by Tiffany deSilva, MSW, LSW

When you were a teenager, did your mother ever ask you the age-old question, “If all of your friends jumped off a bridge, would you jump, too?”

If adolescents answered this question truthfully, their answer would be, “Yes, I might under those particular circumstances.”

Likewise, if you have a teen with food allergies, he or she may be tempted to eat unsafe food or practice other behaviors that undermine safe food allergy management in certain social situations.

You see, when teens get together, they are more likely to take risks and make decisions that they normally wouldn’t make if they were alone or with others outside of their peer group.

What the Research Says

In the first experimental study to examine the effects of peer influence on risky decision making, it was found that, when tested alone, young adolescents, older adolescents, and adults engaged in similar amounts of risk taking. However, early adolescents scored twice as high on an index of risky driving when they were tested with their peers in the room than when tested alone, whereas late adolescents’ driving was approximately 50% more risky in the presence of their peers, and adults showed no difference in risky driving related to social context.[i]

If you look at data from multiple studies, you’ll find that risk-taking and dangerous decision-making increases as teens spend more time together, in general. For instance, first-time use of many substances (e.g., alcohol, tobacco products, and marijuana) peak during the summer months of June and July for teens. Motor vehicle fatalities peak during the summer months of May, June, July, August, and also in October (think Halloween, perhaps), in regards to teenagers.[ii]^,[iii] In addition, fifty-two percent of motor vehicle crash deaths among teenagers in 2015 occurred on Friday, Saturday or Sunday.[iv] The common denominator here is that these are times when teens are spending the most unsupervised time together.

Specifically, as it relates to adolescents and young adults with food allergy, research has revealed that a significant number of teens admit to engaging in risking-taking behaviors, particularly when they are out with friends.[v]

Some of these risky behaviors include: leaving their epinephrine at home when they are going to places like a school dance or a friend’s house, ditching the epinephrine autoinjectors when wearing tight clothing, intentionally consuming potentially unsafe food, and not telling their friends about their allergy.[vi]

All of this is particularly concerning when considering the fact that teenagers and young adults are at the highest risk of fatal food allergy-induced anaphylaxis.[vii]^,[viii]

As parents of teens with food allergies the question is, “How do we keep them safe without locking them away from their friends?”

The answer lies in empowering teens to make safer decisions on their own while supporting them in maintaining a healthy social life.

With the help of research over the years, we have learned that there are a few things that we can do to help reduce risk-taking behavior among adolescents and young adults.

In a recent study, it was found that a number of factors were associated with less food allergy-related risk-taking behavior among adolescents and young adults. Some of those factors include: Having supportive parents, teachers, and peers (especially female friends), having a 504 plan in place, and holding the belief that their food allergy helped them to eat healthier.[ix]

8 Things You Can Do to Help Reduce Risk-Taking Behavior

1. Understand that risk-taking is a natural phenomenon for teens

Though it can be down-right nerve-wracking, risk-taking behavior and giving in to social influence is a normal part of being a teenager.

Research in neurodevelopment tells us that adolescents’ brains are wired to be sensitive to social rewards while their cognitive control of impulsive behavior lags behind. Teens social processing undergoes relatively sudden changes at puberty yet cognitive compacities that support self-regulation mature gradually over the course of adolescence.[x]

This is important to understand because it explains why teens can know what to do most of the time but crumble under peer pressure when they are with their friends. If you know that your teen is going to feel pressure to join in, you can help them come up with ways to handle the sticky situation or eliminate the risk beforehand. 

2. Make sure your teen fully understands the basics of food allergy management

Teenagers and young adults are at higher risk of fatal anaphylaxis due to risk-taking behavior and delayed epinephrine injection. Make sure your teen knows the symptoms of an allergic reaction and anaphylaxis, recognizes when to use epinephrine, and understands that quick delivery of epinephrine is essential.

As with any risk-taking behavior, explain the possible consequences of their actions (e.g. eating unsafe foods) or inaction (e.g. failure to carry epinephrine, failure to inject quickly). Teens are a little more likely to follow the rules when they fully understand the consequences of not following them rather than just being told to do something because an authority figure told them so.

In addition, help your teen to work out a comfortable way to inform their friends of their allergy and on what to do in an emergency. Encourage them to seek out supportive friends whom they can trust.

3. Have a 504 plan in place

A 504 plan is beneficial because it lays out which specific accommodations need to be made to keep your student safe in a number of situations at school.  Having this in writing ensures that everyone, including the teachers, parents, and student, is on the same page and knows what to do to safely manage their food allergy. Going over your 504 plan with your teen helps to solidify what they should be doing and helps them take ownership of managing their food allergies. Visit FAACT’s Civil Rights Advocacy Resource Center for more information on school plans.

4. Talk to your teen’s teachers and coach her on how to do it on her own

Having a supportive teacher as an ally in the classroom goes a long way. He or she can help avoid risky situations before they happen but they may also serve as a “surrogate” parent in the classroom. Your teen may be more likely to stick to their food allergy management plan if they know an informed and caring adult is around.

Also, many teens report that managing their food allergy made them more responsible and better advocates for both themselves and others.[xi] Encouraging your teen to communicate his or her needs to the teacher is a great way to get them in the habit of taking responsibility and self-advocating.

5. Teach your teen safe and healthy food habits

In addition to teaching your teen the importance of why and how to strictly avoid foods that may contain their allergens, teach them to enjoy safe and healthy foods. As mentioned above, adolescents who view their allergy as helping them to eat healthier were less likely to engage in risk-taking behavior. Many teens also report feeling more appreciative of the foods that they can eat.

Cultivate a love of safe healthy foods by teaching them how to find them, how to purchase them, how to prepare them, and the need to take them on the go. You can even encourage them to always bring extras for their friends. This will reduce the temptation to indulge in unsafe foods when they are out and about.

6. Get your teen the gear he needs to be safe

One of the biggest obstacles to teens carrying epinephrine is simply the inconvenience of carrying epinephrine. Involve your teen in deciding what carrier will work best for them. It may vary depending on their activities, their personal style, or even the weather.

Figuring out how they would like to carry it is half the battle. The other half is getting them to remember to take it. Create a system that works with their natural habits. Grabbing their epinephrine should be as automatic as putting on their shoes. If they can find a way to remember their phone, they can find a way to remember their autoinjector, even if you have to rubber band them together.

7. Don’t be overly concerned about being perceived as “overprotective”

In her book, Untangled, psychologist, Lisa Damour, PhD, says, “I think that the safest girls are the ones who can point to their parents’ ‘crazy rules’ to avoid risky behavior.”[xii] Interestingly enough, adolescents and young adults with food allergies who perceive their parents as “overprotective” were less likely to engage in risky behavior.[xiii]  We cannot say why that is for sure, but it could be because they are able to use their parents’ rules as a “way out” of sticky situations.

The challenge here is that you do not actually want to be overprotective—just perceived by your teen as overprotective. You don’t want to get to the point where you are being unreasonable, needlessly isolating your teen, or negatively restricting their natural social development. Remember, connecting with peers and finding a tribe is a very important milestone for adolescents. The key is to set firm rules and uphold your boundaries while involving your teen in their own food allergy management.

8. Prepare your teen to make good decisions under peer pressure

You’ve taught your teen how to manage their allergy, carry their epinephrine, avoid their allergens, and advocate for themselves, but will they do it under pressure?  The best thing you can do is to offer them the space to practice. Have them practice ordering their meals when you’re out. Have them role play what to say if someone offers them unsafe food. Have them practice using their autoinjector.

Encourage them to make mindful decisions instead of impulsive ones by teaching them to take a mental “time-out” if they find themselves about to do something they normally wouldn’t do. Have them excuse themselves to a bathroom or quiet place and just check-in with themselves to see if the decision they are about to make is in alignment with what they know they should do. If it’s not, have them think of a way to defuse the risk. The answer might be simply saying “no, thank you” or it could be leaving the situation.

Some parents find it helpful to establish a code with their teen that signals that they need to be “rescued” from an unsafe situation. This could be a text message that your teen sends to you or a phone call to you with a simple phrase like “I forgot to feed the fish.” They can then blame you for having to leave.

Though there are so many opportunities for risk-taking behavior during the teen years, you can help make them safer by helping your teen to responsibly manage their food allergy. The responsibility and decision-making skills they gain in this area will carry over into others, as well.

About the Author, Tiffany deSilva, MSW, LSW
Tiffany deSilva, MSW, LSW, CPC, CHC is a Social Worker, Author, and Health, Wellness, and Lifestyle Coach at BrightFire Living, LLC. Tiffany is the mother of three kids with multiple food allergies; two also have Celiac disease. She loves helping women, children, and families to live safe, healthy, happy, vibrant lives, despite food allergies, autoimmune disorders, and the many other challenges we face in the modern world. You can find more of Tiffany’s work on living a great, fun, and allergy-friendly life at www.BrightFireLiving.com. You can also follow her on Twitter, Facebook, and Instagram.    

i Albert, Dustin, et al. “The Teenage Brain: Peer Influences on Adolescent Decision Making.”Current Directions in Pyschological Science, vol. 22, no. 2, Apr. 2013, pp. 114–120. Sage, doi:10.1177/0963721412471347.

ii Substance Abuse and Mental Health Services Administration, Center for Monthly Variation in Substance Use Initiation among Adolescents. Rockville, MD.

iii “Teenagers: Driving Carries Extra Risk for Them.” IIHS, Insurance Institute of Highway Safety Highway Loss Data Institute, Nov. 2016, www.iihs.org/iihs/topics/t/teenagers/fatalityfacts/teenagers#When-teenagers-died.

iv “Teenagers: Driving Carries Extra Risk for Them.” IIHS, Insurance Institute of Highway Safety Highway Loss Data Institute, Nov. 2016, www.iihs.org/iihs/topics/t/teenagers/fatalityfacts/teenagers#When-teenagers-died.

v Sampson, M, et al. “Risk-Taking and Coping Strategies of Adolescents and Young Adults with Food Allergy.” Journal of Allergy and Clinical Immunology, vol. 117, no. 6, 2006, pp. 1440–1445., doi:10.1016/j.jaci.2006.03.009.

vi Sampson, M, et al. “Risk-Taking and Coping Strategies of Adolescents and Young Adults with Food Allergy.” Journal of Allergy and Clinical Immunology, vol. 117, no. 6, 2006, pp. 1440–1445., doi:10.1016/j.jaci.2006.03.009.

vii Bock, S. Allan, et al. “Further Fatalities Caused by Anaphylactic Reactions to Food.” Journal of Allergy Clinical Immunology, Apr. 2007, pp. 1016–1018.

viii Bock, S. Allan, et al. “Fatalities Due to Anaphylactic Reactions to Foods.” Journal of Allergy and Clinical Immunology, vol. 107, no. 1, 2001, pp. 191–193., doi:10.1067/mai.2001.112031.

ix Warren, Christopher M., et al. “Food Allergy-Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults.” Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 22 Feb. 2017, pp.381-390.e13

x Albert, Dustin, et al. “The Teenage Brain: Peer Influences on Adolescent Decision Making.”Current Directions in Pyschological Science, vol. 22, no. 2, Apr. 2013, pp. 114–120. Sage, doi:10.1177/0963721412471347.

xi Warren, Christopher M., et al. “Food Allergy-Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults.” Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 22 Feb. 2017, pp.381-390.e13

xii Damour, Lisa. 2. Untangled Guiding Teenage Girls Through the Seven Transitions into Adulthood, Ballantine Books, 2017, p. 63.

xiii Warren, Christopher M., et al. “Food Allergy-Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults.” Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 22 Feb. 2017, pp.381-390.e13