Module-1-Slides-for-sharing-3.pdf

SESSION 1
Module 1: Understanding the Teen 2

Describe the stages of adolescent development (physical,
neurological, cognitive, psychosocial dimensions
3
Module 1: Understanding the Teen

5

• Group 1: Boys 10 – 13 years old
• Group 2: Boys 14 – 16 years old
• Group 3: Boys 17-19 years old
• Group 4: Girls 10 – 13 years old
1. Draw the adolescent
2. Label and draw on what the adolescent
is experiencing in terms of:
‒ Physical: Involving gross and fine motor
skills; control over the body, particularly
muscles and physical coordination
‒ Cognitive: Mental action or process of
acquiring knowledge and understanding
through thought, experience, and the senses
‒ Neurological: Changes in the brain and
nervous system
‒ Psychosocial: Interrelationship of social
factors and individual thought and behavior
6

10 - 19 years of age
- growth spurts and hormonal changes
- increasing levels of individual autonomy
- growing sense of identity and self-esteem
- progressive independence from adults
8

10 – 13 years of age
• Beginning to form their identities
• Signs of physical maturation begins to
appear
9

14 – 16 years of age
•Begins to develop ideals and role models
•Under the strong influence of peers
•Sexual Orientation and possible internal
conflict for non-heterosexual teens

17 – 19 years old
•Acts like adult BUT have not reached cognitive,
behavioral and emotional maturity
•May make decisions independently, employed,
married and with family
•Still benefits from influence of adult role models,
family and social structures to help transition to
adulthood

• Hormonal Changes
• Increase in Height (Growth
Spurt)
• Acquisition of Muscle mass
and distribution of body fat
• Development of secondary
sexual characteristics
- Internal Factors such
as :
§Under-nutrition
§Chronic illness
- External Factors such
as :
§Stress within the
families

• Limbic System: responsible
for pleasure seeking and
reward processing,
emotional response and
sleep regulation
- Analogy: serves as the
“Accelerator” of the vehicle
• Pre-frontal cortex:
responsible for the executive
functions: decision-making
organization, impulse
control and planning for the
future
- Analogy: serves as the
“Brakes” of the vehicle

• Adolescents want greater independence and responsibility,
asserting more autonomy over their decisions, emotions
and actions; disengaging from parental control
• Younger adolescents still developing as they move outside
the confines of their families and make independent
decisions --- from who they spend their time with to what
they eat
• “Self-identity” including that of their sexual identity
increases, with the adolescent concerned about people’s
opinions of them, particularly their peers

•By their 20’s: stronger reasoning skills, logical
and moral thinking. More abstract thinking and
make rational judgments.
•Aware of other people’s perspectives and want
to do something about social issues that they
encounter

Biological Maturity BEFORE Psychosocial maturity
Limbic System/”Accelerator (for sensation seeking behavior) maturing
BEFORE Pre-frontal cortex/”Brakes” (provides capacity of self control)

• MOST RAPID phase in human development
• Individual and Environmental characteristics influence the changes
taking place during adolescence
• Biological maturity comes BEFORE Psychosocial maturity
• Younger adolescents may be particularly vulnerable as their capacities
are still developing while they begin to move outside the confines of
their families
• Changes in adolescence have health consequences OVER THE LIFE
COURSE

•Transition from Childhood to Adulthood with regard
to Disease Burden:
- Onset in puberty (menarche) brings in sexual and
reproductive health problems
- Self-identity issues, may be among the factors of
mental illness
- Rapid growth and adolescent’s incoordination increase
the risk of injuries

• Substance use disorders, mental disorders and injuries,
likely reflects both the biological changes of puberty and
the social context in which young people are growing up
• Increased incidence of certain infectious diseases (e.g.
schistosomiasis) may simply result from the daily activities
of adolescents during this period of their lives
• Adolescent’s health have an impact on their future health
and development. Example: Alcohol Use and Obesity

• Adolescents need explicit attention
• Adolescents are not all the same. Some are more vulnerable than
others
• Adolescent development has implications for adolescent health
and his/her life course
• The changes during adolescence affect how adolescents think and
act

• Adolescents need to understand the processes taking place during
adolescence
• To contribute positively, adults need to understand the processes
taking place during adolescence
• Public health and human rights converge around concepts of
adolescent development

SESSION 2

•Independence
•Body Image
•Peer Relations
•Identity

Early Adolescence Middle Adolescence Late Adolescence
Pulls away from parents and
show less interest in family
activities
Hostile towards parents and
authority figures
Gains confidence with
change in stature
Moody - pleasant then nasty Rebellious nature and risk
behavior
Turns to parents for advice
and guidance but not
necessarily will do what the
parents want
Antagonistic to the “controlling
parent”
Adults find decisions they
made disturbing and are
frustrated that they cannot
control their teens
Most families are
comfortable with the youth’s
individuality and decision
making
Craves for privacy Parent-adolescent
interaction now more adult-
adult

Not sure what to think of the
changes of their body
(pimples, axillary hair,
menstrual cramps) and their
hygienic responsibility
Wants to make the most of
their “new body”
Comfortable with the
changes in their body
Compares self with their
peers (are my breast large
enough?)
Focuses on how they look –
clothing, jewelry and make-
up; as well as taking care of
issues of acne, weight gain
Sexual Relationships become
less exploring and
exploitative, and more loving
and sharing
Increased interest in the
opposite sex
Pelvic exams not that
stressful anymore
Dating and develops skills in
sexual relationships

Peer influence of greater
strength
Teens more comfortable in
their decision making and
independence.
Peer groups do not demand
the same level of
conformity…alright not to
attend the party if they don’t
want to.
Peers demand members to
conform. This reduces stress
in decision making. To do
otherwise, the teen risk being
excluded in the group.
Peer’s influence lessens. Individuality more acceptable
Among the behavior that their
peers would require them to
do are risky behaviors such as
sexual activity, substance
abuse and gang wars.
Adolescent may notice that
some friendships are not as
intense and close anymore.

Values and morals are
similar to parents
Values and morals are
similar to their peers
Values and morals come
back to their family
Sees things “black and
white”.
If nothing happened to her
when she first had sex
without birth control, she
believes she can have
unprotected sex.
Lack of abstract thinking
encourages feelings of
INVULNERABILITY. Teens
believe that nothing bad
will happen to them.
Believes they can have sex,
use drugs, smoke or drive
recklessly without
consequence

• Brain development completed
after the first few years of life.
• 6 year-old brains: 90-95% adult
size
• Remodeling from adolescence up
to mid-20’s

White Matter (Myelin Sheath)
• Insulated cable increases
speed that connects and
transmits ‘messages’
from one part of the
brain to another
• Develops up to middle
age
Gray Matter
•Actual computer
•Thinking, calculating
part of the brain
•Peaks at age 20’s

Unused connections are eliminated
Used connections become more efficient

PHYSIOLOGIC CENTERS EMOTIONAL CENTER COGNITIVE CENTERS
Bottom of the brain Inside of the brain Top and outside of the
brain
Sustains Life Associated with sex,
aggression, attachment
Concerned with thinking,
processing, controlling
or executive functions
Matures Earlier! Continues to develop up
to mid-20’s
Example: amygdala Example: pre-frontal
cortex
What does this mean with regard to the adolescent behavior and decision making?

Determines GOOD vs BAD
Identify future CONSEQUENCES of
current activities and SUPPRESS
IMPULSES
As it matures, it increasingly
connects with limbic system;
allowing reason and emotion to be
better coordinated

• Risk Taking: even if they know that there may be danger in
the action given that it would give them an emotional
high/adrenaline rush they would still take the risk.
• Teen is unable to identify correctly the person’s expression
(e.g. mis-reading the facial expression as confusion rather
than fear) AND responds to the misinterpreted emotion, in
an emotional way.

• Adolescent’s growing ability to
think abstractly outside of
themselves, and see themselves
in the way others see them--
which could contribute to the
feeling of being constantly on
stage and judged that many
adolescents experience
• Abstract Thinking: useful tool
that allows adults to self regulate.
• In ADOLESCENCE: might
contribute to higher vulnerability
to social anxiety and other
emotional disorders

control reasoning,
impulses &
Not fully developed
until about age 25
Without a fully developed
prefrontal cortex,
controlling is a
challenge, specially if it
gives immediate pleasure
or reward to the adolescent
Image credit www.2will.co.nz
Controls rage, and ,
grows in size and mover active as
hormone surges in puberty.
Aside from balance,
motor control and ability
to learn complex motor
sequences, also active in
tasks involving ,
,
and
Not fully developed till 25

center of the brain
is 10% smaller than normal
resulting in lower memory
scores
Reward circuits (
) gets thrown out of
whack. Feeling worse when
not under the influence.
Drugs and alcohol
disrupts healthy brain
development during
growth spurt. Making
and normal
pressures in life difficult

Growth Spurts,
Tanner Stages
Hormonal
Changes
(Menarche, Wet
Dreams)
Impulsive
Behavior
(decreased as
Myelin grows)
Social Anxiety
(Prefrontal
Cortex
Development;
Amygdala)
Identity vs Role
Confusion (12-
18 years old)
Intimacy vs.
Isolation
(19-40 years
old)

SESSION 3

• From the Latin word sexus
• Defined by the gonads, or potential gonads,
either phenotypically or genotypically
• Generally assigned at birth by external
genital appearance, due to the common
assumption that this represents chromosomal
or internal anatomic status
• Male, female but also intersex
• From the Latin word genus, meaning kind or
race.
• Defined by one's own identification as male,
female, or intersex; gender may also be based
on legal status, social interactions, public
persona, personal experiences, and
psychologic setting.
• Refers to the attitudes, feelings, and
behaviors that a given culture associates with
a person’s biological sex

•SO - Sexual Orientation
•GI - Gender Identity
•E - (Gender) Expression
Every person, whether a child or an adult, has a SOGIE.

Meet the Genderbread person
• Sex: the physical sex characteristics the person is born
with and developed, including genitalia, body shape,
voice pitched, body hair
• Sexual Orientation / Attraction: to whom the person
is sexually/romantically attracted to
• Gender Identity: How the person identifies
him/her/themselves
• Gender Expression: The ways the persons presents
their gender, through their actions, dress and
demeanor and how these presentations are
interpreted based on gender norm

From Advocates for Youth
(www.advocatesforyouth,org)

SEXUAL ORIENTATION HAS TO DO WITH THE GENDER OF WHOM WE’RE ATTRACTED TO, PHYSICALLY AND
EMOTIONALLY. WE DON’T CHOOSE OUR FEELINGS JUST LIKE WE DON’T CHOOSE WHO WE FIND ATTRACTIVE.

A PERSON CAN CHOOSE TO LET PEOPLE KNOW THEIR GENDER IN WHATEVER WAY FEELS COMFORTABLE OR RIGHT
TO THEM.

SOME PEOPLE WILL STEREOTYPE ANOTHER PERSON BASED ON THEIR GENDER EXPRESSION.

THIS IS ANOTHER EXAMPLE OF STEREOTYPING.

IT’S IMPORTANT TO REMEMBER THAT THE OUTSIDE DOESN’T ALWAYS HAVE TO MATCH THE INSIDE.

LET’s BREAKOUT
Divide the team into 3 smaller groups:
Group
Female
Male
Non-Binary

LET’s BREAKOUT
Each group will have:
• Facilitator
• Documenter
• Reporter

LET’s BREAKOUT
Identify client’s health issues based on their gender,
answer the following:
• What possible health risks would they have / do they
usually face?
• What services are available for them as “adolescents”?
• What are the challenges/ gaps that can be
encountered when responding to your adolescent?
• What will address the challenges / gaps?

LET’s BREAKOUT for 15 minutes
Reminders:
• Our breakout room is a safe and neutral space.
• We may have biases and respect of ideas is well-
appreciated.
• Your assigned group is your target client.
• Have a 2-minute report based on the
consolidated outputs in the spreadsheet.

Are we ready?

• Video 1:
https://mphdegree.usc.edu/blog/6-ways-gender-affects-health/

• Video 2: https://www.youtube.com/watch?v=CHN3YhMi-5A

To Try To Avoid
Use more gender-neutral terms such as ‘partner’ Avoid asking a female young person or adult if they have a
‘husband/boyfriend’. Avoid asking a male young
person/adult if they have a ‘wife/girlfriend’.
Encourage people to present themselves in ways that feel
right for them and that give them confidence.
Avoid assuming someone’s gender identity
Don’t judge someone’s clothing, appearance or behaviour,
or assume someone’s sexual or gender identity based on
these things.
Only inquire about a person’s sexual orientation if it is
relevant to the service being provided.
Avoid assuming a person’s sexual orientation.
When working with a child, talk with them about: whether
they want this information kept confidential, whether they
would like specific support or more information to connect
with similar peers or to get further advice, how you can
best support them.
Avoid expressing shock or surprise when a child or adult
advises that they are gay, transgender, or any diverse sexual
orientation or gender.

• Challenges in Transgender Healthcare: The Pathology Perspective
Author: Sarika Gupta, FRCPath; Katherine L. Imborek, MD; Matthew D.
Krasowski, MD, PhD, Lab Med. 2016;47(3):180-188.
• Gender Identity
Author: Shuvo Ghosh, MD; Chief Editor: Caroly Pataki, MD more...,
MEDSCAPE
Updated: Mar 16, 2015
• Medical Dictionary
• PRACTICE GUIDE: Children with gender and sexual orientation diversity

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