Paediatrics: Adolescence: overview

Adolescence: overview

Adolescence is the transition period before adulthood. A number of physi-cal and psychological objectives are achieved.

Physical and psychological objectives of adolescence

•   Achievement of physical maturation.

•   Achievement of sexual maturation.

•   Attainment of personal identity.

•   Establishment of independence.

•   Establishment of autonomy.

•   Development of sexual relationships.

Adolescence is therefore filled with major changes that need to be taken into account when caring for adolescents with health-related problems.

Management of adolescents: key areas to consider

Communication issues

Appreciation of adolescent-relevant issues, e.g. sex/drugs/smoking.

Physical examination

•   Privacy and personal integrity.

•   Pubertal assessment.

Psychosocial issues

•   Personal identity.

•   Compliance.

Ethical and legal issues

•   Consent.

•   Competence.

•   Confidentiality.

All those working with adolescents need to acquire the appropriate skills to manage and communicate effectively with young people.

Psychological development

Adolescence marks the beginning of the development of more complex thinking processes. These include:

•   The ability for abstract thinking (thinking about possibilities).

•   The ability to reason from known principles (form own new ideas or questions).

•   The ability to consider many points of view according to different

•   criteria (i.e. compare or debate ideas or opinions).

•   The ability to think about the process of thinking.

During adolescence, young people acquire the ability to think systemati-cally about all logical relationships within a problem. The transition from concrete thinking to formal logical conclusions occurs over time. Each adolescent progresses at varying rates in developing his/her ability to think in more complex ways. Some adolescents may be able to apply logical operations to school work long before they are able to apply them to personal dilemmas. When emotional issues arise, they often interfere with an adolescent’s ability to think in more complex ways. The ability to con-sider possibilities, as well as facts, may influence decision-making, in either +ve or –ve ways. The interactions that occur between puberty and psy-chological development are important, esp. in the context of developing self-esteem and a sense of sexuality and body image.

Social development

Adolescence marks the period of time during which there is a gradual shift in the balance between dependence on others to position of indepen-dence. The timing of this process is variable and will depend on the social and cultural environment.

Physical development

•   Psychological and social changes occur against a background of physical changes of puberty.