Developmental Milestones: Tweens and Teens
by Ola Odufuye, Pediatrician
Talk to the Doc — February 2012
Mother Goose told us that little girls are made of sugar and spice, little boys of snails and puppy dog tails—but we pediatricians know that tweens and teens are also made of estrogen and testosterone. When these hormones surge, parents might feel as overwhelmed as the Old Lady who lived in a shoe.
It can be a rocky road, but this transition to adulthood is just a part of growing up. We all go through it, but what happens, how it happens, and when it happens is different for boys and girls.
Girls typically show signs of physical maturity by age 9, although African-Americans tend to start a little earlier, around age 8.
Breast buds are usually the first indicator, and girls may express discomfort or even pain if jostled in the chest while playing sports or roughhousing.
The pubescent girl will likely have some vaginal discharge or “tummy aches” that to a mom’s ear sound more like menstrual cramps, and are cyclical in nature as she approaches her first period. She will develop armpit and pubic hair, hips, and a waistline.
Once she starts her period, generally around age 11 – 13, she’ll hit a growth phase that will last a year and a half to two years.
If she’s not showing any signs of puberty by age 14 – no breast buds, no pubic hair, nothing at all—she may need to see an endocrinologist. If she’s developing physically but has not menstruated by age 16 (or a little older, if she’s athletic), bring it to the attention of her doctor.
The first sign of puberty in boys isn’t quite as obvious as breast buds and periods. Mom and Dad, or the young man himself, might not even notice.
First, his testicles will get bigger, and then his penis. What you probably will notice is the growth spurt in height that follows soon after, not to mention a difference in body odor. Some moms report that the little-boy scent they cherished is left behind, with a more decidedly man-sweat smell taking its place. It’s time to introduce deodorant, especially as armpit hair sprouts, followed by pubic and facial hair.
Your son’s voice will begin to crack—another sign of approaching adulthood—and he will steadily grow taller for three to four more years.
Something a little more sensitive, but just as important in indicating normal development, is the beginning of nocturnal emissions – less formally known as “wet dreams.” This is kind of like the male version of menstruation, only it’s not as obvious and it happens a little later, typically around age 14. This is a result of hormonal buildup and is proof of his body’s ability to ejaculate.
Boys who are not showing any signs of puberty by age 15 should be seen by a doctor.
Some parents stop taking their children to the doctor for well-child checkups once the shot schedule tapers off, but I highly recommend regular visits to the pediatrician throughout the tween and teen years – not only for their physical health, but to establish healthy practices for when they’re out on their own.
As your kids grow older, I suggest talking to them about what to expect at these visits.
The doctor will check your daughter’s breast development and the stage of pubic hair growth. Your child should not have to disrobe—most often it’s a quick peek via a lift of the waistband or zipper.
Girls do not require gynecological exams or pap smears until the age of 18 – 21 or the onset of sexual intercourse, whichever occurs first.
Boys will have to pull their pants down a little, and the doctor will have to do a little hands-on check to rule out two serious, albeit rare, conditions tween and teen boys are susceptible to – testicular cancer and groin hernias.
Parents should be asked to remain in the exam room for the physical part of the checkup, but some pubescent kids are surprisingly open and candid when given the opportunity for a private chat with their doctor. This is great for doctor-patient counseling about other issues that plague kids – for example, peer pressure, eating habits, and drug/alcohol education. Unless he or she indicates participation in behaviors that are potentially harmful to themselves or others, the conversation remains confidential.
Parents have it tough. They’re excited to see their children grow, but at the same time can’t wait for some of the more difficult phases to be over with – that’s why a favorite mommy mantra is “this too shall pass.”
Dig in, because puberty lasts three to four years. With the guidance of a trusted doctor or pediatrician, all of you will make it to the other side unscathed.
Signs of transition from little girl to young lady:
- breast buds
- underarm and pubic hair
- acne
- hips, curves
- menstruation
Signs of transition from young boy to fine lad:
- testicle and penis growth
- underarm, pubic, chest and facial hair
- voice cracking
- muscle growth
- nocturnal emissions
- Source: www.healthychildren.org, a website organized by the American Academy of Pediatrics
