READING # 2

Stages of Adolescence
By: Brittany Allen, MD, FAAP & Helen Waterman, DO

Adolescence is the period of transition between childhood and adulthood. It includes some

big changes—to the body, and to the way a young person relates to the world.

The many physical, sexual, cognitive, social, and emotional changes that happen during this

time can bring anticipation and anxiety for both children and their families. Understanding

what to expect at different stages can promote healthy development throughout adolescence

and into early adulthood.

Early Adolescence (Ages 10 to 13)

During this stage, children often start to grow more quickly. They also begin

notice other body changes, including hair growth under the arms and near the genitals,

breast development in females and enlargement of the testicles in males. They usually

start a year or two earlier in girls than boys, and it can be normal for some changes to

start as early as age 8 for females and age 9 for males. Many girls may start their

period at around age 12, on average 2-3 years after the onset of breast development.
 These body changes can inspire curiosity and anxiety in some―especially if they do

not know what to expect or what is normal. Some children may also question their

gender identity at this time, and the onset of puberty can be a difficult time

for transgender children.

Early adolescents have concrete, black-and-white thinking. Things are either right

or wrong, great or terrible, without much room in between. It is normal at this stage

for young people to center their thinking on themselves (called "egocentrism"). As

part of this, preteens and early teens are often self-conscious about their appearance

and feel as though they are always being judged by their peers.

Pre-teens feel an increased need for privacy. They may start to explore ways of

being independent from their family. In this process, they may push boundaries

and may react strongly if parents or guardians reinforce limits.

Middle Adolescence (Ages 14 to 17)

Physical changes from puberty continue during middle adolescence. Most males

will have started their growth spurt, and puberty-related changes continue. They may

have some voice cracking, for example, as their voices lower. Some develop acne.

Physical changes may be nearly complete for females, and most girls now have

regular periods.

At this age, many teens become interested in romantic and sexual relationships.

They may question and explore their sexual identity―which may be stressful if they

do not have support from peers, family, or community. Another typical way of

exploring sex and sexuality for teens of all genders is self-stimulation, also

called masturbation.

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 Many middle adolescents have more arguments with their parents as they

struggle for more independence. They may spend less time with family and more

time with friends. They are very concerned about their appearance, and peer

pressure may peak at this age.

The brain continues to change and mature in this stage, but there are still

many differences in how a normal middle adolescent thinks compared to an

adult. Much of this is because the frontal lobes are the last areas of the brain to

mature―development is not complete until a person is well into their 20s! The frontal

lobes play a big role in coordinating complex decision making, impulse control, and

being able to consider multiple options and consequences. Middle adolescents are

more able to think abstractly and consider "the big picture," but they still may lack the

ability to apply it in the moment. For example, in certain situations, kids in middle

adolescence may find themselves thinking things like:

o "I'm doing well enough in math and I really want to see this movie… one night

of skipping studying won't matter."

o Do I really have to wear a condom during sex if my girlfriend takes the pill?"

o "Marijuana is legal now, so it can't be that bad."

While they may be able to walk through the logic of avoiding risks outside of these

situations, strong emotions often continue to drive their decisions when impulses come into

play.
Late Adolescents (18-21… and beyond!)

Late adolescents generally have completed physical development and grown to their full

adult height. They usually have more impulse control by now and maybe better able to

gauge risks and rewards accurately. In comparison to middle adolescents, youth in late

adolescence might find themselves thinking:

o "While I do love Paul Rudd movies, I need to study for my final."

o "I should wear a condom…even though my girlfriend is on birth control, that's

not 100% in preventing pregnancy."

o "Even though marijuana is legal, I'm worried about how it might affect my

mood and work/school performance."

Teens entering early adulthood have a stronger sense of their own individuality now and can

identify their own values. They may become more focused on the future and base decisions

on their hopes and ideals. Friendships and romantic relationships become more stable. They

become more emotionally and physically separated from their family. However, many

reestablish an "adult" relationship with their parents, considering them more an equal from

whom to ask advice and discuss mature topics with, rather than an authority figure.
READING # 3

DEVELOPMENTAL TASKS OF ADOLESCENCE

A developmental task is a task that arises at or about a certain period in life,

unsuccessful achievement of which leads to inability to perform tasks associated with the

next period or stage in life.

Developmental Task Nature of Task

1. Learning to get along with friends of To learn to look upon girls as women and

both sexes. boys as men; to become an adult among

adults; to learn to work with others for a

common purpose, disregarding personal

feelings; to lead without dominating.

2. Accepting one's physical body and keeping To accept one's body; to keep it healthy

it healthy. through good nutrition, exercise, disease

prevention, and other health practices.

To develop affection for parents without

3. Becoming more self-sufficient.
dependence upon them; to develop respect for

older adults without dependence upon them.

4. Making decisions about marriage and To explore attitudes toward family life and

family life. having children; to acquire the knowledge

necessary for home management and, if

desired, child rearing.

5 Preparing for a job or career. To develop career/vocational goals and

ways to reach these goals; to be able to

make a living.

6. Acquiring a set of values to guide

behavior. To develop an outlook toward life based on
what is important.

7. Becoming socially responsible.

To participate as a responsible person with

friends at home, and in the community; to

develop personal moral values to guidebehavior

READING # 4

Middle to Late Adolescence (ages 15 To 22): The Age of

Romance

ANGELA OSWALT, MSW

As a another year or so goes by, when teens are approximately 14-15 years old, they become

more interested in developing romantic relationships with partners. These relationships can be

explosive and short-lived, or they can become long-term monogamous relationships.

However, guys and girls at this age tend to view romance quite differently. Girls tend to be

more concerned about the biological consequences of sexual activity so they may begin to

research topics such as reproduction, pregnancy, and contraceptives, and they may ask more

questions about these topics. Guys don't ordinarily think about these issues quite as much.

Some young ladies feel comfortable asking their parents questions about sexual topics,

while many others do not. Therefore, parents should take advantage of natural opportunities

to educate both their sons and daughters about sexual situations. For instance, if a parent and

teen watched a movie together that had a scene with a sexual theme or content, they might

specifically discuss this scene with their teen as they are having ice cream together after the

movie. Another natural opportunity arises when a relative, or friend of the family, becomes

pregnant. While these natural opportunities for discussion are usually more comfortable,
parents will still need to initiate separate, more thorough discussions to ensure their

children learn this vital information correctly.

Both guys and girls fantasize about sexual acts and wonder about what their limitations

should be. They often wonder about the line between "having sex" and "just fooling around."

For example, they may experiment with foreplay behaviors such as erotic stimulation, touch,

and massage; and, they may also experiment with different types of sexual intercourse such

as oral and anal sex, or mutual masturbation. Many teens who participate in these types of

sexual activities will deny they are "having sex" and consider themselves a "virgin" or

abstinent as long as they avoid penile-vaginal intercourse. This is very unfortunate because

these youth may mistakenly believe these other sexual activities are "safe" and may not

realize they are still at risk for acquiring a sexually transmitted disease (STD). They may also

be unaware a pregnancy can result despite the avoidance of penile-vaginal intercourse.

Furthermore, all forms of sexual activity can result in the same social-emotional

consequences as vaginal intercourse (e.g. peer group rejection, partner rejection, rumors,

deep regret or remorse, etc.)

With advancing cognitive development and moral development, sexual thoughts and

decisions reflect increasing maturity. By ages 15-16 years, girls are considering the moral and

physical consequences of having sexual intercourse. Girls may become concerned about an

unplanned or unwanted pregnancy, and may wonder if sexual intercourse will be painful.

Girls will also begin to define their boundaries with sexual partners, for instance: 1) What

kinds of sexual activities are acceptable? 2) When is it okay to be sexual with a partner, and

under what circumstances? and, 3) What criteria should be used to make these decisions?

Ideally a girl will have thought through these questions before she finds herself in a situation
that requires her to answer them! This is where parents and other adults can be very helpful:

they can guide their daughters to anticipate the need to think about these sorts of decisions

ahead of time. While girls may turn to many different people and resources to help them

make these decisions, their parents will want to be one of their daughters' most reliable

resources. That's why it's so important for parents to open the lines of communication with

their children about sex early on, so they feel comfortable discussing it.

While guys may be less likely to ponder the moral and physical consequences of having

sexual intercourse, they should be encouraged to consider the same sorts of questions that

girls must consider. In previous generations, guys had a choice about whether or not to

acknowledge and accept responsibility for an unplanned or unwanted pregnancy. However, in

today's society with the advent of technologies that can definitively establish paternity, and

the new "dead-beat dad" laws which require boys/men to take financial responsibility for the

children they father, the negative consequences of an unplanned or unwanted pregnancy have

significantly increased for guys. Moreover, guys have the same health risks as girls for

having unprotected sex.

Between the ages of 16 to 18 years, sexual activity increases and intensifies for both guys

and girls, whether by masturbation or in partnered sexual activity. Youth may engage in

sexual activity more frequently, and/or their participation may become more intense and

varied as their sexual experience increases. For youth whose sexual development proceeded

more slowly than their peers, they may begin to experiment with their sexuality. In general,

girls' interest in sex is associated with forming and maintaining long-term, committed

relationships; however, this is also true for some guys as well.

By late adolescence, between the ages of 19 and 22, youth will continue to explore their

sexuality and to experience different types of sexual encounters. Some youth at this stage

will only be interested in casual dating and casual sexual encounters while other youth will

limit sexual activity to emotionally intimate, committed, monogamous relationships. As

youths' cognitive and emotional maturity has significantly improved over early adolescent

stages, youths' sexual decisions become more thoughtful and wise, requiring less need for

parental guidance or involvement. However, if youth have enjoyed an open dialogue with

their parents, they may continue to turn to their parents for additional guidance regarding

complex sexual or romantic issues and concerns.