1. The adolescent cry Are we listening? Prof. J.N.Sharma Department of Pediatrics Gauhati Medical College

2. Adolescence A crucial period of life Is a confusion Adolescents Parents Care taker Neither a child nor an adult Transition difficult to detect A complicated but useful lot of human resources

3. Two most crucial period of life of Growth and development Under five period (Early childhood) Somatic, Brain and lymphoid Adolescence Somatic Psychological Reproductive and secondary sexual characteristics

4. Adolescence What is adolescence? Not clearly defined Beginning and End ? Not clear Problems are peculiar Health problems Psychosocial problems Who will look after the adolescents? Not yet decided

5. Adolescence Period of life marking the end of childhood and setting the foundation for maturity, A critical period of development with manifestations at the biological, psychological and social levels of integration. Most complex part of development in human life.

6. Adolescence 20 % of population + 40% children = 60% Achieve same degree of significance as early childhood Development marked by significant interaction Manifestations at biological, psychological and social levels

7. Adolescence Onset and termination Biological Psychological Social

8. Onset and termination Biologically The onset is signaled by the final phase of acceleration of growth and beginning of secondary sexual character. Termination is marked by epiphyseal fusion and completion of sexual differentiation.

9. Onset and termination Psychologically It is marked by acceleration of cognitive growth and personality formation Succeeded by the stage of parenthood and acquisition of an adult role.

10. Onset and termination Socially It is a period of intensified preparation for the assumption of an adult role Termination is signaled when the person is accorded full adult prerogatives.

11. Onset and termination To note Physical development has a definite pattern and sequence Psychological growth cannot be set in one pattern

12. The adolescent age group Who are adolescents? Boys between the age of 10 – 22 years Girls between the age of 9 – 20 years What is the age of onset and end? Boys: 10 – 12 yrs to 20 – 22 yrs. Girls: 9 – 11 yrs to 18 – 20 yrs.

13. Problems of adolescence Health problems Psychological problems Social problems

14. Problems of adolescence Health problems Usually not reported: Nature of disease If diagnosed therapy is not regular Under treated by physicians Do not come to pediatricians

15. Common health problems Malnutrition: PEM, Obesity Anemia Tuberculosis Heart disease: hypertension, RHD Acne Accidents and injuries STDs Menstrual disorders

16. Psychological development Ability for abstract conceptualization Search for a sense of personal identity No longer a child, not an adult Engages in determining who s/he is and what s/he is to become Examines parents critically, lean more to peer groups.

17. Psychological development Search for identity is influenced by peer groups. Constructive social group: meaningful society membership Delinquent gang: antisocial personality Sound parent relationship: firm and lasting relationship Excessive dependence / hostility: failure of emancipation/ rejection of family

18. Cross cultural evidence have shown that the conflict and distress experienced by adolescents reflect the cultural influences and expectations and are not caused by hormonal changes or physical growth pattern Parents should guide at this juncture

19. Psychosocial problems More common than health problems Peak age: late adolescence Sex variation: equal but problems different Urban / rural: same Urban boys, rural girls: more problems

20. Psychosocial problems Assessment is difficult Variety Difficult to differentiate between normal and abnormal Minor problems go undetected Major problems: Diagnosis is presumptive

21. Psychological problems Identity crisis Depression Suicide Substance abuse Sleep disorders Anorexia nervosa

22. Social problems Contributing factors Poor socioeconomic status No opportunity for education Mass media exposure to violence, corruption and fundamentalism Leads to Loss of social perspectives

23. Social problems Child labour Prostitution Nonaccidental injuries Illegitimate pregnancies Vandalism Violence Sex crimes

24. Care of adolescents Not yet properly decided Pediatricians? WHO: Childhood upto 25 years Upto 18 years in India: No infrastructure No ward, No OPD Rest 3 – 4 years left to general physicians

25. Conclusions Adolescence A phase of intense change Problems multifarious No infrastructure. No serious thought. One cannot sit idle and ignore Because

26. Conclusions It is very important to protect this important human resource This is the time they are shown the right direction, given proper guidance to put them on the right path without hurting their ego.

27. Conclusions The parents at home, the teachers at school and the society at large should take the responsibility to transform children into adults. They must be nurtured in an environment of dignity, love and affection, feeling of being wanted and educated inorder to grow into active, skilled and confident individuals who can take definitive and correct decision.

28. Conclusions God could not make himself available to take care of each child He created. So he gave Parents to take care and nurture, Teacher for guidance and education and Pediatrician for prevention and intervention programmes

29. The adolescent’s cry

30. Are we listening? Probably No Atleast not adequately

31. Thank you