Texas Children's Hospital Identifies a Generation of Adolescents Failing to Thrive

Faced with a myriad of pressures, choices and obstacles, thousands of teenagers are struggling for direction in life.

It is a phenomenon that one expert at Texas Children's Hospital calls failure to thrive adolescence.

"These are adolescents who are not progressing through their second decade or advancing intellectually, emotionally, physically and/or socially," says Dr. Albert Hergenroeder, chief of adolescent and sports medicine at Texas Children's Hospital.

Dr. Hergenroeder and a team of physicians, psychologists, social workers, nurses and nutritionists at Texas Children's Adolescent Clinic work with youths who fit this description. The clinic is one of only a handful of U.S. centers offering specialized medical treatment for teens, combined with training and research in adolescent health issues.

While failure to thrive is not a diagnosable condition, Dr. Hergenroeder is one of the first physicians in the nation to recognize this collection of maladies among troubled teens and develop interventions. Chronic fatigue and pain, learning disorders, difficulty at school, eating disorders and a history of unexplained long-term physical complaints can all contribute to failure to thrive.

Dr. Hergenroeder also has noticed similarities in the situations some of his young patients have experienced. These life changes include difficult transitions, such as a death in the family; relocation or family divorce; a lack of success at school; little family or community support; few opportunities to achieve success; and chronic illness.

"We're witnessing large numbers of a teen-age population dropping out of high school, running away from home; using drugs and alcohol, becoming pregnant, contracting sexually transmitted diseases and facing an increasing risk of violent death by homicide, suicide or accidents," says Dr. Hergenroeder. "These teens are not thriving as they should."

Armed with a vivid picture of the problems facing teens, experts at Texas Children's Adolescent Clinic are better prepared to serve families who seek assistance.

First, experts at Texas Children's determine whether there is an obvious physical reason for a teen's poor performance and health. Potential health problems are evaluated and treated. Other medical specialists skilled in treating teen-agers also may be called in, and referrals are made when necessary.

In the case of youths who display a general failure to thrive, the team investigates further to make a specific diagnosis, which could include depression, an eating disorder or an adjustment disorder. Appropriate treatment may include individual therapy, family counseling, nutrition counseling or exercise programs.

"Youths with chronic fatigue and no identifiable cause, for example, will be transitioned back in school, if they have missed a great deal of school," says Dr. Hergenroeder. "We will put them on a gradually increasing exercise program, meet with a dietitian to address proper nutrition and recommend counseling for the family and youth.

"Being a teenager in our society has never been tougher than it is today," says Dr. Hergenroeder. "But that doesn't mean failure among our young people should be accepted. With counseling, support and medical treatment, these adolescents can succeed and thrive."

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©2006 Texas Medical Center

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