1. Define the key terms listed 2. Identify two major developmental tasks of adolescence 3. Discuss three ways in which youth can help prevent violence 4. Discuss anticipatory guidance for a 15-year-old girl just beginning to date 5. Describe three ways an adolescent can be given responsibility 6. Describe at least five ways a home health care worker can assist in caring for a disabled child 7. Explain three ways parents can be assisted in the skills of parenting adolescents 8. Discuss the strategies for decreasing adolescent pregnancy 9. Discuss how health care workers can assist adolescents in making informed decisions regarding body piercing and tattoos 10. Summarize the nutritional requirements of the adolescent, and cite two factors that may contribute to dietary deficiencies in this age group 11. Discuss the three leading causes of accidents in adolescence, and suggest methods of prevention for each The development of secondary sexual maturation can be assessed using Tanner staging. Stages are based on breast and pubic hair development for girls and genital and pubic hair development for boys (Table 10-1). Development (growth and sexual maturation) is predictable but variable. Tanner staging provides a more accurate assessment of a child’s development than chronologic age (James and Ashwill, 2007). In most girls, changes in the breast with the development of a small bud of breast tissue (thelarche) signals the earliest sign of puberty. The average age is 11 years. Menarche (onset of menstrual periods) occurs approximately 2 years afterward. Menarche can range from Table 10-1 Sexual Maturation Rating (SMR): Tanner Stages *Breast and pubic hair development may continue into late adolescence and increase with pregnancy. Modified from Tanner, J. M. (1962). Growth at adolescence (2nd ed.). Oxford: Blackwell Scientific Publications; Marshall, W. A., and Tanner, J. (1969). Variations in pattern of pubertal changes in girls. Arch Dis Child, 44(235), 291-303. Modified with permission from Blackwell Scientific Publications and The BMJ Publishing Group. Table 10-2 Growth and Development During Adolescence Forms stable relationships and attachment to another Growing capacity for mutuality and reciprocity Intimacy involves commitment rather than exploration and romanticism
The Adolescent
General Characteristics and Development
evolve.elsevier.com/Price/pediatric/
Biological Development
to 15 years and still be within normal guidelines. According to Hockenberry and Wilson (2007), girls’ peak height velocity occurs at about 12 years of age (6 to 12 months before menarche); girls gain 2 to 8 inches in height and 15 to 55 pounds during adolescence. In addition to secondary sex characteristics becoming more apparent before menarche, fat is deposited in the hips and thighs, causing them to enlarge. Hair grows in the pubic area and underarms. The body reaches its adult measurements about 3 years after the onset of puberty. At this time, the ends of the long bones knit securely to their shafts and further growth can no longer take place.
Boys
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Pubic hair: none
Penis: preadolescent
Testes: preadolescent
Pubic hair: slight, long, straight, slightly pigmented at the base of the penis
Penis: slight enlargement
Testes: enlarged scrotum, pink, slight alteration in texture
Pubic hair: darker in color, starts to curl, small amount
Penis: longer
Testes: larger
Pubic hair: coarse, curly, similar to adult but less quantity
Penis: larger, glans and breadth increase in size
Testes: larger, scrotum darker
Pubic hair: adult distribution spread to inner thighs
Penis: adult in size and shape
Testes: adult
Early puberty: Testes, yr; penis,
yr; pubic hair,
yr
Middle puberty: Testes, yr; penis,
yr; pubic hair,
yr
Late puberty: Testes, yr; penis,
yr; pubic hair,
yr
Breast Development in Girls*
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Preadolescent
Breast bud stage (thelarche): breast and papilla elevated as small mound, areolar diameter increased
Breast and areola enlarged, no contour separation
Areola and papilla form secondary mound
Mature, nipple projects, areola part of general breast contour
Early puberty: 9-13 yr
Middle puberty: 12-13 yr
Late puberty: 14-17 yr*
Pubic Hair Development in Girls
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Preadolescent (none)
Sparse, lightly pigmented, straight medial border of labia
Darker, coarser, beginning to curl, increased over pubis
Coarse, curly, less in amount than adult, typical female triangle
Adult female triangle, adult quantity spread to medial surface of thighs
Early puberty: yr
Middle puberty: yr
Late puberty: yr
Developmental Theories
Early Adolescence (11-14 Yr)
Middle Adolescence (14-17 Yr)
Late Adolescence (17-20 Yr)
Growth
Cognition
Identity
Relationships with Parents
Relationships with Peers
Sexuality
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The Adolescent
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