ADOLESCENCE

• usually occur between ages 11 and 14 years

Physical Growth
• age of first menstruation in girls is gradually
decreasing from a mean of 13 years to 12.4 years
• major milestones of physical development: ➢ probably related to more weight gain in girls
✓ 8 to 12 years of age: onset of puberty
✓ 16 to 20 years old: cessation of body growth
SECONDARY SEX CHANGES
• GIRLS
➢ are 1 to 2 in. (2.4 to 5 cm) taller than boys
▪ stop growing within 3 years from • Secondary sex characteristics - are those
menarche
characteristics that distinguish the sexes from each
▪ shorter than boys by the end of other but that play no direct part in reproduction
adolescence
➢ HEIGHT: grows 2 to 8 in. (5 to 20 cm) Age Male Female
➢ WEIGHT: gain 15 to 55 lb (7 to 25 kg) 13–15 Growth spurt Pubic hair thick
➢ GROWTH STOPS at: 16 or 17 years old continuing; pubic and curly,
hair abundant and triangular in
• BOYS
curly; testes, distribution;
➢ HEIGHT: grow about 4 to 12 in. (10 to 30 scrotum, and breast areola and
cm) penis enlarging papilla form
➢ WEIGHT: gain about 15 to 65 lb. (7 to 30 further; axillary secondary
kg) hair present; mound;
➢ GROWTH STOPS at: 18 to 20 years old facial hair fine and menstruation
downy; voice is ovulatory,
• PULSE RATE = 70 beats/min changes happen making
• RESPIRATORY RATE = 20 breaths/min with annoying pregnancy
• BLOOD PRESSURE = 120/70 mmHg frequency possible
15–16 Genitalia adult; Pubic hair curly
• androgen stimulates sebaceous glands: acne
scrotum dark and and abundant;
• apocrine sweat glands form: strong odor heavily rugated; may
facial and body extend onto
hair present; medial aspect of
TEETH sperm production thighs;
mature breast tissue
appears adult;
• second molars at about 13 years of age nipples
• third molars (wisdom teeth) between 18 and 21 years protrude; areolas
no longer project
➢ may erupt as early as 14 to 15 years of age as
separate ridges
from breasts; may
PUBERTY have some degree
of facial acne
16–17 Pubic hair may End of skeletal
• time at which an individual first becomes capable of extend along growth
sexual reproduction medial
• girl has entered puberty when she begins to aspect of thighs;
testes, scrotum,
menstruate
and penis adult in
• boy enters puberty when he begins to produce size; may have
spermatozoa
 some degree of Emotional Milestone
facial acne;
gynecomastia
(enlarged breast
tissue), if present,
IDENTITY vs. ROLE CONFUSION
fades
17–18 End of skeletal 4 main areas in which they must make gains to achieve a
growth sense of identity include:

1. Accepting their changed body image

Sexual maturity in males and females is classified according to 2. Establishing a value system or what kind of person
Tanner stages. they want to be
3. Making a career decision
4. Becoming emancipated from parents

Role Confusion

• have little idea what kind of person they are

• can lead to difficulty functioning effectively as adults
because they are unable

BODY IMAGE

• learned to solve problems and are best equipped to

adjust to the changing body image that comes with
adolescence
• adolescents are usually their own worst critics with
regard to their bodies, they may need help
Developmental Milestone

SELF-ESTEEM
PLAY OR RECREATION
• Help parents understand how important it is for
• more adult forms of
recreation such as adolescents to have immediate successes
listening to music, • Compassionate understanding (“It’s hard to be left
texting or chatting, or out”) is a better communication technique
following a sports
team’s wins and losses
13 - 15 years old • team (or school) VALUE SYSTEM
loyalty becomes
intense and following
a coach’s instructions
becomes mandatory • As they increase the amount of time they spend with
• spend a great deal of their peer group, they may question these values and
time just talking with participate in experiences that may put them at risk
peers as social for physical and/or psychological harm.
interaction • Identifying risk-taking behaviors and offering
16 years old • want part-time jobs to guidance and support is important
earn money
• engage in charitable
endeavors
 SOCIAL COUPLING 16 years old • becoming sexually
mature
• individuals tend to dress and behave similarly to other 17 years old • tend to have adult
members of their peer group values and responses to
events
• bullying behaviors should be identified, and the
appropriate interventions should be initiated
• individuals begin to explore their sexual preferences
Cognitive Development
and may question their gender identity

CAREER DECISIONS
• adolescent may identify an educational and career
trajectory during self-discovery of personal positive
attributes
• process may take several years to achieve, and it
varies for each individual.
EMANCIPATION FROM PARENTS
• Some parents may not yet be ready for their child to
be totally independent, and some adolescents may not
yet be sure they want to be on their own
INTIMACY VERSUS ISOLATION
• Those who do not develop a sense of intimacy are left
feeling isolated; in a crisis situation, they have no one
to whom they feel they can turn to for help or support.
• Empathy: ability to understand the feelings of
another; a developed sense of intimacy in its finest
form
• final stage of cognitive development, the stage of
formal operational thought, begins at age 12 or 13
years and grows in depth over the adolescent years
➢ may not be complete until about age 25
• ability to think in abstract terms and use the scientific
method (i.e., deductive reasoning) to arrive at
conclusions.
Moral and Spiritual Development
• able to respond to the question “Why is it wrong to
steal from your neighbor’s house?” with “It would
hurt my neighbor by requiring him to spend money
to replace what I stole,” rather than with the
immature response of the school-age child, “The
police will punish me.”
• question the existence of God and any religious
practices they have been taught
Promoting Adolescent Safety

SOCIALIZATION
Motor vehicle Always use a seat belt
whether a driver or a
13 years old • begin to experience
passenger. Never use a cell
“crushes,” or
phone or text while driving.
infatuations
Do not drink alcohol while
• spend more time driving and always refuse
longing for someone to ride with anyone who
than they do instituting has been drinking (name a
an in-depth and designated driver or
rewarding relationship arrange with your parents
14 years old • have become quieter to be picked up or provide
and more introspective money for a taxi). Wear a
• have more confidence in helmet and long trousers as
themselves driver or passenger on a
15 years old • fall “in love” five or six motorcycle.
times a year; based on Accepting dares has no
attraction because of place in safe driving.
physical appearance Take graduated driver
programs seriously so you
learn safe driving
 habits for both two-wheel Recommended Dietary Reference Intakes
and four-wheel vehicles.
Firearms Always consider all guns • needs an increased number of calories over that
loaded and potentially needed previously to support the rapid body growth
lethal.
that occurs
Learn safe gun handling
before attempting to clean a
gun or hunt. Promoting Nutritional Health with a
Drowning Learn how to swim. Follow Varied Diet
safe water rules, such as
never swimming • Because vegetables generally contain fewer calories
alone, no diving into the
than meat, adolescents need to consume large
shallow end of swimming
pools, no amounts of them to achieve an adequate caloric intake
hyperventilating before from a vegetarian diet.
swimming underwater, and • Glycogen loading= a procedure used to ensure there
no swimming is adequate glycogen to sustain energy through an
beyond one’s own limit. athletic event
Taking dares has no place
in water safety.
Sports Use protective equipment, Promoting Development in Daily
such as facemasks for
Activities
hockey and pads and
a helmet for football.
Do not attempt to
participate beyond physical DRESS AND HYGIENE
limits.
Keep well hydrated by • capable of total self-care and, because of their body
drinking fluid before and awareness, may even be overly conscientious about
after play. personal hygiene and appearance
Careful preparation for
sports through training is • acutely aware of how their peers dress
essential to safety.
Recognize and set one’s CARE OF TEETH
own limit for sports
participation.
• very conscientious about tooth brushing because of a
fear of developing bad breath
• continue to use a fluoride paste rather than a brand
Promoting Nutritional Health
advertised as providing white teeth
• continue to drink fluoridated water to ensure firm
• experience such rapid growth that they may always enamel growth
feel hungry SLEEP
• they tend to eat faddish or quick snack foods rather
than more nutritionally sound ones
• needs 8 hours of sleep a night, some need more and
• Giving an adolescent some responsibility for food others can adjust to considerably less
planning or meals, such as making dinner every
• protein synthesis occurs most readily during sleep
Wednesday night, can teach some important lessons
and adolescents are building so many new cells, this
about nutrition without conflict
age group may need proportionately more sleep than
any other age groups
 EXERCISE

• need exercise every day both to maintain muscle tone

and to provide an outlet for tension

SUN EXPOSURE
• spend a great deal of time outdoors participating
in athletics, it is a critical time for them to avoid
excessive sun exposure so they don’t develop
skin cancer (i.e., melanoma) from ultraviolet rays
• use sunscreen, avoid tanning beds, and report to
their primary healthcare provider any skin mole
that changes in shape or color