescent medicine as a pediatric subspeciality. The first medical unit in the United States devoted exclusively to adolescents was founded by J. Roswell Gallagher, MD, at Boston Children's Hospital in 1951. The Adolescent Unit represented a major shift in approach to the teenage patient: before the 1950s, most physicians who treated adolescents discussed the patient's health problems with the parent and seldom allowed young people to speak for themselves. In contrast, Gallagher and his staff insisted that teenaged patients needed a doctor of their own who would see patients separately from their parents, who would protect their confidentiality, and who would place teenagers' concerns first. The Boston Adolescent Unit served as a model for other hospitals in North America. By the mid- 1960s, there were 55 adolescent clinics in hospitals in the United States and Canada, and today more than half of all children's hospitals in the United States have units dedicated to the health care of teenagers. The expansion of adolescent health services led to the creation of a professional organization for adolescent specialists, now called the Society for Adolescent Health and Medicine (SAHM), established in 1968, and the founding of its official professional journal The Journal of Adolescent Health Care, first published in 1980 (now the Journal of Adolescent Health) In 1991, an application was made by leaders in the field to institute a board-certification examination for physicians interested in becoming subspecialists in adolescent medicine. The American Board of Pediatrics is the parent board for this examination. However, because of a joint agreement with the American Board of Family Practice and the American Board of Internal Medicine, after completing 3-year residencies in pediatrics, family medicine, or internal medicine, physicians become board-eligible following the successful completion of a fellowship program certified by the Accreditation Council on Graduate Medical Education.
Excerpted from Textbook of Adolescent Health Care by Martin M. Fisher, Elizabeth M. Alderman, Richard E. Kreipe, Walter D. Rosenfeld. Copyright © 2011 American Academy of Pediatrics. Excerpted by permission of American Academy of Pediatrics.
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Table of Contents
Part 1Foundations of Adolescent Health Section 1Adolescence Chapter 1 History of Adolescent Medicine and Health Care Chapter 2 Epidemiology of Mortalities and Morbidities in Adolescents Chapter 3 International Adolescent Health Section 2Growth and Development Chapter 4 Normal Pubertal Physical Growth and Development Chapter 5 Adolescent Brain and Cognitive Changes Chapter 6 Adolescent Sexual Development and Behavior Chapter 7 Adolescent Sexual Development Section 3Approach to the Patient and Family Chapter 8 Medical History Chapter 9 Physical Examination and Laboratory Screening Chapter 10 The Approach to Symptoms in the Adolescent Patient Chapter 11 Legal and Ethical Issues in Adolescent Health Care Chapter 12 Adherence Issues Section 4Health Supervision and Preventive Care Chapter 13 Screening in Adolescent Health Care Chapter 14 Immunizations Chapter 15 Anticipatory Guidance Chapter 16 Adolescent Nutrition and Physical Activity Section 5Management Issues Chapter 17 Complementary and Alternative Medicine Chapter 18 Pain in Adolescents: Pathophysiology and Management Chapter 19 Palliative Care and Psychological Aspects of Death and Dying in Adolescence Chapter 20 Pharmacologic Considerations Chapter 21 Health Policy and Financing for Adolescent and Young Adult Health Services Section 6Office-Based Practice Chapter 22 The Adolescent-Friendly Practice Chapter 23 Documentation, Coding, and Billing Section 7Non-Office Based Practice Settings and Issues Chapter 24 The Adolescent In-patient Unit Chapter 25 School-based Health Care Chapter 26 College Health Chapter 27 Health Care of Incarcerated Adolescents Chapter 28 Health Care of Adolescents in Military Settings Section 8Special Populations of Adolescents Chapter 29 Adolescents in Foster Care Chapter 30 Immigrant Adolescents Chapter 31 Transition of Adolescents with Special Health Care Needs to Adulthood Chapter 32 Solid Organ Transplantation Section 9Family Relationships Chapter 33 Communication Between Parents and Adolescents Chapter 34 Parenting the Adolescent Chapter 35 Divorce, Separation, and Blended Families Chapter 36 Adoption and Adolescence Chapter 37 Adolescents with Lesbian or Gay Parents Chapter 38 Family Systems Approaches to Adolescent Health and Illness Section 10The Adolescent’s Environment Chapter 39 Peers Chapter 40 Socioeconomic Status Chapter 41 The Media Chapter 42 Computers, Technology, and the Internet Chapter 43 Cultural Considerations in Adolescent Health Care Chapter 44 Religion and Spirituality Chapter 45 Cults and Adolescents Chapter 46 Environmental Health Chapter 47 Adolescents at Work Chapter 48 Disasters Part 2Adolescent Sexuality and Reproductive Health Section 1Sexuality Chapter 49 Adolescent Sexual Behaviors Chapter 50 Issues Affecting Gay, Lesbian, and Bisexual Youth Chapter 51 Medical Treatment of the Transgender Adolescent Chapter 52 Contraception Chapter 53 Sexually Transmitted Infections Chapter 54 Adolescent Pregnancy Chapter 55 Adolescent Parenthood Chapter 56 Abortion in Adolescents Chapter 57 Sexual Dysfunction Section 2Reproductive Health Chapter 58 Physiology of Menstruation Chapter 59 Perineal and Vaginal Abnormalities Chapter 60 Cervical Findings and the Papanicolaou Smear Chapter 61 The Uterus and Adnexa Chapter 62 Amenorrhea Chapter 63 Menstrual Disorders: Dysmenorrhea and Premenstrual Syndrome Chapter 64 Abnormal Uterine Bleeding Chapter 65 Hyperandrogenism Chapter 66 Breast Disorders in the Female Chapter 67 Pubertal Gynecomastia Chapter 68 Disorders of the Male Genitalia Part 3Medical and Surgical Disorders Section 1The Endocrine System Chapter 69 Growth Disorders Chapter 70 Disorders of Puberty Chapter 71 Pituitary Disorders Chapter 72 Thyroid Disorders in Adolescents Chapter 73 Diabetes Mellitus Chapter 74 Adrenocortical Disorders Chapter 75 Bone Health and Disorders Section 2Eating Disorders Chapter 76 Anorexia Nervosa Chapter 77 Bulimia Nervosa Chapter 78 The Female Athlete Triad Chapter 79 Obesity Section 3The Cardiovascular System Chapter 80 Chest Pain in Adolescents Chapter 81 Hyperlipidemia and Atherosclerosis Chapter 82 Congenital Heart Disease Chapter 83 Carditis in the Adolescent Chapter 84 Valvular Heart Diseases Chapter 85 Cardiac Dysrhythmias Chapter 86 Sudden Cardiac Death Chapter 87 Shock in the Adolescent Patient Section 4The Respiratory System Chapter 88 Upper Respiratory Tract Infections Chapter 89 Lower Respiratory Infections Chapter 90 Asthma Chapter 91 Vocal Cord Dysfunction in Adolescents Chapter 92 Cystic Fibrosis Chapter 93 Sleep Disorders Chapter 94 Pneumothorax Chapter 95 Pulmonary Embolism Section 5The Gastrointestinal System Chapter 96 The Approach to Abdominal Pain Chapter 97 Function GI Disorders Chapter 98 Disorders of the Esophagus Chapter 99 Peptic Ulcers and Other Disorders of the Stomach and Duodenum Chapter 100 Disorders of the Liver and Pancreas Chapter 101 Diseases of the Gallbladder Chapter 102 Appendicitis Chapter 103 Diarrhea in the Adolescent Chapter 104 Inflammatory Bowel Disease Chapter 105 Celiac Disease Chapter 106 Section 6Hematology and Oncology Chapter 107 Disorders of the Red Blood Cells Chapter 108 Hemostasis and Thrombosis Chapter 109 White Blood Cell Disorders in Adolescents Chapter 110 Lymphadenopathy and Splenomegaly Chapter 111 Malignant Solid Tumors Chapter 112 Brain Tumors in Adolescents Chapter 113 Hematopoietic Stem Cell (Bone Marrow) Transplantation Chapter 114 Cancer Survival Issues Section 7The Urinary System Chapter 115 Proteinuria and Hematuria Chapter 116 Urinary Tract Infections Chapter 117 Nephritis and Nephrosis Chapter 118 Hypertension: Significance, Diagnosis, and Management Chapter 119 Voiding Disorders Section 8Connective Tissue Disease, CFS, Fibromyalgia Chapter 120 Systemic Lupus Erythematosus Chapter 121 Juvenile Idiopathic Arthritis Chapter 122 Vasculitis and Associated Illnesses Chapter 123 Fibromyalgia Syndrome in Adolescents Chapter 124 Chronic Fatigue Syndrome Section 9Central Nervous System Chapter 125 Central Nervous System Infections Chapter 126 Headaches Chapter 127 Seizures in Adolescents Chapter 128 Motor Unit Disorders Chapter 129 Movement Disorders and Ataxia Chapter 130 Demyelinating Diseases Chapter 131 CNS Trauma Chapter 132 Intracranial Vascular Malformations Chapter 133 Myelomeningecele Chapter 134 Altered States of Consciousness Section 10Infectious Diseases Chapter 135 Fever of Unknown Origin Chapter 136 Common Viral Infections in Adolescents Chapter 137 Infectious Mononucleosis and Mononucleosis-Like Syndromes Chapter 138 HIV and AIDS in Adolescents Chapter 139 Bacterial Infections Chapter 140 Tick-Borne Diseases Chapter 141 Mycobacterial Chapter 142 Parasitic Infections Chapter 143 Prevention of Travel-Related Infections Section 11Dermatology Chapter 144 Acne Chapter 145 Dermatitis and Papulosquamous Diseases Chapter 146 Alopecia Chapter 147 Miscellaneous Dermatologic Disorders in Adolescence Section 12Genetic Disorders Chapter 148 Genetic Disorders Chapter 149 Genetic Predisposition to Common Disorders Chapter 150 Special Issues of Genetic Testing in Adolescent Patients Section 13Allergies and Immunologic Disorders Chapter 151 Environmental Allergies Chapter 152 Food Allergies Chapter 153 Immunodeficiencies Section 14Disorders of the Eyes, Ears, Nose, and Throat Chapter 154 Eye Disorders Chapter 155 ENT Disorders Chapter 156 Medical and Psychosocial Considerations for the Deaf Adolescent Chapter 157 Adolescent Oral Health Section 15Orthopaedics Chapter 158 Disorders of the Upper Extremities Chapter 159 Disorders of the Lower Extremities Chapter 160 Bone and Joint Infections Chapter 161 Bone Tumors Chapter 162 Disorders of the Spine Chapter 163 Chest Wall Abnormalities Section 16Sports Medicine Chapter 164 Preparticipation Evaluation Chapter 165 Rehabilitation and Strength Training Chapter 166 Exertional Heat-Related Illnesses Chapter 167 Sport Psychology Part 4Psychosocial Issues Section 1Adolescents and Violence Chapter 168 Physical Abuse Chapter 169 Sexual Abuse and Assault Chapter 170 Prostitution and Sex Trafficking Chapter 171 Adolescents in Gangs Section 2Substance Abuse Chapter 172 Overview: Substance Abuse Chapter 173 Tobacco Chapter 174 Alcohol Chapter 175 Marijuana Chapter 176 Stimulants Chapter 177 Opiates Chapter 178 Hallucinogens, Club Drugs, Inhalants, and Other Substances of Abuse Chapter 179 Abuse of Prescription Drugs Chapter 180 Overdose of Prescription Drugs Chapter 181 Office Management and Laboratory Testing Chapter 182 Treatment Options Section 3Psychiatric Behavioral, and Developmental Health Problems Chapter 183 Somatoform Disorders in Adolescents Chapter 184 Mood Disorders in Adolescents Chapter 185 Disorders of Anxiety in Adolescents Chapter 186 Disorders of Behaviors Chapter 187 Personality Disorders in Adolescents Chapter 188 Psychotic Disorders in Adolescents Chapter 189 Psychiatric Emergencies in Adolescents Chapter 190 Adolescent Psychopharmacology Chapter 191 Mental Health Treatment Modalities for Adolescents Chapter 192 Neuropsychologic Testing of Adolescents Section 4Educational Issues Chapter 193 Academic Overachievement and Underachievement Chapter 194 Psychoeducational Assessment of Adolescents Chapter 195 Gifted Adolescents Chapter 196 ADHD in Adolescents Index