Adolescent medicine is a developmentally grounded subspecialty that hails its expertise in the intersection of the medical, psychological, and social-environmental aspects of adolescent and young adult (AYA) health and wellness.
Adolescence is a period of significant growth, development, and transition. It is the time through which adolescents and young adults learn, grow and develop their sense of health norms, health desires and health expectations within the simultaneous course of their individual identity formation.
These parallel processes can at times create complex layers that adolescent medicine subspecialty trained, and board-certified providers are well-equipped to engage while maximizing both short and long-term health outcomes.
During the adolescent and young adult years, it is challenging to separate health and wellness outcomes from the variety of other factors that influence adolescent’s growth, particularly psychosocial environmental factors that not only influence short-term outcomes, but health and illness outcomes over the lifespan. Recognizing this, adolescent medicine uniquely incorporates all of these aspects (physical, psychological, social, and developmental) into the care and treatment plan for our patients.
The distinctive aspects of the adolescent medicine field uniquely position adolescent medicine fellowship-trained providers to care for the wide variety of needs for our adolescent and young adult patients between the ages of 10 to 26 years old.
The goal of our UC Davis Adolescent and Young Adult Clinic is to IMPACT Wellness by Improving Mental and Physical health through Adolescent Centered Treatment. We happily serve the Greater Sacramento and Central Valley area by providing services to holistically address and comprehensively treat the complex medical and behavioral needs of our adolescent and young adult patients.
Our services include, but are not limited to:
Eating Disorders - Answering Your Questions with Dr. Laura Kester
Nutritional and energy imbalance disorders
- Eating disorders and disordered eating (including anorexia nervosa (typical and atypical), bulimia nervosa (typical and atypical), binge eating disorders, purging disorders, night eating disorders, ARFID
- Nutritional and body image concerns related to inadequate nutritional intake and energy deficiency presentation
- Unhealthy as well as unintended weight loss and weight gain.
- Pre-diabetes or signs of insulin resistance
Reproductive and sexual health care needs
- Irregular menstrual cycle (including amenorrhea, oligomenorrhoea, and PCOS)
- Menstrual related disorders (dysmenorrhea, dysfunctional uterine bleeding)
- Menstrual suppression
- Management of ovarian cysts
- Evaluation and management of delayed onset of menstrual cycles
- Initiation and management of contraception (monthly or extended cycling of progestin only and combined hormonal contraception as well intermediate acting contraception)
- Screening, treatment, and prevention of sexually transmitted diseases
Adolescent mental health
- Medical management along with comprehensive physiologic treatment plan for anxiety disorders, major depressive disorders, suicidal ideation, and obsessive compulsive disorders (OCD).
Gender health care
- Social transition support
- Menstrual suppression
- Cross-hormone management
- Gender-affirming Care
- Topical acne treatment
- Systemic acne treatment
Adolescent/young adult transition and chronic illness support
- Assistance in adolescent to young adult transition-related needs (helping patients better understand and incorporate health care-related medical needs to reach healthier adult outcomes)
- Chronic illness-related disease distress and challenges related to medical related treatment adherence
UC Davis Children’s Hospital seeks to improve the health and wellbeing of youth through accessible health care services for adolescents in the context of their family, culture and community.
UC Davis Adolescent and Young Adult Clinics
IMPACT Wellness: Improving Mental and Physical health through Adolescent Centered Treatment
UC Davis Adolescent Medicine Consult Clinic
DIRECTED BY: Laura Kester Prakash, M.D., Adolescent Medicine
Our adolescent and young adult patients have unique health needs that set them apart from the general pediatric population. It has long been recognized that the behavioral patterns that are developed during adolescence (10-17 years old) and young adulthood (18-25 years old) strongly influence not only their health status during these stages, but also long-term risk for developing chronic illness across the lifespan.
During this time, youth must navigate the complex intersection of learning, understanding and expressing their medical needs, while simultaneously maneuvering the significant physical and mental development that is co-occurring in this period. It is during the adolescent and young adult period that we can see the initiation and/or peaking of many significant health and socio-emotional problems, including mental health disorders, nutritional and weight related disorders, reproductive health conditions related to hormonal and infectious etiologies, substance experimentation and use disorders, undesired teen pregnancies, as well as concerns in the home environment, behavioral and academic challenges and unintended as well as intentional accidents leading to life-threatening injuries.
The UC Davis Adolescent Medicine Consult Clinic is specifically designed to provide a complete evaluation of a patient’s medical presentations through a developmentally appropriate lens, factoring in any contributing psychosocial factors to develop a comprehensive treatment plan personalized to the patients needs and presentation. This clinic is open to all adolescent and young adult consults, including but not limited to consults for Adolescent Reproductive Health Services and Adolescent Mental Health Services.
UC Davis Adolescent and Young Adult Clinic for Eating Disorders and Nutritional Imbalances
DIRECTED BY: Laura Kester Prakash, M.D., Adolescent Medicine
Eating disorders (EDs) are a group of diseases that intersect genetic, physical, mental and psychosocial realms of health. They are defined by the Academy of Eating Disorders as a “serious mental illnesses with significant, life-threatening medical and psychiatric morbidity and mortality, regardless of an individual’s weight.”
The UC Davis Adolescent and Young Adult Clinic for Eating Disorders and Nutritional Imbalances works to provide patients with a comprehensive assessment and personalized outpatient treatment plan that incorporates parents and guardians to achieve nutritional adequacy and medical stabilization. This clinic works closely with community providers to ensure that patients receive appropriate psychological support necessary to return patients to their maximum function and quality of life.
The UC Davis Comprehensive Fatty Liver Clinic
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of chronic liver disease that is characterized by fat and inflammation in the liver. It is a rising problem in children and adolescents (prevalence ranges from 29-37% in obese children), given increasing obesity and metabolic syndrome. It is the most common cause of liver disease in children, and one of the leading causes of liver transplantation in adults. Associated conditions include insulin resistance, diabetes, hypertension, dyslipidemia, polycystic ovary syndrome (PCOS and obstructive sleep apnea. Given the prevalence and the significance for potential complications and sequalae, it is essential that we not only ensure adequate screening for patients with NAFLD, but also that we are closely monitoring and instituting adequate behavioral and lifestyle modification recommendations to ensure the halting and reversal of reversable liver injury that can eventually lead towards permanent liver damage, such as cirrhosis and fibrosis. This crucial window of opportunity is incredibly important in young patients.
The UC Davis Comprehensive Fatty Liver Clinic provides carefully developed clinical management approaches that not only address the medical needs of these patients, but provides a personalized, developmentally age-appropriate strategy to adequately support the nutritional, psychosocial, and behavioral aspects that often intersect to increase patient risk for disease onset as well as disease complication.
UC Davis Pediatric and Adolescent Gender Coordinated Health Clinic
Using a Gender-Affirmative Care Model (GACM), The UC Davis Pediatric and Adolescent Gender Health Clinic works to provide developmentally appropriate care that integrates medical and psychosocial support to transgender and gender diverse patients and their families. Our clinics are designed to support families through complex decision-making process of weighing our patient’s needs along with the medical risks and benefits of available treatments to develop personalized health care plans that meet the needs of our patients. Patients who present to our clinic receive a thorough assessment and appropriate treatment support (including, but not limited to social affirmation support, pubertal blockers, and gender affirming hormone therapies).
UC Davis MAPS Clinic: Multidisciplinary Adolescent PCOS Clinic
Polycystic ovarian syndrome (PCOS) is a condition affecting 8-13% of people with ovaries of reproductive age. This syndrome is associated with higher levels of certain hormones called androgens. Androgens are made in both the ovaries and adrenal glands (glands located above the kidneys) and can result in irregular menstrual cycles, increased hair growth in certain parts of the body, acne and/or hair loss from the scalp. The UC Davis MAPs Clinic (Multidisciplinary Adolescent PCOS Clinic) is specifically designed to allow patients access to experts in the treatment of endocrine, reproductive and nutritional disorders to ensure comprehensive assessment and management plan.For more information, please visit the MAPs Clinic: Multidisciplinary Adolescent PCOS Clinic.
Other adolescent programs, services and resources
Attention-deficit/hyperactivity disorder (ADHD)
UC Davis Children’s Hospital researchers are conducting a variety of investigations involving adolescent medicine, including studies on teens with attention-deficit/hyperactivity disorder (ADHD). One recent study found that adolescents with ADHD are less likely to finish high school on time. Nearly one third of students with ADHD, twice the proportion as students with no psychiatric disorder, either drop out or delay high school graduation.
Working in conjunction with Shriners Hospitals for Children-Northern California, other researchers are exploring a groundbreaking device that uses magnets to correct sunken chest, the most common congenital chest-wall abnormality. Some patients suffer serious emotional difficulties and low self-esteem because the condition often worsens during adolescence, when young people are especially concerned about their physical appearance.
Sunken chest is a deformity of the cartilage that connects the ribs to the breastbone. The deformed cartilage pulls the breastbone inward, giving the chest a caved in or sunken appearance. The new procedure involves placing a surgically embedded magnet about the size of a quarter just under the skin on the surface of the patient’s breastbone. A second magnet is housed in a brace outside the chest, creating a constant magnetic force field that applies a controlled, consistent pull on the magnet on the sternum, pulling the breastbone outward.
The innovative HealthShack program helps homeless Sacramento-area youth track their health information records, which can otherwise seem like a daunting task to an adolescent who is homeless or in foster care, or who has aged out of foster care and doesn’t have health insurance. For these teens, HealthShack provides a place to put health and other personal records where they’re just a passcode and mouse click away.
Adolescent and Young Adult Cancer Advisory Board
Adolescent services are available throughout the UC Davis Health. For instance, the UC Davis Adolescent and Young Adult Cancer Advisory Board at the UC Davis Comprehensive Cancer Center provides a voice for adolescent and young adult cancer patients and survivors by developing educational programs for adolescent and young adult cancer patients and survivors.
Laura Kester Prakash, M.D., is a board-certified pediatric and adolescent medicine sub-specialist who focuses on providing primary and consultative care to adolescents. She specializes in treating patients with acne, menstrual disorders, contraception, sexual, gynecological, and reproductive health services, eating disorders, weight concerns and obesity, gender health services, substance use, depression and anxiety.