The Johnstons need a break, so the family takes off for a tropical vacation in Puerto Rico. Meanwhile, Amber and Trent deliberate on whether they should add another member to the family.

Amber is discharged from the hospital in time to help the family throw Anna a sweet 16 party she'll never forget.

A busy family week is interrupted when one of the Johnstons is rushed to the hospital in the middle of the night.

Elizabeth navigates uncharted territory when she enters a local beauty pageant. Meanwhile, Trent and Amber takes steps to finalize Emma's and Anna's adoptions.

Jonah's grades are slipping and Anna would rather do hair and makeup than go to college, so Amber and Trent arrange a college tour to motivate Jonah, and encourage Anna to find a job at a salon to learn the issues facing a little person in the workplace.

In preparation for his 40th birthday, Trent decides to shed some weight, but the process isn't as much fun as he expected; Amber plans a surprise birthday party for Trent that he will never forget.

Alex is getting ready to undergo brain surgery, and Amber decides to give him a new haircut, which has disastrous results; while Alex is in the hospital, Trent takes the other Johnston children to see the Harlem Globetrotters.

Jonah and Anna are both put to the test- Jonah with his driver's license and Anna with her learner's permit; Alex is diagnosed with central apnea and undergoes an MRI to find out whether he needs brain surgery.

The Johnstons look back at their first year on television, reliving the scary surgeries, surprising behavior issues, challenging home projects, colossal kid chaos, and other memorable moments; with cast commentary.