Growth and Development (Sir Andre): Adolescent

By: YZOBELLE REDONDO

Age: 12-21 y/o

Developmental Task: Identity vs. Role Confusion
Cognitive Development Stage: Formal Operational Thought
Leading Cause of Death: Accidents, Drowning (2nd), Homicide & Suicide (3rd)

Physical Growth
9-12 y/o: onset of puberty
16-17y/o: girls stop growing, during closure of epiphyseal lines of long bones
18- 20 y/o: boys stop growing, during closure of epiphyseal lines of long bones
3 years from menarche: girls stops growing
HR: 70 bpm
RR: 20 breaths per minute respectively

Teeth
13 y/o: growth of second molars
18-21 y/o: growth of third molars

Puberty
 The time at which an individual first becomes capable of sexual reproduction
Girls: enter puberty when she begins to menstruate
Boys: enter puberty when he begins to produce spermatozoa
12.4 y/o: age of first menstruation mostly

Sexual Maturation
Males
13-15y/o:
 Growth spurt
 Pubic hair abundant and curly
 Enlarged testes, scrotum, and penis
 Axillary hair present
 Facial hair fine and downy
 Voice Changes with annoying frequency

15-16 y/o:
 Adult genitalia
 Pubic hair abundant and curly
  Dark scrotum and heavily rugated
 Facial and body hair present
 Sperm production present

16-17 y/o:
 Pubic hair curly and abundant like an adult
 Penis and scrotum are adult size
 Gynecomastia if present, fades
17-18 y/o: end of skeletal growth

Females
13-15 y/o:
 Pubic hair thick and curly
 Triangular distribution of pubic hair
 Breast, areola, papilla form secondary mound
 Menstruation is ovulatory (pregnancy is possible)

15-16y/o:
 Pubic hair curly & abundant like an adult
 Pubic hair extends to the median part of the thigh
 Breast tissue matures
 Nipples protrude
 Areolas no longer project as separate ridges from breast
 May have some degree of facial acne

16-17 y/o: End of skeletal growth

*************************************************************************************
13 y/o:
 tend to be loud and boisterous
 fall “in love”
 spend time longing for someone than instituting in depth rewarding relationship
14 y/o:
 tend to be quieter & more introspective
 become used to their changing bodies
 have IDOLS
 Form friendships with an older adult of the same sex

15 y/o:
 spends time in their room or quiet corner of the home
 falls in love for 5 to 6 times a year (HUWAW), but these relationships are based on attraction bc of
physical appearance
 peak of parent-child friction
16 y/o:
 do part time jobs to earn money
 more willing to listen and talk about problems
 boys become sexually mature
  can understand that adults are only human
 can comprehend how hard it was for parents to get where they are but may not understand why they
aren’t allowed to stay out til midnight
17 y/o:
 quieter and thoughtful about interactions
 Clings to security; wants to go back to a place where vacation was spent, house decorated for a holiday
the same way

4 Main Areas in Which Adolescents Must Make Gains to Achieve Sense of Identity:
1. Accepting their changed body image
2. Establish what kind of person they want to be
3. Making a career decision
4. Becoming emancipated from parents

Changes that Affect Adolescent’s Self-Esteem

1. Changes in one’s body and physiologic functioning
2. Changes in feelings and emotional focus
3. Changes in social relationships
4. Changes in family and school expectations

Play & Recreation

13 y/o: listen to music, chat on computers, following a sports team’s wins and loses
Nutrition
 Iron, Calcium, Zinc tend to be deficient among adolescents
 Large amounts of iron is required, to meet expanding blood volume requirements
 Meat is high in zinc
 Calcium is rich in milk products
 Iron is rich in green leafy vegetables
 Glycogen Loading, a procedure used to ensure there is adequate glycogen to sustain energy through an
athletic event

Sleep
 Lack of sleep leads to FATIGUE and DEPRESSION
 Need more sleep than any other age group

Types of Abused Substances

1. Prescription and Over-the-Counter Drugs
 Sedatives
 Pain Medications
 Cough Syrup with dextromethorphan (DXM)
- Small Dose of DXM: causes lightheadedness
-Large Dose of DXM: hallucinations, “out of the body experiences”
 Methylphenidate – drug prescribed for attention deficit or hyperactivity disorder
 Ketamine – anti-anestheticused in veterinary medicine

2. Tobacco
  Smoking conveys a stamp of maturity, for adolescents
 Nicotine gums and nicotine patches can be effective for those who want to quit smoking
 In instructions given, say a “do as I say” not “do as I do”

3. Alcohol
 Alcohol drinking is related to liver cirrhosis, cognitive challenge, addiction, depression, and
vulnerability to date-rape
 Adolescents admit they use alcohol if asked 2 questions:
 Do you think you have a drinking problem?
 When was your last drink?
 If answer to Question #1 is “YES” and QUESTION #2 is “the last 24 hr.” you should
further assess

4. Performance-Enhancing Drug Abuse

 Anabolic Steroids, aka STANOZOLO: side effect is euphoria and less fatigue
 They take steroids to enhance body mass and muscles

5. Marijuana
 Aka POT, GRASS
 From the Indian hemp plant, Cannabis sativa
 Sinsemilla - seedless form that is even more potent
 Breakdown products of marijuana ARE NOT READILY ELIMINATED FROM THE
BODY, BUT REMAIN IN THE FATTY CELLS OF THE BRAIN
 Psychological Effects:
* Euphoria
* Sense of well-being
* Temporary impairment of motor activities
* Rapid mood swings
* Altered self-image
* Altered sensory perceptions
* Decreased attention span
* Loss of memory for recent events
 Withdrawal Symptoms:
* Irritability
* Drowsiness
* Cravings for high carb snacks
6. Amphetamines
 Aka UPPERS or SPEED (bc they give a false sense of well-being or alertness
 Used to treat hyperactivity and narcolepsy
 Chronic Methamphetamine: causes severe blackened teeth
 Side Effects:
* Aggressive behavior
* Paranoia
* Extreme Restlessness
* Suppress appetite, (leads to weight loss)

6. Cocaine
 One of the most popular drugs of abuse
 Could be sniffed, smoked, or injected IV
 Speedball: term used if combined with heroin
 Snow & White lady: COMMON STREET NAME for cocaine (bc of its fine white powder)
 Crack: stronger form manufactured by heating cocaine w/ baking soda and water
 Freebase or Rock: resulting form (from the crack) which causes cardiac and respiratory
arrhythmias
  If sniffed: absorbed in the mucus membrane then into the bloodstream
- blood then rises rapidly for the first 20 mins. Peak at 60 mins. Decline at 3 hours
 Physiological Side Effects:
* Increased pulse and respiration
* Increased temp
* Increased blood pressure
* Decreased appetite (thin fissured lips due to dehydration and lack of nutrition can be
evident)
 Psychological Side Effects:
* Euphoria
* Excitement
* Restlessness
* Increased sociability
* Hallucinations
 Toxic Symptoms:
* Seizures
* Tachyarrhythmia
* Tachypnea
* Hypertension
* Decreased Deep Tendon Reflex
* Nausea & Vomiting
* Abdominal Pain
* Headaches
* Chills and Fever
 Potentially harmless when swallowed because gastric secretions destroy its effect
 Chronic Inhalation: cause ulceration of the mucous membrane, and injection of substance
exposes the risk of HIV, Hepatitis etc.

7. Hallucinogens
 LSD: Lysergic acid diethylamide
 DMT: dimethyltryptamine
 PCP: phencyclidine hydrochloride
 Can be manufactured by adolescents in a “kitchen lab”
 Side Effects:
* Distorted vision
* Distorted Hearing
* Distorted Vision
 Ecstasy: Methylenedioxymethamphetamine (MDMA)

8. Opiates
 These are drugs such as:
*Heroin
* Meperidine
* Morphine
 Not used by adolescents before, bc they are expensive
 Can decrease respiratory rate
 Can cause physiologic craving, and will do anything to store money to by a day’s supply
 Risk for HIV bc of contaminated needles
 “Snoring” Heroin: cause cerebral vascular accident and death
 Methadone or LAAM (Leyomethadyl Acetate) Program: can help adolescents wean
themselves from opiates
Stages of Substance Abuse
Stage 0: Pre abuse
 Curious about drugs
 Need for peer acceptance
 Anger
 Boredom

Stage 1: Experimentation
 Learning the high
 Little behavior change except lying
 Use is confined to social situations on weekends
 Commonly used:
* Tobacco
* Alcohol
* Marijuana

Stage 2: Early Regular Use

 Seeks drug to relieve mood swing
 Drug used everyday to relieve stress
 Use is frequent and could be solitary, regularly on weekends, occasionally on weekdays
 Commonly used:
*Inhalants
* Sedatives
*Stimulants
 Behavior Changes include:
* Deteriorating school performance
* Change in dress
* Mood swings
* Lying
*Stealing

Stage 3: Late Regular Use

 Dependent on substance
* Deteriorating behavior
* Lying
*Stealing
* Fighting
*Prostitution
* Often depressed
* Self destructive behavior
* Suicidal ideation

Stage 4: End Stage

 Use to avoid dysphoria
 Withdrawal
 Continued deterioration of behavior and mental state
Key points:
 Muscle mass increase faster than heart size
 Heart and lungs increase in size MORE SLOWLY than the rest of the body
 Androgen stimulates sebaceous glands, resulting in acne
 Apocrine sweat glands from shortly after puberty; responsible for body odor
 Urge parents to encourage youngsters to play sports for their own health and well-being
 Spends time talking with peers as social interaction
 Talking with peers is a major way to learn about the world
 Parental comments such as, “When you’re older, these things won’t be so important,” are not likely
to remove the hurt from 16 year olds not being included in the varsity
 Encourage adolescent girls to maintain honesty, and forthrightness
 They need attentive adult ear who will listen to their fears, hopes, dreams and the pressure they feel to
be somebody
 Early adolescents may lack interest with the opposite sex
 Encourage parents to give adolescents more freedom like choosing their clothes to buy
 Encourage parents to still put reactions on adolescent behavior
- say “You must drive the car safely or you can’t use it.”
 The ability to form intimate relationships is strongly correlated with a sense of trust
 Once they have achieved a sense of identity, they are ready for the next developmental task, to achieve
intimacy
 Never do adolescents need an adult to listen to them more than when they are struggling with heart-
rending feelings of young love
 Parents should feel the obligation to inform children of their feelings about early sexual relationships
 Early teenagers feel more self-doubt than self confidence
 Early teenagers want to look grownup but still look like children
 Has the ability to do scientific reasoning
 When asked, “Why is it wrong to steal from your neighbor’s house?” answers, “Because it would hurt
my neighbor by requiring him to spend money to replace what I stole
 Questions the existence of God and religious practices
 For DROWNING, teaching the adolescent how to swim is not the best preventive measure but,
teaching water safety, such as not swimming alone
 Drink fluoridated water to ensure enamel growth
 Teens with braces must be conscientious w/ toothbrushing, to prevent plaque
 Body piercings and tattoos: strong mark of adolescence; way for them to show that they are different
from their parents
 Time where one finds out if he/she is gay or lesbian

Definitions:
 Stalking - repetitive, intrusive, and unwanted actions directed at an individual to gain individual’s
attention or evoke fear

 Empathy - ability to project themselves in another person’s situation

 Role Confusion - having little idea of what kind of person they are
 Flunitrazepam - “date-rape drug,” colorless, odorless and flavorless
 Formal Operational Thought - involves the ability to think in abstract terms and use the scientific
method to arrive at conclusions
 Hazing – demeaning or humiliating rituals that prospective members have to undergo to join sororities,
fraternities, adolescent gangs or sports teams
 Substance Abuse – refers to the use of chemicals to improve a mental state or induce euphoria
 Anabolic Steroids – derivatives of the natural hormone testosterone
 Amphetamines – group of drugs sometimes used in the treatment of hyperactivity and narcolepsy,
among other CNS disorders
 Runaway – a child between the ages 10 and 17 years old, who has been absent from home without
permission of a parent or guardian