Introduction Al Adolescente ( Spanish)
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This document provides guidance on conducting an adolescent visit and summarizes key points to address. It outlines establishing confidentiality and using open-ended questions to obtain a thorough psychosocial history using the HEADS framework. This covers Home, Education, Activities, Diet, Drugs, Depression, Sexuality, and Safety. The physical exam and screening tests should consider the adolescent's stage of development and risk factors. The visit should conclude by discussing strengths, health promotion, anticipatory guidance, and encouraging follow-up.
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AdolescencePhysical & CognitiveDevelopmentSources.docx
Adolescence*
Physical & Cognitive
Development
Sources include: Boyd & Bee (2012) “Lifespan Development”
Defining Adolescence
Challenging: Synonymous with teenage years?
Physical changes may occur by age 9
Level of increased maturity/responsibility
Transitional Period (Childhood – Adult)
Def. Puberty - Collective term for all physical changes (seen/unseen)
required for reproductive maturity
Prefrontal Cortex
Changes in Brain
13 - 15 years:
Cortex thickens
Neural pathway efficiency increases
Increased energy produced/consumed
Just before Puberty
Synapses from Cortex form w/ other parts of brain
Changes in Brain
At Approx. 17 years – beginning Early Adulthood
Frontal lobes (logic/planning) more developed
Still, limited
Prefrontal Cortex (PFC)
Executive Functioning – control & organize thought processes
Impulse Control Won’t be complete until mid 20s
May lead to impulsive actions
(Not well thought out- consequences)
Body Systems
Adolescents: may grow 3 - 6 inches/year
Full adult height:
Girls: by 16 years
Boys: by 18 – 20 years
Cephalocaudal/Proximodistal Dev - “Reversed”
Hands/feet full adult size before arms/legs
Shoe size rapid changes - signal of puberty
Muscle mass differences:
Men - 40% of total body mass is muscle
Women - 24%
Milestones of Puberty
Pituitary Gland (Master Gland – controls all glands)
Signals Adrenal Gland to increase “Androgen”
Adrenarche – begins around aged 7-8
Hormone that stimulates growth of:
Ovaries (Girls) - Estradiol (Form of estrogen)
Testes (Boys) - Testosterone
Pituitary Gland
Pituitary Gland (cont.)
Pituitary gland secretes two other hormones:
Thyroid Stimulating Hormone
General Growth Hormone
Two sets of body changes triggered:
1. Development of sex organs
2. General changes in brain, bone, muscles…
Puberty:
Physical Changes
Physical change most obvious and most associated with adolescence is sexual maturity
Primary Sex Characteristics
Females - Ovaries, Uterus, Vagina
Males - Testes, Penis
Secondary Sex Characteristics
Females – Breast development, body hair
Males – Voice pitch, facial hair, body hair
AGING – Biological / Psychological / Social
Sexual Development:
Females
First Menstruation (Menarche):
Tends to occur 2 years after other visible changes
10% females experience Menarche before age 11
90% females by age 14
Still possible to become pregnant after menarche
However, irregular cycles initially
Approx. 2-3 years after Menarche – no Ovum released
Full adult development takes years
Historical Trends
Timing of menarche
Between 1850 – 1950 (approx. 4 mos./decade earlier)
1840: age 17 years (Dropping 4 months/decade until 1950s)
Secular TrendChanges that occur in developing nations when nutrition and health improve.
Lifestyle/Diet:
Increases in protein and fat consumption
N. Korean refugee camps (limited food): age 16
Critical value: 17% body fat
Sexual Development:
Males
First Ejaculation (Spermarche)
Typically between 13-14 years.
Adolescent growth and development - Dr. Prarthana Das, Pediatrics
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