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Adolescents in Difficult Circumstances. Dr.M.K.C.Nair MD Ph.D, M.Med.Sc., MBA, MA, DCH, FIAP, FIACAM PG Dip in Guidance & Counselling Member, Adol. Working Group, Planning Commission National President, NNF – 2011-12 Chair, IAP Adol Ped Chapter - 2007-09

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Adolescents in Difficult Circumstances

Dr.M.K.C.Nair MD


PG Dip in Guidance & Counselling


Adol. Working Group, Planning Commission

National President, NNF – 2011-12

Chair, IAP Adol Ped Chapter - 2007-09

National President, IndiaCLEN – 2005 - 07

National President, IAP 2004

Un convention on child rights 0 18 years
UN Convention on Child Rights (0 – 18 years)

  • Right to survival (basic needs)

  • Right to development (optimal potential)

  • Right to protection (safe environment)

  • Right to education (capacity building)

  • Right to participation (no discrimination)

Rights, Needs, Wants

Need satisfaction – a must



Love & belonging

Safety needs

Physiological + Sex needs

ERG Theory


Maslow’s Need Hierarchy



Care Counselling for all Adols.

Poverty is Real

  • Trivandrum District Survey

  • Normal Weight – 51.2% Over weight – 8.6%

  • Undernourished – 37.6% Obese – 2.6%

School dropouts need spl attention
School dropouts need spl.attention

Depression using BDI

Severity M S E

School Dropout 20 10 1.7

School Going Girls 13 2.6 0.2

School Going Boys 6.5 1.4 0.2

College Going Girls 10 -- -- - Moderate (21-30) S - Severe (31-40) E- Extreme (> 40)

Nair MKC, Mini KP, CDC Data

Bio psycho social model drugs counselling support
Bio – Psycho – Social ModelDrugs – Counselling – Support

Anil Kumar TV, Nair MKC. Medical College, Trivandrum

Tubo-ovarian abscess



Pelvic abscess

Scarred or blocked fallopian tube / possible infertility

Out of school girls vaginal discharge 13%

Adolescents in difficult circumstances
Adolescents in difficult circumstances

Constitute ready reserves for

  • organized crime

  • participation in armed conflicts

  • human and drug trafficking

  • sexual exploitation

Juvenile delinquency crime school recruitment process
Juvenile Delinquency & Crime – School Recruitment Process!!!

  • The standards of particular subcultures

  • Teachings deriving from religious radicalism

  • The compulsion to use of violence as a means of constructing gender identity.

  • Aggressive and criminal behaviour is positively portrayed in the media, creating a confused picture of acceptable societal norms

Oppositional defiant disorder conduct disorder juvenile delinquency
Oppositional Defiant Disorder Process!!! Conduct Disorder  Juvenile Delinquency



3. Aggressive

Adolescent substance use younger ages getting involved
ADOLESCENT SUBSTANCE USE Process!!!younger ages getting involved

Sexual abuse Process!!!

Self reported sexual abuse among youth (15 – 24 yrs)

UNFPA-CDC-DHS-CDC ARSH Study findings (n=4225)

Girls = 10.2% Boys = 05.2%


“I am the custodian of my mind, body & spirit – I will protect, preserve & enhance it”

Teenage pregnancy risk factors for pregnancy among unmarried adols young adults
Teenage Pregnancy Process!!!Risk factors for pregnancy among unmarried Adols & Young Adults

Sheelamoni.A, MKC Nair. Ph.D Thesis, 2008

Disabled adolescent what all we can do
Disabled Adolescent Process!!!– what all we can do?

Adol. with additional needs 4 times more vulnerable to neglect

Adol. with behavioural problems 6-7 times more vulnerable to neglect

Lack of resources contributing?

Loving parents not always competent parents?

Meeting the needs of neglected adolescents their families a long term multifaceted approach
Meeting the needs of neglected adolescents & their families: A long term multifaceted approach

Concrete resources

Social support:

Formal and informal networks

Cognitive-behavioural interventions:

Parenting programmes

Interventions focused on individual family members

Family-focused home based interventions

Iterative loop

Panchayath / Block / District Planning families:

Iterative Loop

No.& types of disadvantaged adolescents

Causation, risk & associated factors

Upscaling programs & community Effectiveness

Intervention strategies

Child Development Centre families: