‫ وليد عزيز العميدي‬.

‫د‬
School Age, Adolescence, Special Issues of Development, and Adulthood

Objectives :
1- Describe the developmental changes of school age , adolescence and adult persons
2- Enumerate, describe and discuss important signs of puberty

I. LATENCY OR SCHOOL AGE: 7–11 YEARS

A. Motor development.
The normal grade-school child, 7–11 years of age, engages in complex motor
tasks (e.g., plays baseball, skips rope).
B. Social characteristics.
The school-age child:
1. Prefers to play with children of the same sex; typically avoids and is critical
of those of the opposite sex.
2. Identifies with the parent of the same sex.
3. Has relationships with adults other than parents (e.g., teachers, group
leaders).
4. Demonstrates little interest in psychosexual issues (sexual feelings are latent
and will reappear at puberty).
5. Has internalized a moral sense of right and wrong (conscience) and
understands how to follow rules.
6. School-age children and younger children are typically interviewed and
examined by the doctor with the mother present.
C. Cognitive characteristics.
The school-age child:
1. Is industrious and organized (gathers collections of objects)
2. Has the capacity for logical thought and can determine that objects have
more than one property (e.g., an object can be red and metal)
3. Understands the concepts of conservation and seriation; both are necessary
for certain types of learning
a. Conservation involves the understanding that a quantity of a substance
remains the same regardless of the size of the container or shape it is in (e.g.,
two containers may contain the same amount of water even though one is a tall,
thin tube and one is a short, wide bowl).
b. Seriation involves the ability to arrange objects in order with respect to their
sizes or other qualities.
II. ADOLESCENCE: 11–20 YEARS
A. Early adolescence (11–14 years of age)
1. Puberty occurs in early adolescence and is marked by:
A. The development of secondary sex characteristics and increased skeletal
growth:
Tanner Stages of Sexual Development
Stage Characteristics
1. Genitalia and associated structures are the same as in childhood; nipples
(papillae) are slightly elevated in girls
2. Scant, straight pubic hair, testes enlarge, scrotum develops texture; slight
elevation of breast tissue in girls
3. Pubic hair increases over the pubis and becomes curly, penis increases in
length and testes enlarge
4. Penis increases in width, glans develops, scrotal skin darkens; areola rises
above the rest of the breast in girls
5. Male and female genitalia are like adult; pubic hair now is also on thighs,
areola is no longer elevated above the breast in girls
B. First menstruation (menarche) in girls, which on average occurs at 11–14
years of age
C. First ejaculation in boys, which on average occurs at 12–15 years of age
D. Cognitive maturation and formation of the personality
E. Sex drives, which are expressed through physical activity and
masturbation (daily masturbation is normal)
f. Sexual practicing behavior with same- or opposite-sex peers.

2. Early adolescents show strong sensitivity to the opinions of peers but are
generally obedient and unlikely to seriously challenge parental authority.
3. Alterations in expected patterns of development (e.g., acne, obesity, late
breast development in girls, nipple enlargement in boys [usually temporary but
may concern the boy and his parents]) may lead to psychological difficulties.
B. Middle adolescence (14–17 years of age)
1. Characteristics
a. There is great interest in gender roles, body image, and popularity.
b. Heterosexual crushes (love for an unattainable person such as a rock star)
are common.
c. Homosexual experiences may occur. Although parents may become
alarmed, such practicing is part of normal development.
d. Efforts to develop an identity by adopting current teen fashion in clothing
and music, and preference for spending time with peers over family are normal,
but may lead to conflict with parents.
2. Risk-taking behavior
a. Readiness to challenge parental rules and feelings of omnipotence may result
in risk-taking behavior (e.g., failure to use condoms, driving too fast, and
smoking).
b. Education about obvious short-term benefits rather than references to long-
term consequences of behavior is more likely to decrease teenagers' unwanted
behavior. For example, to discourage smoking, telling teenagers that their
teeth will stay white if they don't smoke, or that other teens find smoking
disgusting, will be more helpful than telling them that they will avoid lung
cancer in 30 years.
C. Late adolescence (17–20 years of age)
1. Development
a. Older adolescents develop morals, ethics, self-control, and a realistic
appraisal of their own abilities; they become concerned with
humanitarian issues and world problems.
b. Some adolescents, but not all, develop the ability for abstract reasoning
(Piaget's stage of formal operations).
2. In the effort to form one's own identity, an identity crisis commonly
develops.
a. If the identity crisis is not handled effectively, adolescents may experience
role confusion in which they do not know where they belong in the world.
b. Experiencing role confusion, the adolescent may display behavioral
abnormalities through criminality or an interest in cults.
D. Teenage sexuality
1. In the United States, first sexual intercourse occurs on average at 16 years
of age; by 19 years of age, most men and women have had sexual intercourse.
2. Fewer than half of all sexually active teenagers do not use contraceptives
for reasons that include the conviction that they will not get pregnant, lack of
access to contraceptives, and lack of education about which methods are most
effective.
3. Physicians may counsel minors (persons under 18 years of age) and provide
them with contraceptives without parental knowledge or consent. They may
also provide to minors treatment for sexually transmitted diseases, problems
associated with pregnancy, and drug and alcohol abuse.
4. Because of their potential sensitivity, issues involving sexuality and drug
abuse, as well as issues concerning physical appearance such as obesity, are
typically discussed with teenagers without the parents present.
E. Teenage pregnancy
1. Teenage pregnancy is a social problem in the United States. Although the
birth rate and abortion rate in American teenagers are currently decreasing,
in 2000, teenagers gave birth to approximately 470,000 infants (8,500 of these
infants were born to mothers under 15 years of age) and had about 500,000
abortions.
2. Abortion is legal in the United States. However, in many states, minors must
obtain parental consent for abortion.
3. Factors predisposing adolescent girls to pregnancy include depression, poor
school achievement, and having divorced parents.
4. Pregnant teenagers are at high risk for obstetric complications because they
are less likely to get prenatal care, and because they are physically immature.

III. SPECIAL ISSUES IN CHILD DEVELOPMENT

A. Illness and death in childhood and adolescence.
A child's reaction to illness and death is closely associated with the child's
developmental stage.
1. During the toddler years (15 months – 2.5 years) hospitalized children fear
separation from the parent more than they fear bodily harm, pain, or death.
2. During the preschool years (2.5 – 6 years) the child's greatest fear when
hospitalized is of bodily harm.
3. School-age children (7–11 years of age) cope relatively well with
hospitalization. Thus, this is the best age to perform elective surgery.
4. Ill adolescents may challenge the authority of doctors and nurses and resist
being different from peers. Both of these factors can result in lack of adherence
to medical advice.
5. A child with an ill sibling or parent may respond by acting badly at school
or home (use of the defense mechanism of "acting out" [seeChapter 6, section
II]).
B. Adoption
1. An adoptive parent is a person who voluntarily becomes the legal parent of
a child who is not his or her genetic offspring.
2. Adopted children, particularly those adopted after infancy, may be at
increased risk for behavioral problems in childhood and adolescence.
3. Children should be told by their parents that they are adopted at the earliest
age possible to avoid the chance of others telling them first.
C. Mental retardation
(also referred to as intellectual and/or developmental disability)
1. Etiology
a. The most common genetic causes of mental retardation are Down syndrome
and fragile X syndrome.
b. Other causes include metabolic factors affecting the mother or fetus, prenatal
and postnatal infection (e.g., rubella), and maternal
substance abuse; many cases of mental retardation are of unknown etiology.
2. Mildly (IQ of 50–69) and moderately (IQ of 35–49) mentally retarded
children and adolescents commonly know they are handicapped (see
Chapter 8). Because of this, they may become frustrated and socially
withdrawn. They may have poor self-esteem because it is difficult for them to
communicate and compete with peers.
3. The Vineland Social Maturity Scale (see Chapter 8) can be used to evaluate
social skills and skills for daily living in mentally retarded and other challenged
individuals.
4. Avoidance of pregnancy in adults with mental retardation can become an
issue, particularly in residential social settings (e.g., summer camp). Long-
acting, reversible contraceptive methods such as subcutaneous progesterone
implants can be particularly useful for these individuals.
IV. Early Adulthood: 20–40 Years
A. Characteristics
1. At about 30 years of age, there is a period of reappraisal of one's life.
2. The adult's role in society is defined, physical development peaks, and the
adult becomes independent.
B. Responsibilities and relationships
1. The development of an intimate (e.g., close, sexual) relationship with
another person occurs.
2. According to Erikson, this is the stage of intimacy versus isolation; if the
individual does not develop the ability to sustain an intimate relationship by this
stage of life, he or she may experience emotional isolation in the future.
3. By 30 years of age, most Americans are married and have children.
4. During their middle 30s, many women alter their lifestyles by returning to
work or school or by resuming their careers.
V. MIDDLE ADULTHOOD: 40–65 YEARS
A. Characteristics.
The person in middle adulthood possesses more power and authority than at
other life stages.
B. Responsibilities.
The individual either maintains a continued sense of productivity or develops a
sense of emptiness (Erikson's stage of generativity versus stagnation).
C. Relationships
1. Seventy to eighty percent of men in their middle 40s or early 50s exhibit a
midlife crisis. This may lead to
a. A change in profession or lifestyle
b. Infidelity, separation, or divorce
c. Increased use of alcohol or drugs
d. Depression
2. Midlife crisis is associated with an awareness of one's own aging and death
and severe or unexpected lifestyle changes (e.g., death of a spouse, loss of a
job, serious illness).
D. Climacterium
is the change in physiologic function that occurs during midlife.
1. In men, decreased muscle strength, physical endurance, and sexual
performance (see Chapter 18) occur in midlife.
2. In women, menopause occurs.
a. The ovaries stop functioning, and menstruation stops in the late forties or
early fifties.
b. Absence of menstruation for 1 year defines the end of menopause. To avoid
unwanted pregnancy, contraceptive measures should be used until at least 1 year
following the last missed menstrual period.
c. Most women experience menopause with relatively few physical or
psychological problems.
d. Vasomotor instability, called hot flashes or flushes, is a common physical
problem seen in women in all countries and cultural groups and may continue
for years. While estrogen or estrogen/progesterone replacement therapy can
relieve this symptom, use of such therapy has decreased because it is associated
with increased risk of uterine and breast cancer.

References :

- BEHAVIORAL SCIENCE TEXTBOOK (8TH EDITION) , Barbara

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