Adolescent Development and Health 467TABLE 20.1 Developmental Tasks of Adolescence
Gain independence from family.
Expand relationships outside home:
Other adults.
Same-sex peers.
Opposite-sex peers.
Have realistic self-image.
Handle sexual drives.
Concrete to abstract thought.
Develop value system.
Make realistic plan for social and economic stability.(see Lemonick, 2000). Whatever its origin, this physical
trend prompts concern among both parents and health profes-
sionals regarding the potential impact on girls• psychosocial
development.
Psychosocial Development
The developmental period of life that we term adolescenceis
somewhat elastic in its boundaries, but generally includes
children from 12 to 20 years of age. It is bounded by biology
at one end (the onset of puberty) and by social and legal con-
ventions at the other end (the age when one is considered an
adult). For individual children, the perception that they have
entered adolescence may be triggered by their own pubertal
changes or by changes evident in their peers, hence the lack
of a clear-cut boundary. The end point is also unclear, with
American children being considered suf“ciently adult to
drive at age 16, vote at age 18, and drink only at age 21 (de-
pending on the state where they live). Transition times also
vary in health care settings, with pediatric services typically
including age 12 to 20 (except for college health) while psy-
chiatric services designed for adolescents are generally
unavailable after their eighteenth birthday.
Adolescents have a number of developmental tasks to
accomplish during this relatively brief period of life (see
Table 20.1). They must learn to function as independent
adults, separate from their families, while not severing ties
to the family. They also become increasingly oriented to oth-
ers outside the family as they develop signi“cant relation-
ships with other adults (e.g., teachers, coaches) and with peers
of both sexes. Their self-image is consolidated and incorpo-
rates their sexual identity (e.g., What does it mean to be a
woman? How am I the same as, and different from, a man?).
Self-image includes body image, which many believe is
crystallized during adolescence. A host of new sensations and
feelings emerge, and adolescents must come to terms with
their sex drives and determine how to manage them. The
transition from concrete operations to formal operations not
only paves the way for learning higher order mathematics
and other abstract concepts, but also provides adolescents with
new tools and interests as they increasingly contemplate their
own lives and the human condition. Finally, adolescents need
to develop a plan for their future, establishing a direction,
goals, and appropriate training for a career.
This is a daunting list of tasks to accomplish in eight
years, reinforcing the traditional, psychoanalytic view of
adolescence as a tumultuous, troubled time of life. Yet, a con-
siderable amount of more recent data (Offer, Ostrov, &
Howard, 1981) reports that about 75% to 80% of teenagers
experience adolescence as a positive and pleasant period of
life. How do adolescents manage this, with so many develop-
mental tasks to accomplish?
One reason is that many of these tasks are not begun de
novo in adolescence. For example, children have been gain-
ing increased independence throughout childhood as they
learn to feed and dress themselves, choose preferred activi-
ties, stay overnight at a friend•s house, and go away to camp.
In a study of 483 children and adolescents, Larson and
Richards (1991) reported that the amount of time children
spend with their families decreases from about 50% at Grade
5 to about 25% at Grade 9. While this is a considerable
decrease, it is not an all-to-none change. Similarly, many
aspects of self-image have been developed by the end of
childhood, and preadolescents can identify their assets and
weaknesses. The task in adolescence is to re“ne this self-
image and to incorporate sexual identity. Finally, develop-
ment continues past the age of 20 as the completion of
adolescent tasks continues in young adulthood.
Another reason adolescents manage their developmental
tasks with relative ease is that they focus on different issues at
different times, reducing the number that they must address
simultaneously. As Table 20.2 shows, developmental theorists
divide adolescence into different periods: preadolescence and
early, middle, and late adolescence. Note that boys• progressTABLE 20.2 Focus of Development at Different Stages
of Adolescence
Age Grade Developmental Focus
Preadolescence:
Females: 9...11 years 5...7 Same-sex peers
Males: 10...12 years
Early adolescence:
Females: 11...13 years 6...8 Independence
Males: 12...14 years Same-sex peers
Body image
Abstract thought
Middle adolescence:
Females: 13...16 years 7...10 Opposite-sex peers
Males: 14...17 years Sexual drives
Sexual identity
Morality
Late adolescence:
Females: 16...20 years 11... Vocational plans
Males: 17...20 years College Intimacy