Learning Objectives
1. Explain the term puberty and its relationship to adolescence.
2. Relate the theories of Erikson and Piaget to adolescent growth and development.
3. Discuss the different stages of adolescence.
4. Describe the specific physical changes that occur between ages 11 and 20.
5. Discuss sexual development for boys and girls.
6. Describe the cognitive, emotional, and moral development that occurs during adolescence.
7. Design a plan for presenting information about human sexuality to adolescents.
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IMPORTANT TERMINOLOGY |
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adolescence |
peer group |
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menarche |
preadolescence |
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nocturnal emission |
puberty |
Puberty (from the Latin word meaning adult) is the period when a person becomes able to reproduce sexually. Adolescence is the developmental period between puberty and maturity. It spans the ages between 11 and 20 years, after which a person enters early adulthood.
A rapid growth spurt marks adolescence, by the end of which individuals achieve adult height. Although tremendous physical growth occurs, emotional needs predominate during this period; adolescents spend much of their time searching for meaning in life and for a sense of identity. Adolescents are required to make critical choices that may help to determine the shape of their lives. Such choices include the use of alcohol and other substances, moral obligations and respect for others, school attendance, relationships (family, friends, and sexuality), education after high school, and career alternatives. The Internet has been shown to be both a positive and negative influence on behaviors of this age group.
GROWTH AND DEVELOPMENT THEORIES
The theories of Erikson and Piaget continue to apply to individuals as they enter the adolescent stage. Both theories stress the adolescent’s burgeoning maturity and expanding abilities.
Erikson: Psychosocial Development
The adolescent faces many difficult decisions during the teen years concerning the future and the adult world: What vocation should I choose? Should I go to college? Can I afford further education? Do the courses I am taking in high school meet the college’s admission criteria? Should I join the military? Will I want to get married someday? Should I have a baby though I am not married? Should I live with my parents or move out?The major challenge of adolescence is the achievement of identity: Who am I? Where am I going? With whom? and, How am I going to get there? If this phase is not resolved, the result is role confusion.
The significant group for the adolescent is the peer group, which is made up of contemporaries, or a group of people with whom the teen associates (Fig. 11-1). The peer group is often more important than the family and can influence adolescents in many ways. Peer pressure to try cigarettes, alcohol, marijuana, or other drugs can be the first step to chemical dependency or substance abuse. The peer group can help to determine whether a young person gets good grades in school, joins the military, or buys a car.
TABLE II-I. Erikson’s Theory of Psychosocial Development—Adolescence
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CONCEPT |
ADOLESCENCE |
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Challenge |
Identity versus role confusion |
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Significant others |
Peer group, opposite sex, family |
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Necessary accomplishments |
Make life decisions; achieve personal identity; accept responsibility |
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Virtues |
Independence; self-esteem; self-reliance; self-control; devotion; fidelity |
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Ways to help the adolescent succeed |
Provide privacy; encourage activities; support decisions; allow independence; give recognition and acceptance; maintain a good family atmosphere; facilitate information gathering |
Piaget: Cognitive Development
According to Piaget, the person from 12 to 15 years of age enters stage IV of cognitive development: formal operations. The adolescent thinks in the abstract and develops skills to participate in complex problem-solving.
Skill development is part of cognitive growth and is also preparation for the future. Skill development includes activities such as gymnastics, photography, writing, carpentry, auto mechanics, and dancing. Many skills developed during the teen years help adolescents make educational and career choices. Teens enhance their leadership and diplomatic abilities by participating in student government, debate, and other school programs. Plays, science competitions, choral groups, orchestra, and band are other avenues for young people to increase their intelligence, talent, sense of cooperation, and community spirit. Religious groups geared for teenagers often hold many activities that attempt to provide a sense of moral instruction as well. Sports often become a primary interest. Cooking may appeal to both girls and boys. Most of today’s adolescents have never known life without computers and may develop a keen interest in experimenting with them. Adult encouragement and guidance are needed for skill development.
FIGURE II-I · Throughout adolescence into young adulthood, peer relationships influence psychosocial development.
ADOLESCENT GROWTH AND DEVELOPMENT
Adolescence can be divided into stages. The first stage can be called pubescence, preadolescence, or early adolescence. This stage usually lasts from ages 11 to 14, with girls often maturing faster than boys. It is sometimes referred to as an “awkward stage,” as the person teeters between childish and mature ways of appearing, thinking, and behaving. Middle adolescence lasts from ages 15 to 17. Individuals of these ages are most likely to exhibit behavior considered “typical” of the adolescent. The late adolescent stage lasts from ages 18 to 20. During this time, young people complete their transition into adulthood. The developmental changes of adolescence have prepared them to exhibit the independence and responsibility that have grown as they begin college life, join the military, or seek employment.
Characteristics of Developmental Stages
Early Adolescence (Ages 11-14)
During this period, also known as preadolescence, young people often waver between a desire for independence and trust from their families and silliness, playfulness, and a need for regular approval. Rebellion against authority figures, noisy and fault-finding quarrels with siblings, and evasion of household tasks can be sources of conflict. Patience is essential. As early adolescents attempt new undertakings to test independence and self-reliance, they need strong familial support and guidance. As they get older, adolescents become more controlled emotionally and better able to see situations in perspective. Psychological awareness and objectivity begin to broaden beyond the self to understand the feelings and behavior of others. A growing sense of humor helps to make family relationships more pleasant.
Because young adolescents are usually enthusiastic, they bring spirit and buoyancy to their undertakings. Involvement in extensive projects in school shows initiative and effort and perhaps involves detailed computer use. However, this high initiative may get out of hand. Planned parties and social events require adult supervision to prevent boisterousness from ruining events.
As they head toward middle adolescence, young teenagers may display tendencies to seclusion and moodiness. Emerging reasoning leads to reflection on themselves and others and assessment of new experiences. Appraisals of interaction between self and the world require a place and time, so young teenagers may begin to spend more time alone. Because both girls and boys have long associations with the mirror, they will use the mirror as a prop for role-playing and for testing and measuring themselves in imagined situations. A teenager’s contemplation will naturally include an assessment of the family. As they develop their own perspective of family structure and roles, their criticisms and withdrawals often become a source of puzzlement and hurt to family members. The maturing adolescent takes frequent flights of independence, but has a strong need to return to the “nest” for guidance and encouragement.
By age 14, adolescents are becoming more accepting of other people, and more conscious of what makes their own personality unique from others. They may begin to develop better relationships with siblings, finding that they like their brothers and sisters more than they thought. “Talk, talk, talk” is many adults’ version of this age. Some authorities state that verbalizing ideas is a true growth characteristic and a developmental achievement. Teenagers now show an increased natural ability in perceiving many sides of a situation. They are no longer frustrated by being unable to express or to verbalize ideas. They can say what they think, a task of maturity.
Middle Adolescence (Ages 15-17)
Introspection and fluctuations in self-assurance mark the middle adolescent years, which can baffle many families. Physical alterations, loud self-assertion, self-preoccupation, rapid shifts between dependent and independent attitudes, blithe spirit, and mood swings are challenges for even the most patient and supportive families. Teenagers are pulling away from childhood in a quest for self-reliance (see Table 11-1). Although they value the ability to depend on home and school, these teenagers need to counterbalance security with independence. Because they are searching for balance, immaturity frequently results in withdrawal, belligerence, or defiance. They may begin to believe that any advice from family caregivers is an effort to control them completely. Adolescents may seek guidance away from home.
By age 15 or 16, most adolescents begin to form some ideas about the future and to plan for more than present interests and activities. Vague ideas about courtship, marriage, career, and families of their own result in scrutiny of the family of origin. Family members may sometimes feel rejected because they fail to meet the perfectionist standards of observant middle teenagers.
Increased independence and interest in the opposite sex now cause many young people to take more responsibility for self-care and personal cleanliness. They like to choose their own clothing. Many adolescents of this age group seek part-time employment because a job provides money.
By the time they are about 17, most middle teenagers are beginning to exhibit true attitudes of maturity. In interpersonal relationships, they show an interest in others and an awareness and acceptance of social responsibilities. As they head into late adolescence and young adulthood, they tend to have friendships with many people of both sexes.
Late Adolescence (Ages 18-20)
Older adolescents begin to grapple with everyday, mature issues. They move away from familiar people, places, and things. Graduation from high school leads many teens to colleges and universities far from home, where they become responsible for themselves. Those attending school who remain close to home or at home still find their social circles expanded and their intellectual horizons challenged, as they take courses of particular interest and importance to them. Some late teens enter the work force or join the military after finishing school. Branching into such worlds necessitates increased maturity and improved social and professional skills. During these years, moral questions and issues involving ethical decision-making gain relevance. Increased knowledge and awareness may lead to reflection and internal reevaluation. Exposure to different peoples and other ways of thinking may lead young people to question previously accepted values and ideas.
Relationships are usually important during these years. Young men and women may enjoy dating a variety of individuals. Long-term romantic relationships and friendships that lasted throughout high school may be tested or come to an end, as social circles expand and interests change. As teenagers move into the adult world and are expected to behave maturely, previously critical adolescents may come to appreciate and develop better relationships with parents and other family members.
Physical Growth
Physical changes characterize adolescence. Similar to the childhood periods of growth and development, outward signs of maturity vary. By age 13, most young people reach 90% of their adult height and have all their permanent teeth except the third molars or “wisdom teeth.” They have at least tripled in height and gained 15 times their birth weight. During adolescence, the extremities lengthen, the hands and feet grow, and the hips, chest, and shoulders widen. Girls usually grow between 2 and 8 inches in height and boys 4 to 12 inches during adolescence.
Hormonal changes control growth and many other physical aspects. Increased glandular activity causes an increase in sweat and contributes to the development of body odors. Glandular changes also are partly responsible for the development of acne in some adolescents. Body hair grows in previously hairless areas: the pubic area, under the arms, and for boys, on the face and chest. Hair on other areas such as the arms and legs becomes thicker and coarser.
Alterations in body chemistry, developmental challenges, plus an ever-increasing capacity to consume food provide adolescents with a great supply of energy. By the time a person is approximately age 18, he or she has reached full height, reproductive organs are adult size, and secondary sex characteristics are pronounced.
Sexual Development
Development in Boys
Some boys at age 11 do not yet show the changes of puberty. Others have started to grow rapidly again, and yet others may already have a heavy or defined skeletal structure. Physical growth varies markedly in 12-year-old boys as well. The average boy shows some pubertal changes by the end of this year. The testicles and penis enlarge, and changes occur in the appearance of the scrotum. Pubic hair begins to appear. Spontaneous erections and occasional ejaculations without external cause may be confusing. Young boys should understand that the involuntary discharge of semen while sleeping (nocturnal emission) is a normal part of reproductive health. Other natural developments of puberty are a change in voice and the appearance of chin whiskers.
Most boys grow more at 14 than at any other age. A strong, muscular appearance and continued deepening of the voice add to the impression of maturity. Nocturnal emissions have begun for most boys by this age. By age 16, most young men are close to their adult height.
Development in Girls
Girls also show great variation in sexual development. The average 11-year-old girl has begun a period of rapid growth and shows signs of approaching sexual maturity. Breast and hip development may be noticeable during these years. Pubic hair starts to grow. By age 13, many girls have experienced menarche, the onset of menstruation. Early periods frequently are irregular, and normal cycles may not be established for a few years.
By age 14, many girls have the physical appearance of young women. Few grow in height after age 14. Breasts and other secondary sex characteristics are those of an adult. By age 16, the menstrual cycle has become regular and the young woman generally accepts menstruation as part of adult life.
Sexual Identity and Orientation
Sexual identity may be confusing. As adolescents struggle to understand themselves and begin to experiment, they may question their sexual preferences. Some people may develop a same-sex crush during this period or participate in homosexual activity. For many adolescents, these feelings and behaviors reflect a temporary, experimental stage that does not affect later heterosexuality.
Many gays and lesbians, however, first come to realize their sexual orientation during the teen years. Recognition that they are “different” from others can cause homosexual youths much confusion. Fear of rejection by their families, friends, and community may lead to suffering and unhappiness. In a period marked by the need for self-acceptance and a sense of belonging, gay and lesbian adolescents are at risk for alienation, doubt, and depression. In fact, homosexual youths account for 30% of all teen suicides each year.
Sex Education
Most adolescents are naturally curious about sex, sexuality, and changes in their bodies. If adults provide information with sensitivity, adolescents can form healthy sexual attitudes. If parents, teachers, and counselors do not give such information, adolescents will seek answers elsewhere. Unwholesome attitudes or incorrect beliefs may develop from information they receive from peers and older adolescents who appear to “know it all.” The result may be premature and unsafe sexual activities.
Sexual activity at younger ages is increasing. Even though birth control is available, many young people fail or refuse to use it. In addition, the incidence of sexually transmitted infections (STIs) is on the rise. Many adolescents who may fear pregnancy fail to recognize the risks of gonorrhea, syphilis, genital warts, and HIV/AIDS as well.
Most adolescents welcome sex education as necessary. Family caregivers and other trusted adults can help adolescents to establish reasonable boundaries and, at the same time, give accurate information. Adolescents need the opportunity to discuss with both peers and concerned adults the emotional conflicts involved with refusing and accepting sexual activity. Such discussions help them make better decisions. Sexually active adolescents need counseling about the use of condoms to help prevent STIs and other forms of birth control to prevent pregnancy.
Nursing Alert Adolescents must understand that all forms of birth control contain some risk of failure. Only abstinence is 100% effective against pregnancy and STIs.
Psychosocial Development
The major task of adolescence is to form a sense of identity. Paradoxically, much of the person’s sense of self during this time is defined by relationships with other people. Group conformity and “fitting in” with peers is of great importance to most adolescents. At the same time, outward expressions of rebellion against parents, teachers, and other authority figures are common.
Family Relationships
Family relationships may be delicate throughout adolescence. Attitudes toward younger siblings may alternate between protectiveness and annoyance. Attitudes toward family caregivers range from harsh criticism and displeasure to genuine understanding and great love. During adolescence, solid family relationships can influence lifetime interpersonal success because they foster self-esteem and respect for and from others. Respect from others is essential for adolescents to maintain psychological and emotional health. Such respect includes recognizing the need for self-assertion, privacy, information, acceptance, experimentation, and growth in all developmental areas.
