Adolescents’ Growth and Development

1. Adolescents’ Growth and Development Prepared by Nadin M. Abdel Razeq, Ph.D. RN School of Nursing, The University of Jordan

2. Definition of Adolescence • Age 11-20 year • to grow into maturity“ • Rapid physical, cognitive, social, and emotional maturing • A period of transition between childhood and adulthood. • Generally regarded as the psychological, social, and physical maturation process initiated by pubertal changes

3. Phases of Adolescence 1. Early adolescence age 11- 14 years. 2. Middle adolescence 15-17 years. 3. Late adolescence 18- 20 • Generally regarded as the psychological, social, and physical maturation process initiated by pubertal changes

4. Definition of Puberty • Pubescence >> the maturation, hormonal, and growth processes that occur when: • the reproductive organs begin to function • the secondary sex characteristics develop

5. Stages of Puberty • Prepubescence: • Puberty (Pubescence) • Postpubescence

6. Prepubescence: • the period of about 2 years immediately before puberty when child is developing physical changes that herald sexual maturity

7. Puberty: • between 12-16 years for boys. • between 10-14 years in girls • The point at which sexual maturity is achieved • marked by the first menstrual flow (menarche) in girls, and expulsion of semen (ejaculation) for boys.

8. Postpubescence: • 1-2 years following puberty • Skeletal growth is completed • reproductive functions become fairly well established

9. Neuroendocrine events (Hormonal Changes) of Puberty • The events of puberty are caused by hormonal influences • It is controlled by the anterior pituitary in response to a stimulus from the hypothalamus.

10. Neuroendocrine events (Hormonal Changes) of Puberty • Hypothalamus: Gonadotropine –releasing hormone (GnRH) • Pituitary: Folicular-stimulating (FSH) hormone + Luteinizing hormone (LH) • Stimulate gonadal responses • maturation and functioning of ovaries in girls/ Testicles in boys • Release of Estrogen and progesterone in girls and testosterone in boys

11. Estrogen, • The feminizing hormone, • is found in low quantities during childhood. • is secreted in slowly increasing amounts until about age 11 years. • The onset of estrogen production in the ovary causes a pronounced increase that continues until about 3 years after the onset of menstruation, at which time it reaches a maximum level that continues throughout the reproductive life of the female

12. Androgens • the masculinizing hormones, • are secreted in small and gradually increasing amounts up to about 7 or 9 years of age, • at which time there is a more rapid increase in both sexes, especially boys, until about age 15 years. • These hormones appear to be responsible for most of the rapid growth changes of early adolescence.

13. Sexual maturation

14. Sexual maturation

15. Physical Growth and development

16. growth spurt • marked by sudden and dramatic physical changes • Skeletal muscles and body organs • 24-36 months period • 50% of ideal adult body weight • Occurs earlier in girls (age: 9.5-14.5 y) vs in boys (age:10.5-16 y)

17. Gender differences in growth Girls: • The faster rate of growth in girls occurs at about age 12 • maximum height at about 15 -16 years Boys: • Growth is faster for boys at about 14 years • maximum height is often reach at about 18 -19 years

18. Areas of physical growth • Skeletal growth • Muscle mass (lean body mass) • Adipose tissue (non-lean body mass) • Skin

19. Other changes • Vocal voice changes • Size and strength of the heart • Blood volume • Systolic blood pressure increase • Heart rate decreases increased level of cardiac respiratory and metabolic functioning >> Improved physical functioning

20. Cognitive development

21. Piaget’s 4th stage: formal operation • Their thoughts are influenced by logical reasoning and formal logic • Capacity of abstract thinking • Think beyond the presence • Imagine consequences and sequences of future events • Such as: professional options, planning for college

22. They can detect logical consistency or inconsistency in a set of statements or events in an analytical manners • May criticize and question the inconsistent behaviors of others • Able to understand that few concepts are absolute or independent; accept the diversity of others from oneself self (accepting other cultural values)

23. Begin to consider both: a) their own thinking and b) the thinking of others • Wonder what opinion others have of them • Are able to imagine the thoughts of others

24. Moral development

25. They view moral standards as subjective and based on points of view that are subject to disagreement • Question and disagree with principles, established social codes, and values. • late adolescence is characterized by serious questioning of existing moral values and their relevance to society and the individual

26. Spiritual development

27. Abstract thinking affect adolescent’s uptake of religion • Adolescents beliefs become more oriented towards spiritual ideological matters • and less oriented towards rituals, practices, and religious costumes • Decline in participation in organized religious practices (congregation services and group prayers) with adolescent age

28. Late adolescents re-examine and re-evaluate many of the beliefs and values of their childhood • As adolescents grow-up and form their personal adenitis, they either reject their family’s traditional beliefs or they may decide to follow those beliefs • Greater levels of religiosity and spirituality are associated with fewer high-risk behavior and more health-promotion behavior

29. Psychosocial development

30. Task: identity formation vs role confusion • To develop stable coherent picture of oneself that include integrating one’s past and present experiences with a sense of where one is headed in the future. • In adolescence, they come to see themselves as distinct individuals, somehow unique and separate from other individuals

31. Three forms of identities develop: • Group identity vs alienation • Individual identity • Sex-role identity

32. Group identity vs alienation • Pressure to belong to a group is intensified • Adolescents find it essential to belong to a group from which they can derive status • Belonging to group help adolescents establish differences between themselves and their parents or parental generation • Acts like the peers in the group act • To be different s to be unaccepted and aleinitaed from the group

33. Individual identity • Adolescents attempt to incorporate multiple body changes into a concept of self • Body-awareness is part of self awareness

34. Sex-role identity • Part of the adolescents’ identity formation is the development of: • sexual identity • Sexual orientation

35. 1. sexual identity • Young adolesce involve forming close friendships with same-sex peers • Begin to make shift from relationship with same peers to intimate relationships with members of the opposite sex during middle adolescence

36. 2. Sexual orientation • A pattern of sexual arousal or romantic attraction towards persons of opposite gender (heterosexual) • Dimensions: • Attraction • Fantasy • Actual sexual behavior • Self-labeling or group affiliation

37. Health concerns of adolescents

38. Health concerns of adolescents • Health professionals who work with adolescents should consider their increasing independence and responsibility while maintaining privacy and confidentiality • Parents also should respect their teenage independence • Adolescents can keep their health appointments, take prescribed medications independently, perform procedures when necessary, etc.

39. Nurses should address the following health concerns with adolescents: • Emotional wellbeing (e.g., mood swings, depressions) • Physical growth and development • Social and academic competence (e.g., relationships with peers, family, school performance) • Risk reduction behaviors (e.g., smoking) • Violence and injury prevention

40. Emotional wellbeing

41. Emotional wellbeing • mood swings are common • On minute they enthusiastic, the next minute they are depressed • Therefore, they are frequently labeled as unstable and unpredictable • According to the adolescents interpretation small things can mean a great deal

42. Emotional wellbeing • early adolescents: react immediately and emotionally • Older adolescents: better control of their emotions can approach problems more calmly Often use rational thinking in solving problems

43. Emotional wellbeing To promote emotional health and psychological adjustment, nurses can encourage adolescents to develop • Skills to cope with stress and changes (e.g., school or body changes) • skills to become involved in personally meaningful activities (e.g., exercise, playing music, journal wrtitng)

44. Intentional and unintentional injury

45. risk-taking behaviors and feeling of indestructability make adolescents especially prone to injuries • Leading causes of injury in adolescents include: • Vehicle crashes • Firearms • Drowning • Poisoning (often with substances or drugs) • Burns • Falls

46. Factors contributing to higher rates of car-crashes among adolescent drivers include: • Lake of driving experience • Speeding and driving too fast • Using alcohol • Using cellphones or texting while driving

47. Dietary habitseating disorders and obesity

48. Factors influencing eating habits in adolescents • Puberty: accelerated growth double the adolescents nutritional requirements • Growing independence • Need for peer acceptance • Concern with physical appearance • Active lifestyle

49. Common eating habits in adolescents: • Omitting breakfast • Snacks selected based on accessibility rather than nutritional merits • Excess intake of food high in calories, sugar, fat, and sodium (burgers, beverages, potato fries, and shawarma) • Inadequate intake of certain vitamins (folic acid, B12, Vit A) • Low intake of minerals (Ca, Zinc, Iron)—Milk is usually replaced by beverages and soft drinks (cola)

50. The problems of overeating or undereating • Both problems are common among adolescents • Undereating is common among girl adolescents, less common among boys • The desire for slim figure and fear of becoming fat contribute to undereating and malnutrition among girls • Boys on the opposite are concerned about gaining size and strength, leading to overeating food high in calories but low in nutrients