Q: Why in the world does a very attractive 14-year-old ruin her appearance by slumping? What can we do to improve her posture?
A: We can think of several possible explanations for your daughter's perplexing behavior, two related to the body changes that occur during puberty. If your daughter has developed breasts that are larger than those of her classmates, she may be the object of significant teasing at school by both girls and boys. Her slumping may be an attempt to hide her physical development.
If this is the case, you can help by acknowledging her discomfort and pointing out that girls often tease as a means of coping with concernsabout their own physical development. Boys often comment, unfortunately, because they believe that this is a way to impress their friends or appear more worldly about sexual matters than they really are. Perhaps you can offer to buy some clothing that will downplay the size of her breasts.
If your daughter is a late maturer -- is less physically developed than her classmates -- her posture may be an attempt to hide this fact. Again, gentle reassurance about the variability of physical development among teen-agers may help to allay her concerns. You may find it helpful to share with her the thoughts and feelings you had as you passed through puberty and remind her that all teen-agers, no matter how outwardly self-confident they appear, are concerned about the normality of their physical development.
Alternatively, the body often mirrors how a teen-ager is feeling. How are things going for your daughter in school? With friends? At home? Do you have any concerns she is sad or depressed about something? If so, this may be the clue to her posture.
Finally, there is a relatively rare disease affecting the curvature of the spine that can result in a slumping posture. If your daughter hasn't had a physical exam within the last year, now would be a good time to schedule one. Your daughter's doctor can check her spine as well as reinforce your discussions about body changes and gauge her mood.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.