Just because they can doesn't mean they do

Understanding of adolescent decision making has moved beyond simple "age differences in risk perception and reasoning" to include relevant social and emotional factors that directly inform when and how adolescents make decisions about everything from substance use to condom use.

Adolescence is defined as the period between which "physiologically normal puberty" initiates and adulthood begins. Though adulthood is often culturally defined in legal terms, the World Health Organization defines adolescence as that time in human development characterized by "rapid physical, cognitive and psychosocial growth," typically occurring between 10 and 19 years of age. Though most adolescents are considered medically "healthy," negative outcomes associated with unhealthy risky behavior is the leading cause of death amongst this demographic.

Adolescents in fact possess the same cognitive abilities to evaluate risky behaviors as do adults. However, their ability to competently evaluate risky behavior and make decisions in their best interest is directly dependent upon the presence of "neutral circumstances," i.e., removed of stress, peer pressure and the potential for dopamine gain. In other words, "just because they can doesn't mean they do" make the right decisions is in large part due to numerous influence factors.

Adolescents are more likely to engage in certain risky behaviors - drive at excessive speeds, try marijuana and alcohol, etc. - when accompanied by others their age than when alone. Being friends with others who engage in risky behavior involving substance use directly predicts an adolescent's subsequent decision making.

Adolescents do not necessarily believe themselves to be invulnerable to harm but rather tend to seek experiences that provide a high dopamine or "feel good" gain. It's not that they think they are invincible, but rather the reward is "worth it" in the moment. Experiences deemed "positive" and offering high emotional gains do affect subsequent decision making. They are therefore more likely to engage in risky behavior that makes them feel good than they are to avoid risky behavior with a negative outcome.

Adverse Childhood Experiences include physical and emotional neglect, sexual abuse, violence, parental incarceration, household substance use, etc. put adolescents at greater risk of "impaired self-regulation" due to the negative effects of trauma on cognitive and social-emotional development.

Parent communication and parenting styles affect adolescent decision making. Secure attachments to primary care-givers (particularly mothers), as well as well-informed families and peer groups, all help adolescents develop healthy relationships with others and a subsequent decline in risky behavior.

As parents and teachers of adolescents, how can you help?

The more informed parents and caregivers are about how adolescents are making decisions, as well as what motivators influence them, the more effective is their ability to help them make decisions that have positive effects on their health.

Healthy risk taking must be encouraged during adolescence. From physical, emotional, social, intellectual and spiritual, adolescents need to the opportunities to make "low-stakes" decisions for themselves. Not all risk taking is negative and "healthy risk taking" is a normal part of adolescent development. Examples could include:

• physical - participating in a team sport, trying a new food

• emotional - reaching out for help, apologizing for a mistake

• social - public speaking, asking someone out on a date

• intellectual - enrolling in a challenging course, applying knowledge to a new situation

•spiritual - experimenting with different values systems and identities, volunteering for a good cause

While there have always been a myriad of reasons contributing to an adolescent's decision-making process, we now find ourselves with more data and information to better navigate the elusive mind of an adolescent. We can develop better programs and have better conversations to help ensure we're reinforcing healthy practices and. We can provide them with impactful information so they "do make the right decision" vs. "can make the right decision."

- Helen Baker is a health educator at Candor Health Education in Hinsdale.