Our daughter is at the beginning of puberty.  We were advised by the endo of  the following:

1) Her required amount of cortef clearly needed to be increased based on lab results.   He said this is common during puberty.

2) She needs to have her bloodwork done every 3 months instead of every six months to be sure she continues to get enough hydro.  He says it is important to monitor them more carefully as so many changes are happening. 

3) Compliance is more important than ever.  He cautioned us that "rebellious adolescents" sometimes are less compliant with taking their meds.  Clearly this could result in problems.  However, I believe that if they are taught about their condition early on and understand the consequences, this shouldn't be a problem.  Our daughter is extremely aware and very responsible in general.  She has had to be!  Maybe we are just lucky too.

We have 2 swcah children, and they have had fewer crisis as they have gotten older.  First of all, they have developed some great immunities and therefore get sick less frequently.  Other than the stomach bug with non-stop vomiting (with that, they go inpatient immediately), we have managed their illnesses at home without crisis since they were about 4 years old.  They are now 8 and 10 1/2.  Our recent crisis have been due to injuries, not illnesses.  They are both very active athletically and we have had our share of fractured bones, sprains, and overheating in the hot weather.  Extra hydro, salt tablets and lots of fluids have kept them out of the hospital.  The hardest part for us is ALWAYS BEING THERE TO JUDGE THE SITUATION.  I have not yet gotten comfortable relinquishing that responsibility to anyone other than my husband, and the kids themselves.  We're working on it.

Hope that helps.