II. Precautions

  1. Target the history to the developmental stage of the patient
    1. Adolescent and Young Adult Health Maintenance spans a broad swath of development
    2. See Adolescent Development

III. Approach: Mnemonic -HEEADSSS

  1. Home environment
  2. Education
  3. Employment
  4. Eating
  5. Activities
    1. Electronic Media Use in Children (Screen Time and Social Media use)
    2. Physical Activity
    3. Best friend
  6. Drugs
  7. Sexuality (Contraception, Sexually Transmitted Infection)
  8. Suicide (and Major Depression)
  9. Safety (and Social Media Use in Adolescents)

IV. History: Home Life

  1. Who do you live with?
  2. Where do you live?
  3. How many of you share the same bedroom?
  4. Who can you talk to about things?
  5. Do you get along with your family?
  6. What would you change about your family?
  7. Are there new people in your home?
  8. Are you allowed to come and go as you want?
  9. Have you ever been kicked out of your home?
  10. Have you ever been in Foster Care?
  11. Have you ever been arrested or been in jail or prison?
  12. Have you ever runaway?
  13. Have you moved recently?

V. History: Education

  1. What grade are you in?
  2. What are your favorite subjects?
  3. What are your grades like?
  4. How many different schools have you attended in the last 4 years?
  5. Do you ever skip school?
  6. Have you ever dropped out of school?
  7. Have you had to repeat classes or repeat a year of school due to failing grades?
  8. Have you ever been suspended or expelled from school?
  9. What do you want to do when you are done with school?
  10. Do you have a job?
  11. How do you make money?

VI. History: Activities

  1. Tell me about a day in your life
  2. What type of activities do you do each day?
  3. What do you do for fun or for hobbies?
  4. What do you do on weekends?
  5. Do you have many friends?
  6. Do you play sports?
  7. How much television or online entertainment do you watch each day?
  8. Do you wear Seat Belts?

VII. History: Drugs

  1. Do you smoke Cigarettes, including Electronic Cigarettes?
  2. Do you smoke Marijuana or weed?
  3. Do you drink Alcohol?
    1. How much?
    2. Where do you get it?
  4. Have you ever tried other drugs?
    1. What type of drugs?
    2. How did you pay for them?
  5. Do you ever get sick, pass out or have a hangover from drugs or Alcohol?
  6. Do you ever use drugs or Alcohol to escape from reality?
  7. Have you ever done anything you did not want to do when you were high, drunk or passed out?

VIII. History: Suicide and Safety

  1. Do you ever feel lonely or sad
  2. Have you ever had thoughts of Suicide?
  3. Do you ever get in fights with friends or with a boyfriend or girlfriend?
  4. What is it like when you fight?
  5. Have you ever been abused physically or experienced Violence?

IX. History: Sex

  1. Do you have a boyfriend or girlfriend?
    1. How old are they?
    2. How did you meet?
  2. How many people have you had sex with in your lifetime?
  3. When was the last time you had sex?
  4. Have you ever been pregnant?
  5. Have you ever had a Sexually Transmitted Infection (e.g. Chlamydia, Trichomonas, Gonorrhea)?
  6. Do you use protection (e.g. Condoms)?
  7. Have you ever been pressured into doing things sexually you did not want to do?
  8. Some people trade sex for money, clothes, drugs or housing. Do you know anyone who does this?
  9. Has anyone ever asked you to do sexual things for money?

X. History: Social Media

  1. See Social Media Use in Adolescents
  2. How many hours do you spend per day in front of a screen (e.g. computer, television, smartphone)?
    1. Do you wish you spent less time on Screen Time?
  3. Some of my patients spend most of the free time online. What types of things do you do online?
  4. When was the last time you sent a text message while driving?
  5. Have you messaged photos or texts that you later regretted?
  6. Have any of your friends been harmed by their time spent online?
  7. How often do you view pornography online (nude photos or videos)?
  8. Have you ever sent unclothed pictures of yourself to anyone online?

XII. References

  1. Roszcynialski, Irvine and Walter (2018) Crit Dec Emerg Med 32(12): 3-10

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