GROWTH AND DEVELOPMENT ASSESSMENT OF

ADOLESCENT CHILD

AIM-
At the end of the adolescent school visit gain the brief knowledge about normal
growth and developmental pattern and specific developmental changes at this
age group.

OBJECTIVES-
At the end of the observational visit the students will be able to,

 Understand the growth pattern of adolescent from 13 to 21 years.

 Observe the physical mental emotional and social development.
 Understand the normal growth and developmental changes in adolescent.
 Help the adolescent to understand the physical and psychological changes
they are undergoing and the scientific reasons behind the changes.
 Identify the health needs of adolescent.
BIODATA-
Name of child :-
Age :-

Sex :-

Class :-

Date of birth :-

Order of birth :-

Father/Mother name : -

Education :-

Occupation :-

Address & mobile number: -

Date of visit :-

Name of school :-

Likes and dislikes of child: -

PHYSICAL EXAMINATION-
Parameters Normal range Observed in child Remark
Weight –
1.early adolescence Male-38-60 kg
(12 to 13 years) Female-40-60 kg

2.Middle Male-50-60kg
adolescence (14-16 Female-42-64kg
years)

3.late adolescence Male-56-80kg

(17-21 years) Female48-72kg

Height –
1.early adolescence Male-154-172cm
(12-13 years) Female-153-167cm

2.middle Male-164-180cm
adolescence(14- Female-155-169cm
16years)

(17-21 years) Male-163-182cm

Parameters Female-156-170cm
Normal range
Pulse-
(12-13 years) 65(+) or (-)8 beats/min
(14-16 years) 63+-8beats/min
(17-21 years) 70+-10 beats/min

Respiration-
(12-13 years) 19(+) or (-)3/min
(14-16 years) 17+-3/min
(17-21 years) 17+-3/min

Blood pressure-
(12-13 years) Male-114/68(+) or
(-)10/14
Female-112/66(+) or
(-)10/12

(14-16years) Male-116/70+-12/14
Female-114/70+-14/12

(17-21 years) 126/74+-26/16

 Parameters Normal range Observed in child Remark

Motor and self- Motor function

care comparable to that of
adults.
Eye-hand coordination
at adult level.
Poses manual
dexterity.

sensory Visual acuty:20/20

MATURATIONAL CHANGES DURING ADOLESCENCE-

BOYS
Normal changes Changes in child Remark
Growth spurt
Muscle develops
Skin becomes oily
Shoulder broadens
Voice cracks
Underarms, chest hair
Pubic hair appears
Facial hair appears
Voice cracks
Penis, testis enlarge
Erections in boys
Sperm production,
ejaculation
Sexual desire
Sexual attractions
Initiation of sexual behavior
GIRLS-
Normal physical changes In child Remark

Growth spurt

Breasts develop

Skin becomes oily

Hips widen

Underarm, pubic hair

appears

Uterus, ovaries enlarges

External genital enlarges

Menarche, ovulation

Sexual desire

Sexual attractions

Initiation of sexual behaviors

PSYCHOSOCIAL, PSYCHOSEXUAL, SPIRITUAL DEVOLOPMENT-

DEVOLOPMENT CHARECTERISTICS IN CHILD REMARK

PSYCHOSOCIAL-
(Identity v/s role
confusion)
Early adolescence- -Beginning of
(12-13 years) development of sense
of identity (13-18
years) negative
counterpart: self-
diffusion.
-Egocentric.
-has intensive loyalty to
peer groups.
-show mood swings
and extremes of
behavior.
-experiences sense of
loss as beginning to
separate from parents.
-Day dreams over
heroes.
-continuous same sex
friendships.

Middle -egocentrism
adolescence- diminishes separate
(14-16 years) from parents,
continuous
heterosexual
relationship.
-verbally attacks
parents’ beliefs and
values.

Late adolescence- -sense of identity.

(17-21 years) -sense of intimacy.
Negative counterpart:
isolation.
-severe ties with
parents.
-establishes
interdependent
relationship with
parents.
-has fewer but close
friends.
 -heterosexual
relationships are the
rule.

PSYCHOSEXUAL Masturbation starts.

–  Girls attain
(Genital stage) puberty at
around 10-15
years of age.
 Boys attain
puberty between
12-16 years of
age.

SPIRITUAL-  Adolescent are

(DEEP capable of
SPIRITUAL understanding
CONCERNS) abstract concepts
and of interpreting
analogies and
symbols.
 Synthetic
conventional faith.

COGNITIVE, EMOTIONAL, MORAL AND LANGUAGE DEVELOPMENT-

COGNITIVE OR -Formal operational
INTELLECTUAL- thoughts.
(Formal operative) -Generates
hypotheses.
-Uses scientific
method for problem
solving.
-Expresses concern for
education and
vocation.

EMOTIONAL OR -
PSYCHOLOGICAL Fantasy/daydreaming.
- -Rapid mood changes,
emotional instability.
-Attention seeking
behavior.
-Curious
-Full of energy,
restless.
-Self-exploration and
evaluation.
-Conflicts with family
over control.
-Peer group defines
behavioral code.
-Formation of new
relationships.

MORAL- -Fixed rules in moral

(Internalized set of decisions.
moral principles) -Obligation to do no
harm and to do duty.
-Social contracts
understood and
formulated.
-Laws recognized as
changeable.
-Correct actions
depend on standards
and individuals’
rights.

LANGUAGE-
-Uses slangs within
and outside peer
group.
-Uses distinct
meanings for words.
SCHOOLING: -
(how is the child progress, academic and curriculum activities, competition at school
and inter school level, mid-day meal program)

RELATIONSHIP WITH PARENTS-

(During adolescence the parent-child relationship changes from protection-dependency
to mutual affection and equality. Adolescents are accepted as maturing preadults. They
must conform to regulations and restrictions set by adults.)

TEACHER STUDENT RELATIONSHIP: -

RELATIONSHIP WITH PEERS-
(The peer group serves as a strong support to teenagersproviding them with a sense of
belonging and feeling of strength and power.
Within the larger groups smaller, distinct, and rather exclusive crowds or cliques of
selected close friends who are emotionally attached to each other.
To be ignored or criticized by peers creates feelings of inferiority, inadequacy and
incompetence.)

INTEREST AND ACTIVITY-

(Adolescent spend a large amount of time engaging inleisure time activities. Chooses
activities according to individual interests• Parties, Conversation, Helping others,
Interest in world affairs, Expressive arts, Hobbies, social drinking, drugs etc.)

SMART PHONE USES: -

(how many hours, which video games played mostly)
NUTRITION-
Increased nutritional requirements. The calorie and protein requirement during this
time are higher. there is a substantial increase in the need for the minerals, calcium,
iron and zinc for the generation of both skeletal and bone tissue.
NUTRIENTS REQUIRMENTS
calories Average teenage Boy-2,800 Cal/day
Average teenage girl-2,200 Cal/day
Grains Boys (14-19 years)-9 oz
Girls (14-19 years)-6 oz
(1 oz=1/2 cup)

Protein Boys (14-19 years)- 54.3 to 61.5 g/day

Girls (14-19 years)-51.9 to 55.5 g/day

Calcium 800 mg/day

MEAL PATERN OF CHILD-

BREAKFAST-

LUNCH-

SNACKS:

DINNER-

SLEEP AND REST-

(Rapid physical growth the tendency towards overexertion, and the overall increased
activity of this age contribute to fatigue in adolescents.
Adequate sleep and rest at this time are important to a total health regimen
In child-

IMMUNIZATION-
VACCINE CRITERIA IN CHILD REMARK
TT Booster at 10 and 16 years

Rubella As part of MMR vaccine 1 dose to

girls at 12-13 years of age, if not
given earlier

MMR 1 dose at 12-13 years of age. (if not

given earlier)

Hepatitis B 3 doses (0,1, and 6) if not given

earlier

Typhoid TA,Vi or oral typhoid vaccine every

3 years

Varicella 1 dose up to 12-13 years, and 2

doses after 13 years of age. (if not
given earlier)

Hepatitis A 2 doses (0 and 6 months) if not

given earlier

HEALTH SERVICES PROVIDED TO CHILDREN FOR PREVENTION OF

DISEASE AND PROMOTION OF HEALTH: -
IDENTIFICATION OF NEEDS ON PRIORITY-

HEALTH EDUCATION-
CONCLUSION-

BIBLIOGRAPHY-
1. Mayoor K Chheda, practical aspects of paediatrics, CBS publishers and
distributors 7th edition.
2. O P Ghai, Essential paediatrics, CBS publishers and distributors, edition 9 th
edition,2019.
3. Parul Datta, Pediatric Nursing, second edition, Jaypee.
4. Marlow’s, Text book of pediatric nursing, south asian edition, ELSEVIER
publisher.
5. Rimple Sharma’s Essentials of Pediatric Nursing, second edition