The development of children ages 12 through 18 years old should include expected physical and mental milestones.
Development - adolescent; Growth and development - adolescent
During adolescence, children develop the ability to:
During adolescence, young people go through many changes as they move into physical maturity. Early, prepubescent changes occur when the secondary sexual characteristics appear.
The sudden and rapid physical changes that adolescents go through make adolescents very self-conscious. They are sensitive, and worried about their own body changes. They may make painful comparisons about themselves with their peers.
Physical changes may not occur in a smooth, regular schedule. Therefore, adolescents may go through awkward stages, both in their appearance and physical coordination. Girls may be anxious if they are not ready for the beginning of their menstrual periods. Boys may worry if they do not know about nocturnal emissions.
During adolescence, it is normal for young people to begin to separate from their parents and make their own identity. In some cases, this may occur without a problem from their parents and other family members. However, this may lead to conflict in some families as the parents try to keep control.
Friends become more important as adolescents pull away from their parents in a search for their own identity.
In mid- to late adolescence, young people often feel the need to establish their sexual identity. They need to become comfortable with their body and sexual feelings. Adolescents learn to express and receive intimate or sexual advances. Young people who do not have the chance for such experiences may have a harder time with intimate relationships when they are adults.
Adolescents very often have behaviors that are consistent with several myths of adolescence:
Adolescents become stronger and more independent before they have developed good decision-making skills. A strong need for peer approval may tempt a young person to take part in risky behaviors.
Motor vehicle safety should be stressed. It should focus on the role of the driver/passenger/pedestrian, the risks of substance abuse, and the importance of using seat belts. Adolescents should not have the privilege of using motor vehicles unless they can show that they can do so safely.
Other safety issues are:
If adolescents need to be evaluated if they appear to be isolated from their peers, uninterested in school or social activities, or doing poorly at school, work, or sports.
Many adolescents are at increased risk for depression and potential suicide attempts. This can be due to pressures and conflicts in their family, school or social organizations, peer groups, and intimate relationships.
PARENTING TIPS ABOUT SEXUALITY
Adolescents most often need privacy to understand the changes taking place in their bodies. Ideally, they should be allowed to have their own bedroom. If this is not possible, they should have at least some private space.
Teasing an adolescent child about physical changes is inappropriate. It may lead to self-consciousness and embarrassment.
Parents need to remember that it is natural and normal for their adolescent to be interested in body changes and sexual topics. It does not mean that their child is involved in sexual activity.
Adolescents may experiment with a wide range of sexual orientations or behaviors before feeling comfortable with their own sexual identity. Parents must be careful not to call new behaviors "wrong," "sick," or "immoral."
The Oedipal complex (a child's attraction to the parent of the opposite sex) is common during the adolescent years. Parents can deal with this by acknowledging the child's physical changes and attractiveness without crossing parent-child boundaries. Parents can also take pride in the youth's growth into maturity.
It is normal for the parent to find the adolescent attractive. This often happens because the teen often looks very much like the other (same-sex) parent did at a younger age. This attraction may cause the parent to feel awkward. The parent should be careful not to create a distance that may make the adolescent feel responsible. It is inappropriate for a parent's attraction to a child to be anything more than an attraction as a parent. Attraction that crosses the parent-child boundaries may lead to inappropriately intimate behavior with the adolescent. This is known as incest.
INDEPENDENCE AND POWER STRUGGLES
The teenager's quest to become independent is a normal part of development. The parent should not see it as a rejection or loss of control. Parents need to be constant and consistent. They should be available to listen to the child's ideas without dominating the child's independent identity.
Although adolescents always challenge authority figures, they need or want limits. Limits provide a safe boundary for them to grow and function. Limit-setting means having pre-set rules and regulations about their behavior.
Power struggles begin when authority is at stake or "being right" is the main issue. These situations should be avoided, if possible. One of the parties (typically the teen) will be overpowered. This will cause the youth to lose face. The adolescent may feel embarrassed, inadequate, resentful, and bitter as a result.
Parents should be ready for and recognize common conflicts that may develop while parenting adolescents. The experience may be affected by unresolved issues from the parent's own childhood, or from the adolescent's early years.
Parents should know that their adolescents will repeatedly challenge their authority. Keeping open lines of communication and clear, yet negotiable, limits or boundaries may help reduce major conflicts.
Most parents feel like they have more wisdom and self-growth as they rise to the challenges of parenting adolescents.
Hazen EP, Abrams AN, Muriel AC. Child, adolescent, and adult development. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 5.
Holland-Hall CM. Adolescent physical and social development. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 132.
Marcdante KJ, Kliegman RM. Overview and assessment of adolescents. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 67.
Review Date: 3/6/2019
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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