Peds, part 13: G&D - Adolescents - Development and Parental Guidance
by Meris Shuwarger BSN, RN, CEN, TCRN December 22, 2021 Updated: June 16, 2022 6 min read
Hi, I'm Meris with Level Up RN. And in this video, I'm going to be talking to you about the normal growth and development of adolescents, which are those who are ages 12 through 20. I'm going to be following along using our pediatrics flashcards. These are available on our website, leveluprn.com. If you don't have a set, I highly suggest grabbing one for yourself to study and help you guide your studying. But if you already have your own deck, I'd invite you to follow along with me. All right, let's get started.
So first up, we're talking about growth and development physically. So we have a nice card here that's got a table so you can kind of see everything laid out. But I'm going to say the weight gain and height gain, it's important. But we're talking about such a big span of time that it's kind of hard to say exactly. And this isn't something that we're checking as much as an infant who's growing because that's really important. They're doing so much. So women, girls, in this age, they're going to gain 15 to 55 pounds, whereas boys will gain 15 to 65 pounds. And girls will grow 2 to 8 inches, while boys will grow 4 and a half to 12 inches during this time. But what I do want to bring your attention to is the growth-spurt timing. So remember. Adolescence, we have that big growth spurt. And I mean, we have periods of growth spurts. But the thing that's important to note is that there's a difference between when it happens to girls and boys. So girls, their growth-spurt timing is between 9 and a half to 14 and a half years old. Whereas with boys, it's between 10 and a half and 16 years old. So if you think back to being in middle and high school, you might remember that one summer you came back to school, and all the girls were like a foot taller. And they were all taller than the boys, right? And that's very normal. We see those growth spurts in girls first. And then the boys catch up and usually surpass them. So very important to remember that.
Now, let's talk about maturational changes. And here, we're talking specifically about sexual maturity and puberty here. So the stages of physical maturity differ slightly depending on who you talk to you. So that's one of the things that you need to just defer to your textbook, specifically what that guidance is on the stages of development. But one thing is the same. And it is the first sign of physical maturity in boys and girls. So in girls, the first maturational change is going to be the development of breast buds. So breast buds, we're not talking about a fully grown breast that you would think of on an adult woman. We're talking about the underlying tissue is starting to grow and develop. So rather than a flat chest, they start to have little budding at the breasts. So that is the first maturational change for girls. Now, with boys, the first maturational change is going to be testicular enlargement. So defer to your textbooks. But those are the two that we can say for certain. We've all agreed upon these are the first signs of maturational changes.
Okay. Moving on to cognitive and psychosocial. So in cognitive work, again, we're in this formal operational phase. And this is where we actually have abstract thought. We can think scientifically. We can have reasoning and formal logic. I mean, certainly a 12-year-old is not just suddenly going to grasp all of the abstract thinking, but we're going to get there. And by the time the child reaches adulthood, they should have that fully developed sense of abstract thinking and the ability to think with reason and logic. Can't reason with a three year old, right? But you can, sometimes, with an adolescent. Okay. Psychosocial development. So for our Ericksen stage here, we are in identity versus role confusion. So think about being an adolescent. It is a time of deciding who I am as a person, right? I'm deciding the friends I have, the clothes I wear, the music I listen to, my likes and dislikes. And I'm starting to really form the skeletal framework of who I am going forward. So this means that I care a lot about what my peers think of me, right? I'm highly susceptible to peer pressure because I want people to like the person that I am becoming, right? So if I get the message that I'm cool and okay and likable as I am, that's awesome. And I'm probably going to feel really cemented in that idea, right? I'm going to feel really good about that, in who I am. But if I'm getting the message that who I am is not okay, is not cool, is not somebody I want to be friends with, I'm going to start to think, what's wrong with me as a person, right? And maybe try to change something about myself that isn't necessarily who I am or who I want to be.
Now, things here. Body image concerns, right? This is where we're starting to-- again, am I okay the way I am? The answer is yes by the way. You are okay exactly as you are. But this is a hard thing for kids to learn. They also believe that they are invincible. Meaning they understand the concept of death, of injury, of being maimed, of losing a limb, right? They understand that. But that will never happen to me, right? It's not even necessarily a thing that they think I can't get hurt. It's just more risk-taking behavior because I have yet to experience something like that. It's not going to happen to me. That's an old people problem, right? So they are at risk for injury. They're also forming their sexual identity here. So we will talk about that in just a moment.
Now, when it comes to vaccinations, it's a little bit easier here. Thank goodness. Again, remember that everyone should be getting their seasonal flu vaccine-- so even when we're talking about adolescents and adults, seasonal flu vaccine, if it is seasonally appropriate. Now, at 16 years, they should get their second dose of the meningitis vaccine. And between 16 to 18 years, they should get two doses of the meningitis B vaccine. Okay? So a lot of meningitis is really what we're worried about because we're swapping spit with people, right? We are at risk because we are in these densely populated schools, especially if I'm going off to college. We're living communally, right? I'm at big risk for meningitis.
Now, parental guidance. So kids in this age are going to start experiencing this need for privacy. Maybe they used to just walk around out of the shower completely naked. My kids are three and five. They get out of the shower, and they're just walking around naked, right? They're going to start to have this idea of I need privacy. I'm not going to do those things anymore. They may spend more time away from the family. And as long as it is not all of the time, that's normal. And we want to respect their need for privacy. We want to teach monthly testicular self-exam or breast self-exam. Very important also for testicular because remember that boys in this age range up until about 35 are at high risk for testicular cancer. We also need to teach whatever safe sex practices this family is teaching. I'm not making a moral call here. So either we're going to be teaching about abstinence or safe sex practices. So if you choose to have sexual contact, how can you be safe about that? It's very important to be open about that so that our kids in this age range don't end up unarmed with this information. And I would also say it's important to consider that not all sexual contact is heterosexual. So we need to teach about sex safety and how to have safe sex within different types of sexual contact as well, including same-sex contact.
All right. Let's see here. Monitor for depression, self-harm, and substance abuse. Remember. I said it's normal for a child to want to spend some time away from the family on their own, in private, talking to their friends. It's not normal for them to sequester themselves and hole up in their rooms and refuse to come down. We need to be thinking about those sorts of concerns. And then we also need to reinforce motor vehicle safety. Again, remember, these kids think that they are invincible. And they have newly learned how to drive. So we are wearing our seatbelts. We are not drinking and driving. And we are not looking at our phones when we drive.
All right. Let's test your knowledge of some key facts using my quiz questions right here. First up, I want you to tell me between what ages does an adolescent male experience growth spurts?
Next up, I want you to tell me what is the first maturational change in girls? And lastly, I want you to tell me what is the first maturational change in adolescent males? Let me know how you did in the comments. I'm sure you rocked it, and I can't wait to hear. Thanks so much and happy studying.
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