Prepared by dr. Hoda Abd el azim Adolescence Prepared by dr. Hoda Abd el azim

Learning outcomes Identify physical and hormonal changes during adolescent. State the reliable signs of puberty. Differentiate between boy and girls growth. Identify the signs of sexual maturity Discus nutrition and eating disorders of adolescent. Identify cognitive development during adolescent. Discus psychosocial relation of adolescent.

Adolescence Developmental transition between childhood and adulthood entailing major physical, cognitive and psychosocial changes. Early adolescence ( 10-14 years) Middle adolescence ( 14- 18) Late adolescence ( 18-19years) Puberty Process by which a person attains sexual maturity and ability to reproduce.

Puberty : the end of childhood Physical development Puberty : the end of childhood The biological changes of puberty include. Rapid growth in hight, weight. Changes in body proportions and form. Sexual maturity

How puberty begins? (Hormonal changes) Puberty begin with a sharp increase in production of sex related hormones, and tack place in two stage. First stage (Adrenarche) : maturing the adrenal gland. The adrenal gland secrete androgens Growth of pubic, axillary and facial hair. Faster body growth. Oilier skin. Development of the body odor.

Girls ovaries secrete estrogen: Second stage (Gonadarch): ( maturing the sex organs) Girls ovaries secrete estrogen: Stimulate growth of female genitals and breast. In boy the testes secrete testosterone: Stimulate growth of male genitals, muscle mass and body hair. Testosterone in the girls influence growth of the clitoris, bones and pubic and axillary hair. Boy and girls have both type of hormones. Girls have higher level of estrogen. Boy have higher level of androgen.

Timing, sequence and signs of puberty and sexual maturity. Process of puberty begins up to three years earlier in girls than in boys. The average age for boy’s entry into puberty is 10-11, or may be begin between 9- 16. Most girls begin to show pubertal changes at 9 – 10 years of age, and may be early as 6 or as late as 13 or 14.

Physical changes during puberty Development of pubic hair Deepening of the voice Spurt and muscular growth. Maturation of reproductive organs: Beginning of menstruation in girls. Production of sperm in boys.

Primary sex characteristics (Biological changes) Growth and maturation of primary sex organs during puberty necessary for reproduction. In the female Ovaries, fallopian tubes, uterus, and vagina. In male Testes, penis, scrotum, seminal vesicles and prostate gland. In the boy the first signs of puberty is the growth of testes and scrotum, in girls not apparent because these organs are internal

Secondary sex characteristics Reliable signs of puberty In girls Growth of breasts (enlarge nipples and areola). Rounded shape. In boys The voice deepens, broad shoulders, muscular development. Oilier skin. Acne is more common due to increase level of testosterone. Growth of pubic, facial, axillary and body hair.

Factors influences the onset of puberty. Children who are healthier. Better nourished Better cared

Adolescent growth spurt. A rapid increase in height and weight begins at: In girls : 9.5 and 14.5 years. In boys : 10.5 and 16 years Girls growth spurt usually occurs earlier than boys. Girls between age 11-13 tend to be (taller, heavier, and stronger than boys the same age. Both girls and boys reach full height by age 18

Boy and girls growth differently In boys Shoulder wider. His leg longer relative to his trunk. Forearms longer relative to his upper arms and his height. In girls pelvis widens to make childbearing easier. Layers of fat accumulate under her skin, giving her rounded appearance.

Signs of sexual maturity In boy The first ejaculation (spermarche) occurs at an average age of 13 Involuntary ejaculation of semen. In girls The first menstruation (menarche), normal time can vary from ages 10-16.5.

Psychological effects of the timing of puberty and sexual maturation Early or late maturation are most likely to be negative effect when adolescent are much more or less developed than their peers.

Specific health concerns Physical activity needs Exercise or lack of it affects both physical and mental health. Improves strength and power. Help build healthy bones and muscles. Help control weight. Reduce anxiety and stress. Increase self confidence and well being.

2. Sleep needs Many adolescent do not get enough sleep. Average nighttime sleep declines from 10 hours at age 9 to 8 hours at age 16. Adolescents tend to be sleepy during daytime even when they sleep full nine hours. A pattern of late bedtimes and over sleeping in the morning can contribute to insomnia, daytime naps.

Why do adolescents stay up late? Need to do homework. Want to talk on the phone with friends. Adolescents undergo a shift in the brain’s natural sleep cycle.

3.Nutrition and eating disorders Obesity / overweight The average teenage girl needs about 2,200 calories per day, The average teenage boy needs about 2,800 calories per day. Many adolescents eat more calories than expend and thus accumulate excess body fat.

Overweight or obese teenagers tend to be in poorer health than their peer and more have functional limitations as: Difficulty attending school. Engaging in strenuous activity. They have risk for High cholesterol Hypertension Diabetes Obese adult

Body image and eating disorders Normal increase in girls body fat during puberty become unhappy and dissatisfaction about their appearance. Boys who are becoming more muscular become more satisfied with their body.

Other eating disorders Anorexia nervosa (self starvation ). Bulimia nervosa ( eating within short time and then try to undo the high caloric intake with self induced vomiting, strict dieting. Adolescent with bulimia are obsessed with their weight and shape and they have low self esteem and a history of wide weight fluctuation, dieting.

Bulimia nervosa

Peer influence on smoking and drinking. Adolescents who begin smoking by age 11 are engage to risky behaviors: Riding in a car with drinking driver Carrying knives or guns to school. Using inhalants or cocaine. Making suicide plans. Early use of alcohol Peer influence on smoking and drinking.

Cognitive development Adolescents not only look different from younger children, they also think differently. Although their thinking may remain immature in some way, many are capable of: - abstract reasoning and sophisticated - moral judgments - can plan more realistically for the future.

Piaget’s stage of formal operations Formal operations : Piaget’s final stage of cognitive development characterized by the ability to think abstractly. This development usually around age 11, gives them a new more flexible way to manipulate information. They can think in terms of what might be, not just what is. They can imagine possibility and can form and test hypotheses.

Changes in information processing in adolescence. 1.Structure change include: Changes in information processing capacity The increasing amount of knowledge stored in long term memory.

Declarative : Procedural : Conceptual : Information stored can be : consists of all the factual knowledge a person has acquired. Procedural : all the skills a person has acquired. Conceptual : is an interpretive, understandings stored in long term memory.

2. Functional change Process of handling, obtaining, learning, remembering, reasoning and decision making. This process improve during adolescence.

Language development reflect cognitive advances. Adolescence more skilled in social perspective, Able to understand another person’s point of view and level of knowledge and to speak accordingly. Speak a different language with peers than with adults. Language development reflect cognitive advances.

Factors influence motivation and achievement succeed Parenting practice Socioeconomic status Quality of the home environment. Peer influence Quality of schooling Students belief in themselves.

Psychosocial changes Adolescents and parents Adolescents feel tension between dependency on their parents and the need to break away. Parents often have mixed feelings. They want their children to be independent, yet they fined it hard to permit to go.

Family conflict: It is most frequent during early adolescence related to the need to assure autonomy. Parenting styles Authoritative parenting foster adolescent’s character development. Teens whose parents were firm in enforcing behavioral rules had more self control and fewer behavioral problem than those with more permissive parents.

Adolescents and Sibling Adolescents are less close to sibling than to either parents or friends. More independence on the part of the younger person and less authority exerted by the older person. As the younger sibling grows up, the older one may look younger brother or sister as a pesky.

Adolescents and Peers The peer group is a source of affection, understanding, and moral guidance, a place for experimentations and a setting for achieving autonomy and independence from parents.

Friends influence each other, particularly toward risky or problem behavior. The increased intimacy and understanding of adolescent friendship reflects cognitive as well as emotional development, so better to express their private thought and feeling, and define their identity.

Adolescents who have close, stable, supportive friendship generally do well in school, sociable, and unlikely to be aggressive, anxious, depressed.

Romantic Relationship It is a central part of most adolescents’ social worlds. With the onset of puberty most heterosexual boys and girls begin to think about and interact more with members of other sex. They move from mixed groups to one on one romantic relationship.

Early adolescence : little or no attention to attachment or sexual needs. Mid adolescence : have at least one exclusive partner lasting for several months. At age 16 adolescents interact with and think about romantic partners more than parents, friends or siblings. The peer group may affect an adolescent’s choice of a partner and the way the relationship develops.

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