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Growth and development of adolescence

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Growth and development of adolescence

  2. 2. ADOLESCENCE Is a period of transition between childhood and adulthood. A time of rapid physical, cognitive, social and emotional maturing as the boy prepares for manhood and the girl prepares for womanhood.
  3. 3. Cont.….. Adolescence is generally regarded as the psychologic, social, and maturational process initiated by the pubertal changes. It involves three stages  Early adolescence(11-14yrs) Middle adolescence(15-17yrs) Late adolescence(18-20yrs)
  4. 4. BIOLOGICAL DEVELOPMENT Physical changes of puberty are primarily the result of hormonal activity under the influence of central nervous system.
  5. 5. BIOLOGICAL DEVELOPMENT cont.….. Obvious changes are - Increased physical growth -Development of secondary sexual characters -Physical distinction between the sexes
  6. 6. Cont.…. Primary sex characteristics- The external and internal organs that carry out the reproductive function Secondary sex characteristics- Changes that occur through out the body as a result of hormonal changes
  7. 7. The Tanner scale (also known as the Tanner stages) is a scale of physical development in children, adolescents and adults The scale defines physical measurements of development based on external primary and secondary sex characteristics
  8. 8. Tanners scale
  9. 9. Breasts (female )  Tanner I no glandular tissue: areola follows the skin contours of the chest (prepubertal) [typically age 10 and younger]  Tanner II breast bud forms, with small area of surrounding glandular tissue; areola begins to widen [10-11.5]  Tanner III breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast [11.5-13]  Tanner IV increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast [13-15]  Tanner V breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla. [15+]
  10. 10. Pubic hair (both male and female)  Tanner I no pubic hair at all (prepubertal Dominic state) [typically age 10 and younger]  Tanner II small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora (females) [10– 11.5]  Tanner III hair becomes more coarse and curly, and begins to extend laterally [11.5–13]  Tanner IV Adult-like hair quality, extending across pubis[disambiguation needed] but sparing medial thighs [13–15]  Tanner V hair extends to medial surface of the thighs [15+]
  11. 11. Testis(males)  Tanner I prepubertal (testicular volume less than 1.5 ml; small penis of 3 cm or less) [typically age 9 and younger]  Tanner II testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged [9-11]  Tanner III testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm [11-12.5]  Tanner IV testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10 cm and circumference [12.5-14]  Tanner V testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length [14+]
  12. 12. HORMONAL CHANGES I t is caused by the hormonal influence and control by anterior pitutary in response to the stimulus from hypothalamus. Functions of gonads- 1) Production and release of gamates 1) Secretion of sex appropriate hormones
  13. 13. Cont.……. Estrogen- Feminizing hormone, it is secreted slowly increasing amount until 11yrs. It increases and continuous until about 3yrs after the onset of menstruation. Androgen-Masculinizing hormone, they are secreted in small and gradually increasing amount up to about 7 or 9yrs of age
  14. 14. Usual sequence of maturational changes Girls Boys Breast changes Enlargement of testicles Rapid increase in height and weight Growth of pubic hair, axillary hair, hair on upper lip, hair on elsewhere on body Growth of pubic hair Rapid increase in height Appearance of axillary hair Changes in the larynx and consequently the voice Menstruation (usually begins 2yrs after first signs) Nocturnal emissions Abrupt deceleration of linear growth Abrupt deceleration of linear growth
  15. 15. PUBERTAL DELAY In girls - If breast development has not occurred by age 13 or if menarche has not occurred within 4 years of the onset of breast development. In boys – If no enlargement of the testis or scrotal changes by 13.5-14 years of age ,or if genital growth is not complete 4 years after testicles begin to enlarge.
  16. 16. General growth pattern Boys Girls Increased shoulder width Due to hormonal effect bones are more strong, Broader hip Voice become striking, deep to high tones as a result of enlarged larynx and vocal cords Voice become slightly deeper and considerably fuller Lean body mass Chubby body Muscles well developed Muscle mass increase is proportionate to general tissue growth Sebaceous gland is more active Sebaceous gland is more active Fat deposits present over body parts Fat deposits present over body parts Heavy sweating Less sweating Extremity hairs are more Less extremity hair
  17. 17. THEORIES  Psychosocial development- Identity v/s role confusion  Psychosexual – Genital stage  Cognitive development – Formal operative  Moral development –Internalised set of moral principles  Spiritual development – Deep spiritual concerns
  18. 18. Psychosocial development  Adolescence see themselves as distinct individuals  During this period the adolescent is faced with the problem of group identity.  It is followed by developing a sense of personal identity as opposed to role diffusion  Group identity appears to be essential to the development of a sense of personal identity.
  19. 19. Cognitive development  Cognitive thinking cumulates with the capacity for abstract thinking .  This stage, the period of formal operations, is piaget’s fourth and last stage.  They think beyond the present.  They can imagine a sequence of events that might occur  Thoughts can be influenced by logical principles rather than just their own perceptions and experiences
  20. 20. Moral development  Strong pressure to violate the old beliefs.  Their decision involving moral dilemmas must be based on an internalised set of moral principles .  Late adolescence is characterised by serious questioning of existing moral values and their relevance to society and the individual.
  21. 21. Spiritual development  Adolescent are capable of understanding abstract concepts and of interpreting analogies and symbols.  They are able to empathize, philosophize, and think logically.  Tendency towards introspection and emotional intensity often makes it difficult for others to know what they are thinking.  May reveal deep spiritual concerns.
  22. 22. Social development  Adolescents want to grow up and to be free of parental retrain restraints  They are fearful as they try to comprehend the responsibilities that are linked with independence.  Acceptance by peers, a few close friends, and the secure love of a supportive family are requisites for interpersonal maturation.
  23. 23. Relationship with parents  During adolescence the parent- child relationship changes from protection-dependency to mutual affection and equality.  On the one hand adolescents are accepted as maturing preadults.  On other hand they must conform to regulations and restrictions set by adults.
  24. 24. Cont.…….  Teenagers become more competent, and with this competence come a need for more autonomy.  Parents should use an authoritative style of parenting in which authority is used to guide the adolescent while allowing developmentally appropriate levels of freedom and providing clear, consistent messages regarding expectations
  25. 25. Cont.……..  To gain trust of adolescents, parents must respect their youngster’s privacy, as well as show a sincere interest in what the adolescent believes and feels.
  26. 26. Relationship with peers  The peer group serves as a strong support to teenagers providing them with a sense of belonging and a feeling of strength and power.  To gain acceptance by a group, younger teenagers tend to confirm completely in such things as mode of dress, hairstyle, taste in music and vocabulary
  27. 27. Cont.………  Within the larger groups smaller, distinct, and rather exclusive crowds or cliques of selected close friends who are emotionally attached to each other.  Cliques are usually made up of one sex, and girls tend to be more cliquish than boys.  To be ignored or criticized by peers creates feelings of inferiority, inadequacy and incompetence
  28. 28. Interest and activity  Adolescent spend a large amount of time engaging in leisure time activities.  In addition to providing teenagers with fun and enjoyment, leisure time activities assist in the development of social, physical, and cognitive skills.  Leisure time activities also allow teenagers the opportunity to learn to set priorities and structure their time.
  29. 29. Nutrition  Increased nutritional requirements.  The calorie and protein requirement during this time are higher than at almost any other time of life.  There is a substantial increase in the need for the minerals, calcium, iron, and zinc for the generation of both skeletal and bone tissue.
  30. 30. Cont.…..  Girls with very heavy or frequent menses may be especially susceptible for iron deficiency resulting from blood loss.  Dietary intervention should promote the regular consumption of breakfast and a balanced intake of a variety of foods.
  31. 31. Nutritional requirements for adolescents  Calories  The average teenage boy get about 2,800 calories per day and the average teenage girl get about 2,200 calories a day.  Grains  All teens should aim to get at least half of their grains from whole grain products.  girls who are between the ages of 14 and 19 should get 6 oz and boys between the ages of 14 and 19 should get 9 oz. (1 OZ = ½ CUP)
  32. 32. CONT…..  Protein  All teenage girls should get 5 oz. equivalents of protein each day. Teenage boys who are 13 should also get 5 oz. of protein a day, and teenage boys older than 13 should get 6 ½ oz. equivalents.  All teenagers, regardless of age or gender, should get 3 cups of dairy each day.
  33. 33. Sleep and rest  Rapid physical growth the tendency towards overexertion, and the overall increased activity of this age contribute to fatigue in adolescents.  Teenagers vary in there need for sleep and rest.  Adequate sleep and rest at this time are important to a total health regimen.
  34. 34. Exercise and activity  Many adolescents participated in sports within the school.  The practice of sports, games and even dancing contributes significantly with growth and development, the educational process, and better health.
  35. 35. CONT….  The activities provide exercise for growing muscles, interactions with peers, and a socially acceptable means of enjoying stimulation and conflict.  Competitive activities provide teenagers a sense of self-appraisal and development of self-respect
  36. 36. Immunization TT Booster at 10 and 16 years Rubella As part of MMR vaccine or (Monovalent) 1 dose to girls at 12-13 years of age, if not given earlier MMR 1 dose at 12-13 years of age. (if not given earlier) Hepatitis B 3 Doses (0, 1 and 6 m) if not given earlier Typhoid TA, Vi or Oral typhoid vaccine every 3 years Varicella* 1 dose upto 12-13 years, and 2 doses after 13 years of age. (if not given earlier) Hepatitis A* 2 doses (0 and 6 months) if not given earlier
  37. 37. Dental health  Dental health should not be neglected during adolescence, although the rate of caries formation is not as great as in childhood. Early adolescence is usually when corrective orthodontic appliances are worn, and these are frequently a source of embarrassment and concern to the youngsters.
  38. 38. Personal care  Body changes associated with puberty bring special needs for cleanliness.  The hyperactive sebaceous glands and newly functioning apocrine glands make frequent bathing or showering a necessity, and underarm deodorants assume an important place in personal care
  39. 39. Sexuality education and guidance  The development of primary and secondary sex characteristics and the increased sensitivity of the genitals produce thoughts and fantasies about sexual relationship.  The responsibility for providing sex education has been assumed by parents, schools, churches , community agencies and health professionals.  Sexuality education should consist of instruction concerning normal body functions and should be presented in a straight forward manner using correct terminologies.
  40. 40. CONT……  When discussing sex and sexual activities, nurse should use simple but correct language, not highly scientific terminology or evasive jargon.  Teenagers need to discuss intercourse,and how to resist peer pressure, prevention of sexually transmitted disease and also value education.  Make them to develop decision making skills and problem solving so that they can anticipate negative and positive outcomes of a decision
  41. 41. Injury prevention  Physical injuries are the common cause for death in adolescent age group.  The most vulnerable age are 15-25yrs  Accidental injuries accounts for 60% in boys and 40% in girls.  Educate the child regarding safety precautions.  They must also help to initiate and develop prevention strategies that will decrease the number and severity of these injuries.
  42. 42. ANTICIPATORY GUIDANCE  Encourage parents to:  Accept adolescent as individual.  Respect their ideas, likes and dislikes.  Listen their views  Avoid comparing with other children  Avoid criticism about no win topics  Provide opportunity to select solutions and accept their consequences.
  43. 43. Cont….  Encourage learning by doing.  Respects adolescent privacy.  Try to make the communication clear.  Provide clear reasonable limits.  Avoid comparison with sibling.  Assist them in selecting appropriate career goals and prepare them for adult role.  Provide unconditional love.  Be willing to apologize when mistaken.