Kids may start drinking much younger than parents anticipate so it is important to start conversations about alcohol early and look for signs of potential abuse, said an adolescent medicine specialist at Baylor College of Medicine.

Teen drinking, not like adults

Many parents make the mistake of watching for the signs of abuse they see in other adults – like slurring speech or stumbling when walking. But teens often do not exhibit these symptoms, explained Dr. Sharonda Taylor, assistant professor of pediatrics at BCM.

"The telltale signs of alcohol abuse for teens are changes in their peer group, changes in personality and a decline in grades," Taylor said.

Other behavior parents may start noticing include erratic behavior and disheveled dress. Parents may also spot empty containers that they didn't leave around or parts of their own alcohol in the home missing.

Waiting until a child is in high school to watch out for these signs or to initiate conversations about alcohol use may put parents behind the curve, said Taylor, also on staff at Texas Children's Hospital.

Many kids have had their first drink by middle school, or about 12 years of age, she said. The earlier a child starts drinking, the more likely they are to abuse alcohol.

Talk to your kids

"I tell parents, if you're wondering if you should talk to your child about alcohol, then talk about it. Don't wait until you think they're old enough – you just have to start talking about it in terms they can understand," Taylor said.

With a 10 or 11 year old, conversations can develop naturally from something you see on television or in a movie. Ask your child what they think of what they saw and offer to answer any questions he or she may have. This is the time to create an open and nonthreatening environment that you can build on as the child matures.

Be direct

Teenagers, on the other hand, want parents to speak directly to them. Parents shouldn't beat around the bush, Taylor advised.

"Talk about how they'll be going to more parties as school progresses, alcohol may be present and that you want them to make the best decisions possible for their own safety and that of their friends," she said. "Starting by talking about friends and then moving more specifically to them allows for a more open conversation."

Parents should let their children know that they will always protect their best interests – for example, by providing a ride home if the teen has been drinking – even if they don't like the situation.

Parents must be mindful of their own behavior as well, Taylor said. Permitting a child to have a sip of champagne at a family wedding, for example, could send the message that the parent doesn't have a problem with the child drinking.

Alcohol affects maturing brain

Teens and parents alike should be aware of the harmful effects of alcohol abuse, Taylor said. Alcohol is a neurotoxin, meaning it has a toxic affect on the brain, and during adolescence the brain is still developing. Teens at this point shift from responding from the emotional center of the brain to what is called executive functioning, which includes good decision making, understanding consequences of behavior and better control over emotions.

"There is important neurodevelopment going on and you certainly don't want alcohol to interfere with that," she said.

Alcohol also impairs the ability to recognize visuospatial relationships, she said. This can lead to serious injury when a teen driver doesn't recognize how close the car in front of them is and an accident occurs.

If parents suspect their child is abusing alcohol, they should make an appointment with their pediatrician or adolescent medicine physician. Teens should have the opportunity to talk privately with their doctor, since they may be more likely to talk about things they may be afraid of or embarrassed to tell their parents.

If necessary, the pediatrician can make a referral to a counselor or alcohol abuse agency. School counselors are another good resource, Taylor said.