By Ann L. O'Sullivan, PhD, CRNP, FAAN
and Mary Ann Krisman-Scott, MSN, CRNP

Nurses care for adolescents in multiple settings. To provide adequate care, nurses must understand normal growth and development and factors which influence that development. A great deal of progress has been made in identifying factors that influence teen development, either positively or negatively. Knowledge of these factors will help nurses to provide care to teens and their families.

Traditional View of Adolescent Growth & Development

Adolescence is the time of transition from childhood to adulthood. It is characterized by rapid growth, development of secondary sex characteristics and cognitive and psychosocial development. Typically, adolescence is divided into three phases based on age; early (10 - 13 years), middle (14-17 years), and late (17 - 21 years).

Adolescent development is multidimensional, complex and marked by periods of rapid growth alternating with periods of remission. In the last century, the onset of physical change has occurred at increasingly younger ages, increasing the likelihood that the psychosocial and cognitive changes will lag behind (Neinstein, 1996).

Timing of the physical changes of puberty varies as much as the number of adolescents going through them. Children of the same age show tremendous variation in growth and sexual development. Teens who develop earlier or later than 10-14 are faced with more questions of normalcy. Body image concerns are greatest in early adolescence. By middle adolescence, physical change is less rapid and dramatic and teens' focus shifts to concerns about improving appearance. By late adolescence many teens have dealt with these concerns and are more at ease with themselves (Krisman-Scott, 1996).