Growth and development of an adolescent (13 to 18 years):
Adolescence starts with the quick alteration in the body and experiences. These changes create inner alteration exhibited in the adolescent's behaviours.
1. Psycho-social development:
According to Erikson (1968), establishing, a sense of identity is the developmental crisis of adolescent. Development of identity is the major need of the adolescent, before development of an intimate relationship. Adolescents perceive themselves as unique and distinct individuals.
The adolescents experience unfamiliar feeling and seek peer approval because of the rapid physical growth and maturational changes. During this period, adolescents try to achieve autonomy from the family, hope to have group identity and try to develop a sense of personal identity.
Adolescents are egocentric, therefore, lack the ability to differentiate their own opinions from that of others. Because of their egocentrism, they lack understanding to assess the circumstances that require empathy and cooperation.
During early adolescence, adolescents have concrete thinking. Gradually concrete functioning develops into abstract during middle adolescence.
Adolescents experience different roles and are confused with role diffusion. Adolescents find it difficult to form satisfactory identity from the various aspirations, roles, and identifications.
2. Social Development:
Adolescents do not like parental restraints, but they are afraid to be independent when they think of the responsibilities along with their independence. Their wish to enjoy freedom helps them to develop social relationship and identify their social role.
Adolescents need acceptance from friends, few close friends, and supportive family for interpersonal maturity.
Adolescents tend to be critical, argumentative, and reject parental control. They spend more time outside the family, with the peer group. Their behaviors fluctuate according to their mood. Adolescents become more competent and feel the need for more autonomy. Adolescents face difficulty to face transitions at once, such as, beginning of puberty, starting to date, and attending a new school. Adolescents have a fear that they may not be able to cope with the expected role and responsibilities as an adult.
3. Sex-role identity:
In early adolescence, peer group begins to provide information regarding sexual relationships and expects development of such relationship. These expectations vary from culture to culture, among geographic area, and among socioeconomic groups.
4. Evaluation of the Physical Measurement
4. A Weight and Height
The standardized grid growth charts, percentile charts, are used to evaluate the physical growth. On these charts, the child's height and weight at different ages are plotted. This shows a linear picture of the child's growth along with the comparison of weight, and growth with the expected values at the respective ages.
The percentile chart is used to assess the growth status of the child. This chart shows the frequency divided into percentile lines, for example, a child whose weight is on the 30th percentile line would be treated as lighter that 70 per cent and heavier than 29 % of children of the same age.
To illustrate, a-five-year old marasmic child weighing 8 kg. and who is 85 cm. tall, falls below three percentiles, as is evident from the growth grid chart cited above. The height and weight of the child are generally on the same percentile. Any discrepancy should be noted. The head circumference is measured on the similar basis. This measurement is more valuable from birth to three years of age. This measurement may be useful to detect hydrocephalus and mental retardation.
The nurse can assess the growth of the child by obtaining accurate measurement of the weight, height, and head circumference, and by comparing it with the expected values for the respective age within the normal limits. The fiftieth percentile can be considered as an average. If the measurement falls above the ninetieth or below tenth percentile, it is necessary to refer the child for further evaluation.