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developmental concepts > lecture seven: adolescence > Flashcards

lecture seven: adolescence Flashcards

1
Q

stages of development review

A
  • infancy: birth to 1 yr
    • neonatal: birth to 2 wks of age
    • infant: 3 wks to 12 months of age
  • toddlerhood: 13 months to 2 yrs (2 yrs, 11 months)
  • early childhood:
    • preschool: 3-5 yrs
    • elementary school: 5-10 yrs (10 yrs, 11 months)
  • adolescence: 11-18 yrs
  • young adulthood: 18-22/25 yrs
    • pediatric PTs are often involved in the care of children through early adulthood
  • adulthood: 22-40 yrs
  • middle age: 40-65 yrs
  • late adulthood (older adult): 65+
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2
Q

adolescent period

A
  • viewed as a transition period between childhood and adulthood
  • begins with sexual maturity and ends with cessation of growth
  • involves physical and psychological development
    • reach physical and sexual maturity
    • grow self-consciousness and search for identity
    • develop more sophisticated reasoning ability and abstract thinking
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3
Q

puberty

A
  • pre-adolescence
    • marked by rapid physical growth and development of secondary sex characteristics
      • females: 8-10 yrs of age
      • males: 9-11 yrs of age
  • a child’s sexual and physical characteristics mature
  • occurs due to gonadal hormone changes
  • ends with onset of menses
    • females: menarche at age 12-13
    • males: production of sperm
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4
Q

four major changes of puberty

A
  • development of primary sex characteristics (sex organs)
  • development of secondary sex characteristics
  • rapid physical growth —> spurt in height and weight
  • changes in body proportions
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5
Q

primary sex characteristics

A

testes and ovaries

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6
Q

secondary sex characteristics

A

physical appearance

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7
Q

factors affecting timing of puberty

A
  • genetics
  • stress
  • socioeconomic status
  • environmental toxins
  • nutrition and diet, exercise
  • amount of fat and body weight
  • chronic illness
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8
Q

puberty in female athletes

A
  • delayed menarche (first menstruation)
  • menstrual irregularities
    • first ovulation cycle occurs after menarche
    • pubertal maturation: establishment of cyclic ovarian function
    • establishment of successive ovulatary cycles does not occur for months to years after menarche
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9
Q

rapid physical growth

A
  • puberty is second to the prenatal period as phase of most rapid growth
    • rate of physical growth slows down after puberty (adolescence)
  • growth spurt begins with feet —> legs —> trunk
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10
Q

rapid physical growth during puberty

A
  • height
    • boys: 4-12 inches
    • girls: 2-8 inches
  • weight
    • boys: 15-65 pounds
    • girls: 15-65 pounds
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11
Q

rapid physical growth during adolescence

A
  • height
    • girls
      • ceases growth between 16-17 yrs of age
      • reach 98% of final height by age 17
    • boys
      • continue to grow in height up to 18-20 yrs of age
      • reach 98% of final height by age 18
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12
Q

body mass index

A
  • underweight: <18.5
  • healthy weight: 18.8 - 24.9
  • overweight: 25 - 29.9
  • obese: 30+
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13
Q

body mass index for age

A
  • underweight: <5%
  • healthy weight: 5%-85%
  • overweight: 85%-95%
  • obese: 95%+
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14
Q

changes in body proportions (puberty)

A
  • face —> nose reaches adult size first
  • hands and feet reach adult size before arms and legs
  • limbs and trunk —> LE becomes longer than trunk
  • bones often grow faster than muscles leading to motor awkwardness
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15
Q

changes in body proportions (later in adolescence)

A
  • growth slows down
  • body proportions are similar to those of adults
  • bone growth stops at approximately 18 for girls and 21 for boys
  • permits adolescents to stabilize the organization of different muscular patterns (improved coordination)
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16
Q

skeletal system maturation (growth plates)

A
  • skeletal maturity is attained when epiphyseal plates close
  • epiphyseal closure begins in childhood
    • ex: cranial bones fuse at approx 2 yrs old, fusion of vertebral arches of vertebral arches is typically in the first yr of life and in lumbar spine by 6 yrs
  • epiphyseal closure is typically complete (all epiphyseal growth plates closed) at age 25
  • precautions
    • fracture across growth plate can lead to asymmetrical growth of that joint
    • use of ultrasound is contraindicated over epiphyseal areas in children
17
Q

growth spurt

A
  • for most people, height will not increase after age 18 to 20 due to closure in growth plates of long bones
  • on average, females stop growing around age 13-15 and boys around 15-17
18
Q

skeletal system

A
  • bone is immature through much of adolescence
    • more porous with thick periosteum
    • unstable physes (growth plates)
  • indicator of maturation: compare ossification amount on x-ray with standards
19
Q

muscular system

A
  • increase muscle size, strength, and endurance
  • muscle mass increases first as body grows
  • adult muscle diameter reached in early teens (12-15 yrs)
  • increases in strength directly related to increases in muscle mass during growth
  • strength increases linearly with age from childhood through adolescence (6-18 yrs)
    • girls: level off after age 15
    • boys: accelerates between age 13-20
20
Q

as skeletal system grows, muscles have to _________ to establish appropriate length-tension relationship

A

lengthen

21
Q

cardiopulmonary system

A
  • at rest
    • pulse rate: 60-90 bpm
    • respiratory rate: 16-24 breaths/min
    • increase size of heart and blood volume
    • increase weight and volume of lungs
  • during acute exercise
    • HR: higher during sub max and max exercise
    • stroke volume: lower
    • adjusted for mass, cardiac output (HR x SV = CO) is higher in children and teens
    • BP: lower at rest —> slope of systolic rise is less dramatic with exercise
22
Q

temperature regulation

A
  • greater surface area-to-body mass ratio
  • produce more metabolic heat/mass unit during physical activities (!)
  • lower sweating capacity due to fewer sweat glands
  • implication
    • at high temps: risk for heat-related injuries
    • at low temps: risk for increased heat loss
23
Q

exercise prescription

A
  • frequency
    • 3-5 x per week
  • intensity
    • 50-85% of VO2max
    • 40-50% in deconditioned individuals
    • borg scale of perceived exertion
  • time
    • 30-60 min
    • if less than 30 min, increase frequency
  • type
    • play, games, sports, chores, recreation, PE
    • keep it fun, developmentally appropriate and vary activities in context of family, school, and community activities
24
Q

fitness and wellness

A
  • healthy musculoskeletal tissues
  • healthy cardiovascular and pulmonary systems
  • neuromuscular awareness
  • facilitate main entrance of a healthy body weight
  • psychological benefits
25
Q

psychosocial development and behavioral issues

A
  • often becomes negative in their attitudes and interaction
    • growing self consciousness related to their changing bodies
  • social antagonism
    • need for privacy, resent supervision and reactions, struggle for independence, wish to be free from restrictions and parental control
  • search for identity
    • separation from the family
    • develop their own self concepts —> question and test out values and beliefs
    • emotion issues: confusion, depression, discouragement
  • adolescence
    • identity vs confusion (erikson)
26
Q

growth spurt changes _________ and ___________

A
  • self esteem; peer group status
    • grow self-consciousness
27
Q

young teens (13-14 yrs)

A
  • most self-centered, seen from their point of view
  • value peer’s opinions with the stereotypical adolescent preoccupations
28
Q

middle teens (15-16 yrs)

A
  • better at compromising, more tolerant of others’ views
  • think more independently and make more of their own decisions
  • risk taking behaviors with a focus on the present and denial of consequence
  • dating begins around 15-16 yrs
29
Q

late teens (17-18 yrs)

A
  • develop a sense of seriousness
  • ends when they take on adult work roles, marry, or become parents
30
Q

cognitive development

A
  • ages 11-14
  • increasingly capable of thinking hypothetically, applying formal logic, and using abstract concepts
  • more relative and less absolute
  • more self-reflective
  • capable of considering an extended time perspective
31
Q

self esteem

A
  • small gains in self esteem have been documented during second decade of life
    • initial decline in early adolescence, particularly among girls
    • low self esteem associated with depression, suicidal behavior, delinquent behavior, and drug use
  • self esteem affected by personal judgement of
    • physical attractiveness, particularly among girls
    • acceptance by peers
    • academic competence
    • athletic ability and conduct
  • perceived support from parents and peers is associated with adolescent self-esteem
    • peer support takes on increasing importance during this period
32
Q

depression/suicide

A
  • symptoms and signs
    • feel sad, tired, withdrawn, think hopelessly or negatively
    • 5000 young people aged 15-24 commit suicide
    • 3rd leading cause of death in youths and young adults
  • causes
    • problems with family, school, high expectations, relationship break ups, substance abuse, poor choices
  • masked by anxiety, eating disorders, substance abuse, hyperactivity
33
Q

destructive behaviors

A
  • disordered eating
    • bulimia, anorexia, obesity
    • signs include low energy, fatigue, preservation on food, and obsession with body image
  • self injurious behavior
  • substance abuse
34
Q

sexuality

A
  • puberty accompanied by increase in sexual arousal
  • end of high school —> 48% have had sexual intercourse
  • children with special needs at greater risk for sexual abuse
  • safe sex —> taking precautions and reduce change of STDs or pregnancy
  • condom use —> 57%
35
Q

increased risk for injury in adolescent athletes

A
  • sports specialization
    • neuromuscular control improves when adolescents play multiple sports
  • rapid growth spurts and change in body proportion
    • decreased coordination
  • increased training volume
    • training several hours each week and year round
36
Q

RED-S (relative energy deficiency in sport)

A
  • insufficient caloric intake and/or excessive energy expenditure leading to inadequate energy to support body’s physiological functions
  • common among adolescent athletes
  • implications
    • decreased muscular strength and endurance performance
    • chronic fatigue
    • bone loss —> increased risk of stress fractures
    • psychological stress, depression, and anxiety
37
Q

ACL injury

A
  • anterior cruciate ligament —> resist anterior translation of tibia
  • typically occurs with rapid change in direction or during non contact situations (i.e. landing from a jump or a quick twisting motion)
  • more common in female athletes
38
Q

ACL injury implications

A
  • in a pediatric patient, ACL injuries can commonly occur with a fracture of the growth plate
    • growth plates typically close by ages 13-15 for girls and 15-17 for boys
  • increased risk for osteoarthritis later in life
  • rehabilitation
    • early on —> range of motion and mobility
    • gradually progress to strengthening, endurance, and neuromuscular training (hamstrings and gluteals)
    • later on —> sports specific activities

developmental concepts (7 decks)

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