The adolescent cryAre we listening?

Prof. J.N.SharmaDepartment of PediatricsGauhati Medical College

Adolescence

A crucial period of life Is a confusion• Adolescents• Parents• Care taker• Neither a child nor an adult• Transition difficult to detect• A complicated but useful lot of human

resources

Two most crucial period of lifeof Growth and development

Under five period (Early childhood)• Somatic, • Brain and • lymphoid

Adolescence• Somatic• Psychological• Reproductive and secondary sexual characteristics

Adolescence

What is adolescence?• Not clearly defined

Beginning and End ? • Not clear

Problems are peculiar• Health problems• Psychosocial problems

Who will look after the adolescents?• Not yet decided

Adolescence

Period of life marking the end of childhood and setting the foundation for maturity,

A critical period of development with manifestations at the biological, psychological and social levels of integration.

Most complex part of development in human life.

Adolescence

• 20 % of population + 40% children = 60%• Achieve same degree of significance as early

childhood• Development marked by significant interaction• Manifestations at biological, psychological and

social levels

Adolescence

Onset and termination• Biological

• Psychological

• Social

Onset and termination

Biologically• The onset is signaled by the final phase of

acceleration of growth and beginning of secondary sexual character.

• Termination is marked by epiphyseal fusion and completion of sexual differentiation.

Onset and termination

Psychologically• It is marked by acceleration of cognitive growth and

personality formation• Succeeded by the stage of parenthood and

acquisition of an adult role.

Onset and termination

Socially• It is a period of intensified preparation for the

assumption of an adult role• Termination is signaled when the person is accorded

full adult prerogatives.

Onset and termination

To note• Physical development has a definite pattern and

sequence• Psychological growth cannot be set in one

pattern

The adolescent age group

Who are adolescents?• Boys between the age of 10 – 22 years• Girls between the age of 9 – 20 years

What is the age of onset and end?• Boys: 10 – 12 yrs to 20 – 22 yrs.• Girls: 9 – 11 yrs to 18 – 20 yrs.

Problems of adolescence

• Health problems• Psychological problems• Social problems

Problems of adolescence

Health problems• Usually not reported: Nature of disease• If diagnosed therapy is not regular• Under treated by physicians• Do not come to pediatricians

Common health problems

• Malnutrition: PEM, Obesity • Anemia• Tuberculosis• Heart disease: hypertension, RHD• Acne• Accidents and injuries• STDs• Menstrual disorders

Psychological development

• Ability for abstract conceptualization• Search for a sense of personal identity

• No longer a child , not an adult• Engages in determining who s/he is and what s/he is

to become• Examines parents critically, lean more to peer groups.

Psychological development

• Search for identity is influenced by peer groups.• Constructive social group: meaningful society

membership• Delinquent gang: antisocial personality• Sound parent relationship: firm and lasting

relationship• Excessive dependence / hostility: failure of

emancipation/ rejection of family

• Cross cultural evidence have shown that the conflict and distress experienced by adolescents reflect the cultural influences and expectations and are not caused by hormonal changes or physical growth pattern

• Parents should guide at this juncture

Psychosocial problems

• More common than health problems• Peak age: late adolescence• Sex variation: equal but problems different• Urban / rural: same• Urban boys, rural girls: more problems

Psychosocial problems

Assessment is difficult• Variety • Difficult to differentiate between normal and

abnormal• Minor problems go undetected• Major problems: Diagnosis is presumptive

Psychological problems

• Identity crisis• Depression• Suicide• Substance abuse• Sleep disorders• Anorexia nervosa

Social problems

Contributing factors• Poor socioeconomic status• No opportunity for education• Mass media exposure to violence, corruption and

fundamentalism

Leads to

Loss of social perspectives

Social problems

• Child labour• Prostitution• Nonaccidental injuries• Illegitimate pregnancies• Vandalism• Violence• Sex crimes

Care of adolescents

Not yet properly decided

Pediatricians?• WHO: Childhood upto 25 years• Upto 18 years in India: No infrastructure• No ward, No OPD• Rest 3 – 4 years left to general physicians

Conclusions

Adolescence• A phase of intense change• Problems multifarious• No infrastructure. No serious thought.

• One cannot sit idle and ignore• Because

Conclusions

• It is very important to protect this important human resource

• This is the time they are shown the right direction, given proper guidance to put them on the right path without hurting their ego.

Conclusions

• The parents at home, the teachers at school and the society at large should take the responsibility to transform children into adults.

• They must be nurtured in an environment of dignity, love and affection, feeling of being wanted and educated inorder to grow into active, skilled and confident individuals who can take definitive and correct decision.

Conclusions

God could not make himself available to take care of

each child He created. So he gave • Parents to take care and nurture, • Teacher for guidance and education and • Pediatrician for prevention and intervention

programmes

The adolescent’s cry

Are we listening?

Probably No

Atleast not adequately

Thank you