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Jimma University College of Health Sciences
Population and Family Health Department
Course Title: ASRH(Growth & Development)
By- Abebe H.
1
Adolescent Growth and
Development
2
Objectives
• At the end of this section you will be able to
– Define adolescence and adolescent period
– Describe general principles of adolescent
development
– Describe adolescent growth and development with
their components
3
4
Introduction
What is adolescence?
5
• Adolescence is
– Period of transition from childhood to adulthood
– A time of profound
• biologic
• intellectual and
• psychosocial change
• During this period, individuals
– reach to physical and sexual maturity
– develop more sophisticated reasoning and decision
making abilities
– development of adult mental processes and adult identity
– socioeconomic dependence to relative independence
6
Introduction…
Intro…
• Adolescence is a period of
– sexual development
– psychological development
– socio-economic development
7
Introduction….
8
Age related definitions
WHO classified age group:
Young people
10 24
Adolescent
10 19
Youth
15 24
9
Intro…
• Adolescence is a joyful and creative time
• Youth can be a boundless national and international
resources if:
– nurtured carefully and
– their energies are channelled in positive directions
(demographic dividend )
10
Intro…
Growth and development in adolescence
11
Development in adolescence
12
• General principles of development
– Gradual replacement of simple by complex structures and
functions
– Continuous
– It is dependent upon the interaction between genetics and
environmental factors
– (Epigenetic principles)
– Adolescents are no longer children, not yet adults
Development…
• Adolescence is a distinct phase of
development
• The most rapid phase of human dev’t
–It has three phases
• Early  10-13
• Middle  14-16 years
• Late 17-19
• Understanding this phase can promote
health development
13
Development…
• Early adolescence (10-13) is characterized by
– a spurt of growth, and the beginnings of sexual
maturation
– have concrete, black-and-white thinking(“egocentrism”
– Onset of puberty and rapid growth
– Impulsive ,experimental behavior
– Adolescent sphere of influence extends beyond her/his
own family
– Increasing concern with image and acceptance by peers
14
• Mid-adolescence (14-15) is characterized by
– Continues physical growth and development
– completion of main physical changes
– Starts to challenge rules and test limits
– Develops more analytical skills
– development of a stronger individual sense of identity
– relating individual (his/her) identity strongly to his or
her peer group
– more reflective thinking( techniqual, practical and
critical)
15
In late adolescence (16-19)
– Body fills out and takes its adult form
– Reaches physical and sexual maturity
– Developing greater self identification
– Reintegration into family
– Has a distinct identity and more settled ideas
and opinions
– These changes take place at a different rate for
each individual 16
Characteristics of Adolescence
1.Biological growth and development
-marked by beginning of puberty
-Voice changes
-development of sexual characteristics and
- Specific hormones are released
17
Characteristics of Adolescence
2.Undefined Status
-Unclear social expectations
some treated as children ,some as adult
-Allow marry? Allow vote? driver license?
3.Increased decision making
-more decisions must be made by oneself
18
Characteristics of Adolescence
4.Increased pressure
-It is the strongest
-Parents, friends, and teachers all pressure
adolescents to behave in particular way
5. Search for self
-finding oneself
-preparing for future roles
-Anticipatory socialization(learning the rights,
obligation, and expectations assuming role in the future)
19
• As teens move from early to late adolescence
– they experience three major stages of developments:
• Physical growth
== biological and physical changes
 puberty
• Cognitive development
== thinking ability
concrete to abstract
• Psychological and social development
== interactions and understanding of each other
20
Development…
Physical growth and development
• Adolescents experience changes in their physical
development
• The physical and biological changes of adolescence are
often referred to as puberty
• Puberty is only one component of adolescent development
• defines the onset of adolescence
• most visible and tangible developmental changes
occur during this period
21
Physical growth...
• Puberty is
– A significant marker of
• biological growth and development
• physical transformation during adolescence
– Biological changes occur during puberty including
• sexual maturation
• increases in height and weight
• completion of skeletal growth accompanied by a marked
increase in skeletal mass and
• changes in body composition
22
• The sequence of these events during puberty is consistent
among adolescents
• However, differences may exist in the
–age of onset
–duration and speed of these events between and
within individuals.
• For this reason, adolescents of the same chronological age
can vary greatly in physical appearance
Consequently, sexual maturation should be used to assess the
extent of biological growth and development
23
Physical growth…
• The beginning of puberty can vary by individual especially by
gender
• Instance
– for girls, it can start as early as 8 years and continue until
age 16
– for boys it may begin when they are 11 and extend until
they are 18
(Brittany Allen, MD, FAAP & Helen Waterman, DO)
24
Physical growth…
• Rapid gains in height and weight
• height velocity increases sharply, reaching its peak in
mid-puberty, prior menarche in girls and sperm
production in boys
• weight gain results from increased muscle
development for boys and body fat in girls
25
Physical growth…
• Development of 2ry sexual characteristics – changing
hormonal levels play a role in activating the development of 2ry
sex characteristics
• The progression of 2ry sexual characteristics – described by
Marshall and Tanner
• Sexual Maturity Rating (SMR)
–used to assess the extent of biological growth and
development among adolescents regardless of
chronological age
26
Physical growth…
 Help health professionals to measure degree of pubertal
maturation regardless of chronological age
• SMR criteria differs based on gender
– for boys –
–appearance of pubic hair and
–testicular and penile development
– for girls –
–appearance of pubic hair
–development of breasts and
–occurrence of menarche
27
Physical growth...
• SMR stage 1:
– corresponds with prepubertal growth and development
• SMR stages 2-4:
– indicate the progression of puberty
• By SMR stage 5:
– sexual maturation has been completed
• Sexual maturation correlates remarkably with
– changes in weight and body composition and
– hormonal changes
28
Physical growth...
SMR for Boys
Genital development Stage Pubic hair growth
Pre-pubertal:
no change in size of genital organs.
1 Pre-pubertal:
no pubic hair.
Enlargement of scrotum and testes; change in
texture in skin of scrotum.
2 Sparse growth of hair at base of
penis.
Enlargement of penis; growth of testes and
scrotum.
3 Darkening, coarsening and
curling, increase in amount.
Enlargement of penis; growth of
testes and scrotum; darkening of
scrotal skin.
4 Resembles adult type but not
spread to medial thighs.
Adult size and shape genitalia. 5 Adult type and quantity, spread to
medial thighs.
29
SMR for Girls
Breast development Stage Pubic hair growth
Pre-pubertal:
nipple elevation only
1 Pre-pubertal:
no pubic hair.
Small, raised breast bud 2 Sparse growth of hair along
labia
General enlargement of raising of breast and
areola
3 Pigmentation, coarsening
and curling, with an increase in
amount
Further enlargement with projection of areola
and nipple as secondary mound
4 Resembles adult type,
but not spread to medial thighs
Mature, adult contour, with areola in same
contour as breast, and only nipple projecting
5 Adult type and quantity, spread
to medial thighs
30
Cognitive development
• The mental process includes
– awareness
– perception
– reasoning and
– judgment
• The early adolescence stage is a time of great cognitive
development
• At the beginning of adolescence
– cognitive abilities are dominated by
• concrete thinking
• egocentrism and impulsive behavior
31
Cognitive development…
• Gradually develop advanced reasoning skills
– ability to think about multiple options and possibilities
– more logical thought process
– ability to think about things hypothetically –
• it involves:
– asking and answering the question, “what if...?”
• Develop abstract thinking skills:
– thinking about things that cannot be seen, heard or touched…..E.g.,
faith, trust, beliefs and spirituality. 32
Psychosocial development
• Psychological development includes:
– individuals’ interactions and understanding of each other
– understanding of their own knowledge and
– understanding of themselves as members of society
• There are five main psychological and social issues during
adolescence:
1. Forming an identity
– Incorporates important task of adolescent:
• become aware of what they like to do,
• begin to integrate the opinion of others into their likes and
dislikes (in terms of idea)
33
Psychosocial development…
2. Becoming independent (autonomous)
– Emotional autonomy:
• establishment of close relationships,
• begin to give consideration to the needs and wants of others and
weigh personal priorities.
– Behavioral autonomy:
• ability to make independent decisions,
• usually turn to peers for social matters
– Value autonomy:
• development of a set of principles about right and wrong,
• may challenge family and societal values
34
3. Seeking intimacy
– expanding relationships with peers and developing romantic
interests
4. Exploring sexuality
– begin to experiment with sexual behaviors and seek out
intimate relationships
5. Achieving goals and milestones
– Need to figure out:
– what their achievement preferences are,
– what they are currently good at,
– areas in which they are willing to strive for success.
35
Psychosocial development…
Eight stages of psychosocial development
(Erikson (1958, 1963 ) theory)
-Personality develops through eight stages
of psychosocial development, from infancy to
adulthood
-During each stage, the person experiences a
psychosocial crisis
-Psychosocial nature involve psychological needs of
the individual (i.e., psycho) conflicting with the
needs of society (i.e. social)
36
Erikson theory…
-successful completion of each stage results the
acquisition of basic virtues
-Failure to successfully complete a stage can result
unhealthy personality
- Can be resolved successfully at later
37
38
Stage Psychosocial Crisis Basic Virtue Age
1. Trust vs. Mistrust Hope 0 - 1½
2. Autonomy vs. Shame Will 1½ - 3
3. Initiative vs. Guilt Purpose 3 – 5
4. Industry vs. Inferiority Competency 5 – 12
5. Identity vs. Role Confusion Fidelity 12 – 18
6. Intimacy vs. Isolation Love 18 – 40
7. Generativity vs. Stagnation Care 40 – 65
8. Ego Integrity vs. Despair Wisdom 65+
Industry vs. Inferiority
- Eagerness of learning to read and write, to do
sums, to do things on their own
- Teachers, peer group …major source of the child’s
self-esteem
- Need to win approval by demonstrating specific
competencies that are valued by society
If encouraged and reinforced begin to feel
industrious (competent)
Success in this stage lead to the virtue of
competence
Restricted----- develop a sense of Inferiority 39
Identity vs. Role Confusion
-It occurs during adolescence, from about 12-18 years
- Adolescents search for a sense of self and personal
identity
- Intense exploration of personal values, beliefs, and
goals
- Major stage of development where the child has to
learn their roles, occupy as an adult
40
- 2 identities involved(sexual & occupational)
Success in this stage lead to the virtue of fidelity
 Fidelity involves being able to commit
 one's self to others on the basis of accepting
others even when there may be ideological
differences
Failure to establish a sense of identity within
society lead to role confusion/identity crisis
"I don’t know what I want to be when I grow up"
41
Why we need to study the characteristics of
adolescents?
42
Desirable health status
-Adequate height and weight for age
-Good nutrition
-Up-to-date with immunizations
-Free of disease and illness
-Emotional support from family/friends
-Ability to avoid substance abuse
-Ability to make an informed decision on sexual activity
-Good self image both in terms of physical appearance and personal
character 43
Rationale
• To understand what is happening:
– physically,
– cognitively and
– socially –
• for parents – to provide a supportive environment for
their teens
• for program managers – to design a program that is
appropriate for adolescents
44
 Ethiopia is at a crucial point
 Facing a large rapid population growth(2.6%/annum)
 Puts tremendous pressure on country’s health service
infrastructure
 The most effective intervention to address the rapid
population growth
 Empower young people to make informed choice on their
RH including their desired fertility
 Young the assets of the country and its future 45
Summary
• Would you please able to
– Define adolescence and adolescent period
– Describe the general principles of adolescent
development
– Describe adolescent growth and development with their
components
– Describe adolescent growth measurement scale/s
– Why the need to study adolescent characteristics
46
Assignment
PROJECT TITLE
 Reduces food shortage during COVID 19 among
street adolescents through strengthen the income
generating activities in Jimma Town, Ethiopia
• Components of the project (at least include)
47
• Introduction
• Background
• Statement of the problem
• Scope and limitations
• Project goals and objectives
• Goals
• Objectives
• Project Activities
• Project sustainability
• References
• Indicators and Targets
48
Thank you for all!!
49

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1. lecture 1.ppt

  • 1. Jimma University College of Health Sciences Population and Family Health Department Course Title: ASRH(Growth & Development) By- Abebe H. 1
  • 3. Objectives • At the end of this section you will be able to – Define adolescence and adolescent period – Describe general principles of adolescent development – Describe adolescent growth and development with their components 3
  • 4. 4
  • 6. • Adolescence is – Period of transition from childhood to adulthood – A time of profound • biologic • intellectual and • psychosocial change • During this period, individuals – reach to physical and sexual maturity – develop more sophisticated reasoning and decision making abilities – development of adult mental processes and adult identity – socioeconomic dependence to relative independence 6 Introduction…
  • 7. Intro… • Adolescence is a period of – sexual development – psychological development – socio-economic development 7
  • 9. Age related definitions WHO classified age group: Young people 10 24 Adolescent 10 19 Youth 15 24 9 Intro…
  • 10. • Adolescence is a joyful and creative time • Youth can be a boundless national and international resources if: – nurtured carefully and – their energies are channelled in positive directions (demographic dividend ) 10 Intro…
  • 11. Growth and development in adolescence 11
  • 12. Development in adolescence 12 • General principles of development – Gradual replacement of simple by complex structures and functions – Continuous – It is dependent upon the interaction between genetics and environmental factors – (Epigenetic principles) – Adolescents are no longer children, not yet adults
  • 13. Development… • Adolescence is a distinct phase of development • The most rapid phase of human dev’t –It has three phases • Early  10-13 • Middle  14-16 years • Late 17-19 • Understanding this phase can promote health development 13
  • 14. Development… • Early adolescence (10-13) is characterized by – a spurt of growth, and the beginnings of sexual maturation – have concrete, black-and-white thinking(“egocentrism” – Onset of puberty and rapid growth – Impulsive ,experimental behavior – Adolescent sphere of influence extends beyond her/his own family – Increasing concern with image and acceptance by peers 14
  • 15. • Mid-adolescence (14-15) is characterized by – Continues physical growth and development – completion of main physical changes – Starts to challenge rules and test limits – Develops more analytical skills – development of a stronger individual sense of identity – relating individual (his/her) identity strongly to his or her peer group – more reflective thinking( techniqual, practical and critical) 15
  • 16. In late adolescence (16-19) – Body fills out and takes its adult form – Reaches physical and sexual maturity – Developing greater self identification – Reintegration into family – Has a distinct identity and more settled ideas and opinions – These changes take place at a different rate for each individual 16
  • 17. Characteristics of Adolescence 1.Biological growth and development -marked by beginning of puberty -Voice changes -development of sexual characteristics and - Specific hormones are released 17
  • 18. Characteristics of Adolescence 2.Undefined Status -Unclear social expectations some treated as children ,some as adult -Allow marry? Allow vote? driver license? 3.Increased decision making -more decisions must be made by oneself 18
  • 19. Characteristics of Adolescence 4.Increased pressure -It is the strongest -Parents, friends, and teachers all pressure adolescents to behave in particular way 5. Search for self -finding oneself -preparing for future roles -Anticipatory socialization(learning the rights, obligation, and expectations assuming role in the future) 19
  • 20. • As teens move from early to late adolescence – they experience three major stages of developments: • Physical growth == biological and physical changes  puberty • Cognitive development == thinking ability concrete to abstract • Psychological and social development == interactions and understanding of each other 20 Development…
  • 21. Physical growth and development • Adolescents experience changes in their physical development • The physical and biological changes of adolescence are often referred to as puberty • Puberty is only one component of adolescent development • defines the onset of adolescence • most visible and tangible developmental changes occur during this period 21
  • 22. Physical growth... • Puberty is – A significant marker of • biological growth and development • physical transformation during adolescence – Biological changes occur during puberty including • sexual maturation • increases in height and weight • completion of skeletal growth accompanied by a marked increase in skeletal mass and • changes in body composition 22
  • 23. • The sequence of these events during puberty is consistent among adolescents • However, differences may exist in the –age of onset –duration and speed of these events between and within individuals. • For this reason, adolescents of the same chronological age can vary greatly in physical appearance Consequently, sexual maturation should be used to assess the extent of biological growth and development 23 Physical growth…
  • 24. • The beginning of puberty can vary by individual especially by gender • Instance – for girls, it can start as early as 8 years and continue until age 16 – for boys it may begin when they are 11 and extend until they are 18 (Brittany Allen, MD, FAAP & Helen Waterman, DO) 24 Physical growth…
  • 25. • Rapid gains in height and weight • height velocity increases sharply, reaching its peak in mid-puberty, prior menarche in girls and sperm production in boys • weight gain results from increased muscle development for boys and body fat in girls 25 Physical growth…
  • 26. • Development of 2ry sexual characteristics – changing hormonal levels play a role in activating the development of 2ry sex characteristics • The progression of 2ry sexual characteristics – described by Marshall and Tanner • Sexual Maturity Rating (SMR) –used to assess the extent of biological growth and development among adolescents regardless of chronological age 26 Physical growth…
  • 27.  Help health professionals to measure degree of pubertal maturation regardless of chronological age • SMR criteria differs based on gender – for boys – –appearance of pubic hair and –testicular and penile development – for girls – –appearance of pubic hair –development of breasts and –occurrence of menarche 27 Physical growth...
  • 28. • SMR stage 1: – corresponds with prepubertal growth and development • SMR stages 2-4: – indicate the progression of puberty • By SMR stage 5: – sexual maturation has been completed • Sexual maturation correlates remarkably with – changes in weight and body composition and – hormonal changes 28 Physical growth...
  • 29. SMR for Boys Genital development Stage Pubic hair growth Pre-pubertal: no change in size of genital organs. 1 Pre-pubertal: no pubic hair. Enlargement of scrotum and testes; change in texture in skin of scrotum. 2 Sparse growth of hair at base of penis. Enlargement of penis; growth of testes and scrotum. 3 Darkening, coarsening and curling, increase in amount. Enlargement of penis; growth of testes and scrotum; darkening of scrotal skin. 4 Resembles adult type but not spread to medial thighs. Adult size and shape genitalia. 5 Adult type and quantity, spread to medial thighs. 29
  • 30. SMR for Girls Breast development Stage Pubic hair growth Pre-pubertal: nipple elevation only 1 Pre-pubertal: no pubic hair. Small, raised breast bud 2 Sparse growth of hair along labia General enlargement of raising of breast and areola 3 Pigmentation, coarsening and curling, with an increase in amount Further enlargement with projection of areola and nipple as secondary mound 4 Resembles adult type, but not spread to medial thighs Mature, adult contour, with areola in same contour as breast, and only nipple projecting 5 Adult type and quantity, spread to medial thighs 30
  • 31. Cognitive development • The mental process includes – awareness – perception – reasoning and – judgment • The early adolescence stage is a time of great cognitive development • At the beginning of adolescence – cognitive abilities are dominated by • concrete thinking • egocentrism and impulsive behavior 31
  • 32. Cognitive development… • Gradually develop advanced reasoning skills – ability to think about multiple options and possibilities – more logical thought process – ability to think about things hypothetically – • it involves: – asking and answering the question, “what if...?” • Develop abstract thinking skills: – thinking about things that cannot be seen, heard or touched…..E.g., faith, trust, beliefs and spirituality. 32
  • 33. Psychosocial development • Psychological development includes: – individuals’ interactions and understanding of each other – understanding of their own knowledge and – understanding of themselves as members of society • There are five main psychological and social issues during adolescence: 1. Forming an identity – Incorporates important task of adolescent: • become aware of what they like to do, • begin to integrate the opinion of others into their likes and dislikes (in terms of idea) 33
  • 34. Psychosocial development… 2. Becoming independent (autonomous) – Emotional autonomy: • establishment of close relationships, • begin to give consideration to the needs and wants of others and weigh personal priorities. – Behavioral autonomy: • ability to make independent decisions, • usually turn to peers for social matters – Value autonomy: • development of a set of principles about right and wrong, • may challenge family and societal values 34
  • 35. 3. Seeking intimacy – expanding relationships with peers and developing romantic interests 4. Exploring sexuality – begin to experiment with sexual behaviors and seek out intimate relationships 5. Achieving goals and milestones – Need to figure out: – what their achievement preferences are, – what they are currently good at, – areas in which they are willing to strive for success. 35 Psychosocial development…
  • 36. Eight stages of psychosocial development (Erikson (1958, 1963 ) theory) -Personality develops through eight stages of psychosocial development, from infancy to adulthood -During each stage, the person experiences a psychosocial crisis -Psychosocial nature involve psychological needs of the individual (i.e., psycho) conflicting with the needs of society (i.e. social) 36
  • 37. Erikson theory… -successful completion of each stage results the acquisition of basic virtues -Failure to successfully complete a stage can result unhealthy personality - Can be resolved successfully at later 37
  • 38. 38 Stage Psychosocial Crisis Basic Virtue Age 1. Trust vs. Mistrust Hope 0 - 1½ 2. Autonomy vs. Shame Will 1½ - 3 3. Initiative vs. Guilt Purpose 3 – 5 4. Industry vs. Inferiority Competency 5 – 12 5. Identity vs. Role Confusion Fidelity 12 – 18 6. Intimacy vs. Isolation Love 18 – 40 7. Generativity vs. Stagnation Care 40 – 65 8. Ego Integrity vs. Despair Wisdom 65+
  • 39. Industry vs. Inferiority - Eagerness of learning to read and write, to do sums, to do things on their own - Teachers, peer group …major source of the child’s self-esteem - Need to win approval by demonstrating specific competencies that are valued by society If encouraged and reinforced begin to feel industrious (competent) Success in this stage lead to the virtue of competence Restricted----- develop a sense of Inferiority 39
  • 40. Identity vs. Role Confusion -It occurs during adolescence, from about 12-18 years - Adolescents search for a sense of self and personal identity - Intense exploration of personal values, beliefs, and goals - Major stage of development where the child has to learn their roles, occupy as an adult 40
  • 41. - 2 identities involved(sexual & occupational) Success in this stage lead to the virtue of fidelity  Fidelity involves being able to commit  one's self to others on the basis of accepting others even when there may be ideological differences Failure to establish a sense of identity within society lead to role confusion/identity crisis "I don’t know what I want to be when I grow up" 41
  • 42. Why we need to study the characteristics of adolescents? 42
  • 43. Desirable health status -Adequate height and weight for age -Good nutrition -Up-to-date with immunizations -Free of disease and illness -Emotional support from family/friends -Ability to avoid substance abuse -Ability to make an informed decision on sexual activity -Good self image both in terms of physical appearance and personal character 43
  • 44. Rationale • To understand what is happening: – physically, – cognitively and – socially – • for parents – to provide a supportive environment for their teens • for program managers – to design a program that is appropriate for adolescents 44
  • 45.  Ethiopia is at a crucial point  Facing a large rapid population growth(2.6%/annum)  Puts tremendous pressure on country’s health service infrastructure  The most effective intervention to address the rapid population growth  Empower young people to make informed choice on their RH including their desired fertility  Young the assets of the country and its future 45
  • 46. Summary • Would you please able to – Define adolescence and adolescent period – Describe the general principles of adolescent development – Describe adolescent growth and development with their components – Describe adolescent growth measurement scale/s – Why the need to study adolescent characteristics 46
  • 47. Assignment PROJECT TITLE  Reduces food shortage during COVID 19 among street adolescents through strengthen the income generating activities in Jimma Town, Ethiopia • Components of the project (at least include) 47
  • 48. • Introduction • Background • Statement of the problem • Scope and limitations • Project goals and objectives • Goals • Objectives • Project Activities • Project sustainability • References • Indicators and Targets 48
  • 49. Thank you for all!! 49