{"id":296,"date":"2021-06-01T19:45:33","date_gmt":"2021-06-01T19:45:33","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/child\/?post_type=chapter&#038;p=296"},"modified":"2024-07-11T18:42:32","modified_gmt":"2024-07-11T18:42:32","slug":"physical-growth-2","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/child\/chapter\/physical-growth-2\/","title":{"raw":"Physical Growth","rendered":"Physical Growth"},"content":{"raw":"<h2>Physical Growth in Infancy<\/h2>\r\nThe average newborn weighs approximately 7.5 pounds, although a healthy birth weight for a full-term baby is considered to be between 5 pounds, 8 ounces (2,500 grams), and 8 pounds, 13 ounces (4,000 grams). The average length of a newborn is 19.5 inches, increasing to 29.5 inches by 12 months and 34.4 inches by 2 years old (WHO Multicentre Growth Reference Study Group, 2006).\r\n\r\nFor the first few days of life, infants typically lose about 5 percent of their body weight as they eliminate waste and get used to feeding.\u00a0This often goes unnoticed by most parents but can be cause for concern for those who have a smaller infant.\u00a0This weight loss is temporary, however, and is followed by a rapid period of growth.\u00a0By the time an infant is 4 months old, it usually doubles in weight, and by one year has tripled its birth weight.\u00a0By age 2, the weight has quadrupled.\u00a0The average length at 12 months (one-year-old) typically ranges from 28.5-30.5 inches.\u00a0The average length at 24 months (two years old) is around 33.2-35.4 inches (CDC, 2010).\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"975\"]<img src=\"https:\/\/textimgs.s3.amazonaws.com\/ospsych\/m49112\/CNX_Psych_09_04_Growth.jpg#fixme\" alt=\"A collage of four photographs depicting babies is shown. From left to right they get progressively older. The far left photograph is a bundled up sleeping newborn. To the right is a picture of a toddler next to a toy giraffe. To the right is a baby blowing out a single candle. To the far right is a child on a swing set.\" width=\"975\" height=\"244\" \/> <strong>Figure 1.<\/strong>\u00a0Children experience rapid physical changes through infancy and early childhood. (credit \"left\": modification of work by Kerry Ceszyk; credit \"middle-left\": modification of work by Kristi Fausel; credit \"middle-right\": modification of work by \"devinf\"\/Flickr; credit \"right\": modification of work by Rose Spielman)[\/caption]\r\n<h3>Monitoring Physical Growth<\/h3>\r\nAs mentioned earlier,\u00a0growth is so rapid in infancy that the consequences of neglect can be severe. For this reason, gains are closely monitored. At each well-baby check-up, a baby's growth is compared to that baby's previous numbers. Often, measurements are expressed as a <strong>percentile\u00a0<\/strong>from 0 to 100, which compares each baby to other babies of the same age. For example, weight at the 40th percentile means that 40 percent of all babies weigh less, and 60 percent weigh more. For any baby, pediatricians and parents can be alerted early just by watching percentile changes. If an average baby moves from the 50th percentile to the 20th, this could be a sign of <strong>failure to thrive,<\/strong> which could be caused by various medical conditions or factors in the child's environment. The earlier the concern is detected, the earlier intervention and support can be provided for the infant and caregiver.\r\n\r\n<a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033131\/growth-chart-female.png\"><img class=\"alignnone wp-image-6915\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033131\/growth-chart-female-214x300.png\" alt=\"\" width=\"473\" height=\"664\" \/><\/a> <a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033143\/growth-chart-male.png\"><img class=\"alignnone wp-image-6916\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033143\/growth-chart-male-214x300.png\" alt=\"\" width=\"472\" height=\"662\" \/><\/a>\r\n<p style=\"text-align: center;\"><strong>Figure 2.\u00a0<\/strong>Growth charts display a normal growth curve for boys and girls from birth to 3 years old.<\/p>\r\n\r\n<h3><strong style=\"font-size: 1em; color: #6c64ad;\">Body Proportions<\/strong><\/h3>\r\nAnother dramatic physical change that takes place in the first several years of life is a change in body proportions.\u00a0The head initially makes up about 50 percent of a person's entire length when developing in the womb.\u00a0At birth, the head makes up about 25 percent of a person's length (just imagine how big your head would be if the proportions remained the same throughout your life!). In adulthood, the head comprises about 15 percent of a person's length. Imagine how difficult it must be to raise one\u2019s head during the first year of life!\u00a0And indeed, if you have ever seen a 2- to 4-month-old infant lying on their stomach trying to raise the head, you know how much of a challenge this is.\r\n<h2>Physical Growth in Early Childhood<\/h2>\r\nChildren between the ages of 2 and 6 years tend to grow about 3 inches in height each year and gain about 4 to 5 pounds in weight each year.\u00a0The average 6-year-old weighs about 46 pounds and is about 46 inches in height.\u00a0The 3-year-old is very similar to a toddler with a large head, large stomach, short arms, and short legs. During early childhood, children start to lose some of their baby fat, making them less like a baby, and more like a child as they progress through this stage. By around age 3, children will have all 20 of their primary teeth, and by around age 4, may have 20\/20 vision. Many children take a daytime nap until around age 4 or 5, then sleep between 11 and 13 hours at night.\r\n\r\nBy the time the child reaches age 6, the torso has lengthened and body proportions have become more like those of adults. It should be noted that these growth patterns are seen where children receive adequate nutrition. Studies from many countries support the assertion that children tend to grow more slowly in low SES areas, and thus they are smaller.\r\n\r\nThis growth rate is slower than that of infancy and is accompanied by a reduced appetite between the ages of 2 and 6. This change can sometimes be surprising to parents and lead to the development of poor eating habits.\r\n<h2>Physical Growth in Middle Childhood<\/h2>\r\nRates of growth generally slow during middle childhood. Typically, a child will gain about 5-7 pounds a year and grow about 2\u00a0inches per year. Many girls and boys experience a prepubescent growth spurt, but this growth spurt tends to happen earlier in girls (around age 9-10) than it does in boys (around age 11-12). Because of this, girls are often taller than boys at the end of middle childhood. Children in middle childhood tend to slim down and gain muscle strength and lung capacity making it possible to engage in strenuous physical activity for long periods of time.\r\n\r\nThe brain reaches its adult size at about age 7. That is not to say, however, that the brain is fully developed by age 7. The brain continues to develop for many years after it has attained its adult size. The school-aged child is better able to plan, coordinate activity using both left and right hemispheres of the brain, and to control emotional outbursts. Paying attention is also improved as the prefrontal cortex matures. As the myelin continues to develop throughout middle childhood, the child's reaction time improves as well.\r\n\r\nDuring middle childhood, physical growth slows down. One result of the slower rate of growth is an improvement in motor skills. Children of this age tend to sharpen their abilities to perform both gross motor skills such as riding a bike and fine motor skills such as cutting their fingernails.\r\n<h3>Losing Primary Teeth<\/h3>\r\n<img class=\"wp-image-5741 alignleft\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2014\/09\/09154009\/kid-386642_1280.jpg\" alt=\"smiling boy on a swing with gap in teeth\" width=\"125\" height=\"188\" \/>\r\n\r\n<span style=\"font-size: 1rem; text-align: initial;\">Deciduous teeth, commonly known as\u00a0milk teeth,\u00a0baby teeth, primary teeth,\u00a0and\u00a0temporary teeth,<sup id=\"cite_ref-:0_1-0\" class=\"reference\"><\/sup>\u00a0are the first set of\u00a0teeth\u00a0in the growth development of humans.\u00a0The primary teeth are important for the development of the mouth, development of the child's speech, for the child's smile, and play a role in\u00a0chewing food, Most children lose their first tooth around age 6, then continue to lose teeth for the next 6 years. In general, children lose the teeth in the middle of the mouth first and then lose the teeth next to those in sequence over the 6-year span. By age 12, generally, all of the teeth are permanent teeth, however, it is not extremely rare for one or more primary teeth to be retained beyond this age, sometimes well into adulthood, often because the secondary tooth fails to develop.<\/span>\r\n<h2>Physical Growth in Adolescence<\/h2>\r\n<strong>Puberty<\/strong> is the period of rapid growth and sexual development that begins in adolescence and\u00a0starts at some point between ages 8 and 14. While the sequence of physical changes in puberty is predictable, the onset and pace of puberty vary widely. Every person\u2019s individual timetable for puberty is different and is primarily influenced by heredity; however environmental factors\u2014such as diet and exercise\u2014also exert some influence.\r\n\r\nAdolescence has evolved historically, with evidence indicating that this stage is lengthening as individuals start puberty earlier and transition to adulthood later than in the past. Puberty today begins, on average, at age 10\u201311 years for girls and 11\u201312 years for boys. This average age of onset has decreased gradually over time since the 19th century by 3\u20134 months per decade, which has been attributed to a range of factors including better nutrition, obesity, increased father absence, and other environmental factors (Steinberg, 2013). Completion of formal education, financial independence from parents, marriage, and parenthood have all been markers of the end of adolescence and beginning of adulthood, and all of these transitions happen, on average, later now than in the past. In fact, the prolonging of adolescence has prompted the introduction of a new developmental period called emerging adulthood that captures these developmental changes out of adolescence and into adulthood, approximately occurring from ages 18 to 29 (Arnett, 2000). We'll learn more about this phase in the next module on early adulthood.\r\n\r\n[caption id=\"attachment_5790\" align=\"alignright\" width=\"290\"]<img class=\"wp-image-5790 \" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2016\/02\/10030831\/Screen-Shot-2019-08-09-at-11.07.27-PM.png\" alt=\"Drawing of adolescent pointing to receding hairline, acne appearing, facial hair growth, larynx gets bigger (voice deepens), armpit hair grow, pubic hair grows, penis grows, and muscles develop.\" width=\"290\" height=\"479\" \/> <strong>Figure 3.<\/strong>\u00a0Major physical changes in males during puberty.[\/caption]\r\n<h3>Hormonal Changes<\/h3>\r\nPuberty involves distinctive physiological changes in an individual\u2019s height, weight, body composition, and circulatory and respiratory systems, and during this time, both the adrenal glands and\u00a0sex glands mature. These changes are largely influenced by hormonal activity.\u00a0Many hormones contribute to the beginning of puberty, but most notably\u00a0a major rush of <strong>estrogen<\/strong> for girls and <strong>testosterone<\/strong> for boys. Hormones play an\u00a0<em>organizational role\u00a0<\/em>(priming the body to behave in a certain way once puberty begins) and an\u00a0<em>activational role\u00a0<\/em>(triggering certain behavioral and physical changes). During puberty, the adolescent\u2019s hormonal balance shifts strongly towards an adult state; the process is triggered by the pituitary gland, which secretes a surge of hormonal agents into the bloodstream and initiates a chain reaction.\r\n\r\nPuberty occurs over two distinct phases, and the first phase, <strong>adrenarche<\/strong>, begins at 6 to 8 years of age and involves increased production of adrenal androgens that contribute to a number of pubertal changes\u2014such as skeletal growth. The second phase of puberty, <strong>gonadarche<\/strong>, begins several years later and involves increased production of hormones governing physical and sexual maturation.\r\n<h3>Sexual Maturation<\/h3>\r\n[caption id=\"attachment_5789\" align=\"alignleft\" width=\"279\"]<img class=\"wp-image-5789 \" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2016\/02\/10030826\/Screen-Shot-2019-08-09-at-11.08.13-PM.png\" alt=\"Drawing of woman showing changes of acne appearance, armpit hair, breast develop, uterus grows bigger, menarche, pubic hair grows, body shape rounds.\" width=\"279\" height=\"494\" \/> <strong>Figure 4.<\/strong>\u00a0Major physical changes in females during puberty.[\/caption]\r\n\r\nDuring puberty, primary and secondary sex characteristics develop and mature. <strong>Primary sex\u00a0characteristics<\/strong> are organs specifically needed for reproduction\u2014the uterus and ovaries in females and testes in males. <strong>Secondary sex\u00a0characteristics<\/strong> are physical signs of sexual maturation that do not directly involve sex organs, such as the development of breasts and hips in girls, and the development of facial hair and a deepened voice in boys.\u00a0Both sexes experience the development of pubic and underarm hair, as well as increased development of sweat glands.\r\n\r\nThe male and female <strong>gonads<\/strong> are activated by the surge of the hormones discussed earlier, which puts them into a state of rapid growth and development. The testes primarily release testosterone and the ovaries release estrogen; the production of these hormones increases gradually until sexual maturation is met.\r\n\r\nFor girls, observable changes begin with nipple growth and pubic hair. Then the body increases in height while fat forms particularly on the breasts and hips. The first menstrual period (<strong>menarche<\/strong>) is followed by more growth, which is usually completed by four years after the first menstrual period began.\u00a0Girls experience menarche usually around 12\u201313 years old.\u00a0For boys, the usual sequence is the growth of the testes, initial pubic-hair growth, growth of the penis, first ejaculation of seminal fluid (<strong>spermarche<\/strong>), appearance of facial hair, a peak growth spurt, deepening of the voice, and final pubic-hair growth. (Herman-Giddens et al, 2012). Boys experience spermarche, the first ejaculation, around 13\u201314 years old.\r\n<h3>Physical Growth: The Growth Spurt<\/h3>\r\nDuring puberty, both sexes experience a rapid increase in height and weight (referred to as a <strong>growth spurt<\/strong>) over about 2-3 years resulting from the simultaneous release of growth hormones, thyroid hormones, and androgens.\u00a0Males experience their growth spurt about two years later than females. For girls, the growth spurt begins between 8 and 13 years old (average 10-11), with adult height reached between 10 and 16 years old. Boys begin their growth spurt slightly later, usually between 10 and 16 years old (average 12-13), and reach their adult height between 13 and 17 years old. Both nature (i.e., genes) and nurture (e.g., nutrition, medications, and medical conditions) can influence both height and weight.\r\n\r\nBefore puberty, there are nearly no differences between males and females in the distribution of fat and muscle. During puberty, males grow muscle much faster than females, and females experience a higher increase in body fat and bones become harder and more brittle. An adolescent\u2019s heart and lungs increase in both size and capacity during puberty; these changes contribute to increased strength and tolerance for exercise.\r\n<h3>Reactions Toward Puberty and Physical Development<\/h3>\r\nThe accelerated growth in different body parts happens at different times, but for all adolescents, it has a fairly regular sequence. The first places to grow are the extremities (head, hands, and feet), followed by the arms and legs, and later the torso and shoulders. This non-uniform growth is one reason why an adolescent body may seem out of proportion. Additionally, because rates of physical development vary widely among teenagers, puberty can be a source of pride or embarrassment.\r\n\r\nMost adolescents want nothing more than to fit in and not be distinguished from their peers in any way, shape, or form (Mendle, 2015). So when a child develops earlier or later than his or her peers, there can be long-lasting effects on mental health. Simply put,\u00a0beginning puberty earlier than\u00a0peers presents great challenges, particularly for girls.\u00a0The picture for early-developing boys isn't as clear, but evidence suggests that they, too, eventually might suffer ill effects from maturing ahead of their peers. The biggest challenges for boys, however, seem to be more related to late development.\r\n\r\nAs mentioned in the Khan Academy video about physical development, early maturing boys tend to be stronger, taller, and more athletic than their later maturing peers. They are usually more popular, confident, and independent, but they are also at a greater risk for substance abuse and early sexual activity (Flannery, Rowe, &amp; Gulley, 1993; Kaltiala-Heino, Rimpela, Rissanen, &amp; Rantanen, 2001). Additionally, more recent research\u00a0found that while early-maturing boys initially had lower levels of depression than later-maturing boys, over time they showed signs of increased anxiety, negative self-image, and interpersonal stress. (Rudolph, Troop-Gordon, Lambert, &amp; Natsuaki, 2014).\r\n\r\nEarly maturing girls may be teased or overtly admired, which can cause them to feel self-conscious about their developing bodies. These girls are at increased risk of a range of psychosocial problems including depression, substance use and early sexual behavior (Graber, 2013). These girls are also at a higher risk for eating disorders, which we will discuss in more detail later in this module (Ge, Conger, &amp; Elder, 2001; Graber, Lewinsohn, Seeley, &amp; Brooks-Gunn, 1997; Striegel-Moore &amp; Cachelin, 1999).\r\n\r\nLate-blooming boys and girls (i.e., they develop more slowly than their peers) may feel self-conscious about their lack of physical development. Negative feelings are particularly a problem for late maturing boys, who are at a higher risk for depression and conflict with parents (Graber et al., 1997) and more likely to be bullied (Pollack &amp; Shuster, 2000).\r\n\r\nhttps:\/\/youtu.be\/DWKWjpVsGng\r\n\r\n<strong>Video 1.\u00a0<\/strong><em>Development in Adolescence\u00a0<\/em>provides an overview of physical changes during adolescence and psychosocial impacts.\r\n<h2><\/h2>\r\n&nbsp;","rendered":"<h2>Physical Growth in Infancy<\/h2>\n<p>The average newborn weighs approximately 7.5 pounds, although a healthy birth weight for a full-term baby is considered to be between 5 pounds, 8 ounces (2,500 grams), and 8 pounds, 13 ounces (4,000 grams). The average length of a newborn is 19.5 inches, increasing to 29.5 inches by 12 months and 34.4 inches by 2 years old (WHO Multicentre Growth Reference Study Group, 2006).<\/p>\n<p>For the first few days of life, infants typically lose about 5 percent of their body weight as they eliminate waste and get used to feeding.\u00a0This often goes unnoticed by most parents but can be cause for concern for those who have a smaller infant.\u00a0This weight loss is temporary, however, and is followed by a rapid period of growth.\u00a0By the time an infant is 4 months old, it usually doubles in weight, and by one year has tripled its birth weight.\u00a0By age 2, the weight has quadrupled.\u00a0The average length at 12 months (one-year-old) typically ranges from 28.5-30.5 inches.\u00a0The average length at 24 months (two years old) is around 33.2-35.4 inches (CDC, 2010).<\/p>\n<div style=\"width: 985px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/textimgs.s3.amazonaws.com\/ospsych\/m49112\/CNX_Psych_09_04_Growth.jpg#fixme\" alt=\"A collage of four photographs depicting babies is shown. From left to right they get progressively older. The far left photograph is a bundled up sleeping newborn. To the right is a picture of a toddler next to a toy giraffe. To the right is a baby blowing out a single candle. To the far right is a child on a swing set.\" width=\"975\" height=\"244\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 1.<\/strong>\u00a0Children experience rapid physical changes through infancy and early childhood. (credit &#8220;left&#8221;: modification of work by Kerry Ceszyk; credit &#8220;middle-left&#8221;: modification of work by Kristi Fausel; credit &#8220;middle-right&#8221;: modification of work by &#8220;devinf&#8221;\/Flickr; credit &#8220;right&#8221;: modification of work by Rose Spielman)<\/p>\n<\/div>\n<h3>Monitoring Physical Growth<\/h3>\n<p>As mentioned earlier,\u00a0growth is so rapid in infancy that the consequences of neglect can be severe. For this reason, gains are closely monitored. At each well-baby check-up, a baby&#8217;s growth is compared to that baby&#8217;s previous numbers. Often, measurements are expressed as a <strong>percentile\u00a0<\/strong>from 0 to 100, which compares each baby to other babies of the same age. For example, weight at the 40th percentile means that 40 percent of all babies weigh less, and 60 percent weigh more. For any baby, pediatricians and parents can be alerted early just by watching percentile changes. If an average baby moves from the 50th percentile to the 20th, this could be a sign of <strong>failure to thrive,<\/strong> which could be caused by various medical conditions or factors in the child&#8217;s environment. The earlier the concern is detected, the earlier intervention and support can be provided for the infant and caregiver.<\/p>\n<p><a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033131\/growth-chart-female.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-6915\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033131\/growth-chart-female-214x300.png\" alt=\"\" width=\"473\" height=\"664\" \/><\/a> <a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033143\/growth-chart-male.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-6916\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5451\/2021\/01\/20033143\/growth-chart-male-214x300.png\" alt=\"\" width=\"472\" height=\"662\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><strong>Figure 2.\u00a0<\/strong>Growth charts display a normal growth curve for boys and girls from birth to 3 years old.<\/p>\n<h3><strong style=\"font-size: 1em; color: #6c64ad;\">Body Proportions<\/strong><\/h3>\n<p>Another dramatic physical change that takes place in the first several years of life is a change in body proportions.\u00a0The head initially makes up about 50 percent of a person&#8217;s entire length when developing in the womb.\u00a0At birth, the head makes up about 25 percent of a person&#8217;s length (just imagine how big your head would be if the proportions remained the same throughout your life!). In adulthood, the head comprises about 15 percent of a person&#8217;s length. Imagine how difficult it must be to raise one\u2019s head during the first year of life!\u00a0And indeed, if you have ever seen a 2- to 4-month-old infant lying on their stomach trying to raise the head, you know how much of a challenge this is.<\/p>\n<h2>Physical Growth in Early Childhood<\/h2>\n<p>Children between the ages of 2 and 6 years tend to grow about 3 inches in height each year and gain about 4 to 5 pounds in weight each year.\u00a0The average 6-year-old weighs about 46 pounds and is about 46 inches in height.\u00a0The 3-year-old is very similar to a toddler with a large head, large stomach, short arms, and short legs. During early childhood, children start to lose some of their baby fat, making them less like a baby, and more like a child as they progress through this stage. By around age 3, children will have all 20 of their primary teeth, and by around age 4, may have 20\/20 vision. Many children take a daytime nap until around age 4 or 5, then sleep between 11 and 13 hours at night.<\/p>\n<p>By the time the child reaches age 6, the torso has lengthened and body proportions have become more like those of adults. It should be noted that these growth patterns are seen where children receive adequate nutrition. Studies from many countries support the assertion that children tend to grow more slowly in low SES areas, and thus they are smaller.<\/p>\n<p>This growth rate is slower than that of infancy and is accompanied by a reduced appetite between the ages of 2 and 6. This change can sometimes be surprising to parents and lead to the development of poor eating habits.<\/p>\n<h2>Physical Growth in Middle Childhood<\/h2>\n<p>Rates of growth generally slow during middle childhood. Typically, a child will gain about 5-7 pounds a year and grow about 2\u00a0inches per year. Many girls and boys experience a prepubescent growth spurt, but this growth spurt tends to happen earlier in girls (around age 9-10) than it does in boys (around age 11-12). Because of this, girls are often taller than boys at the end of middle childhood. Children in middle childhood tend to slim down and gain muscle strength and lung capacity making it possible to engage in strenuous physical activity for long periods of time.<\/p>\n<p>The brain reaches its adult size at about age 7. That is not to say, however, that the brain is fully developed by age 7. The brain continues to develop for many years after it has attained its adult size. The school-aged child is better able to plan, coordinate activity using both left and right hemispheres of the brain, and to control emotional outbursts. Paying attention is also improved as the prefrontal cortex matures. As the myelin continues to develop throughout middle childhood, the child&#8217;s reaction time improves as well.<\/p>\n<p>During middle childhood, physical growth slows down. One result of the slower rate of growth is an improvement in motor skills. Children of this age tend to sharpen their abilities to perform both gross motor skills such as riding a bike and fine motor skills such as cutting their fingernails.<\/p>\n<h3>Losing Primary Teeth<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-5741 alignleft\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2014\/09\/09154009\/kid-386642_1280.jpg\" alt=\"smiling boy on a swing with gap in teeth\" width=\"125\" height=\"188\" \/><\/p>\n<p><span style=\"font-size: 1rem; text-align: initial;\">Deciduous teeth, commonly known as\u00a0milk teeth,\u00a0baby teeth, primary teeth,\u00a0and\u00a0temporary teeth,<sup id=\"cite_ref-:0_1-0\" class=\"reference\"><\/sup>\u00a0are the first set of\u00a0teeth\u00a0in the growth development of humans.\u00a0The primary teeth are important for the development of the mouth, development of the child&#8217;s speech, for the child&#8217;s smile, and play a role in\u00a0chewing food, Most children lose their first tooth around age 6, then continue to lose teeth for the next 6 years. In general, children lose the teeth in the middle of the mouth first and then lose the teeth next to those in sequence over the 6-year span. By age 12, generally, all of the teeth are permanent teeth, however, it is not extremely rare for one or more primary teeth to be retained beyond this age, sometimes well into adulthood, often because the secondary tooth fails to develop.<\/span><\/p>\n<h2>Physical Growth in Adolescence<\/h2>\n<p><strong>Puberty<\/strong> is the period of rapid growth and sexual development that begins in adolescence and\u00a0starts at some point between ages 8 and 14. While the sequence of physical changes in puberty is predictable, the onset and pace of puberty vary widely. Every person\u2019s individual timetable for puberty is different and is primarily influenced by heredity; however environmental factors\u2014such as diet and exercise\u2014also exert some influence.<\/p>\n<p>Adolescence has evolved historically, with evidence indicating that this stage is lengthening as individuals start puberty earlier and transition to adulthood later than in the past. Puberty today begins, on average, at age 10\u201311 years for girls and 11\u201312 years for boys. This average age of onset has decreased gradually over time since the 19th century by 3\u20134 months per decade, which has been attributed to a range of factors including better nutrition, obesity, increased father absence, and other environmental factors (Steinberg, 2013). Completion of formal education, financial independence from parents, marriage, and parenthood have all been markers of the end of adolescence and beginning of adulthood, and all of these transitions happen, on average, later now than in the past. In fact, the prolonging of adolescence has prompted the introduction of a new developmental period called emerging adulthood that captures these developmental changes out of adolescence and into adulthood, approximately occurring from ages 18 to 29 (Arnett, 2000). We&#8217;ll learn more about this phase in the next module on early adulthood.<\/p>\n<div id=\"attachment_5790\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5790\" class=\"wp-image-5790\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2016\/02\/10030831\/Screen-Shot-2019-08-09-at-11.07.27-PM.png\" alt=\"Drawing of adolescent pointing to receding hairline, acne appearing, facial hair growth, larynx gets bigger (voice deepens), armpit hair grow, pubic hair grows, penis grows, and muscles develop.\" width=\"290\" height=\"479\" \/><\/p>\n<p id=\"caption-attachment-5790\" class=\"wp-caption-text\"><strong>Figure 3.<\/strong>\u00a0Major physical changes in males during puberty.<\/p>\n<\/div>\n<h3>Hormonal Changes<\/h3>\n<p>Puberty involves distinctive physiological changes in an individual\u2019s height, weight, body composition, and circulatory and respiratory systems, and during this time, both the adrenal glands and\u00a0sex glands mature. These changes are largely influenced by hormonal activity.\u00a0Many hormones contribute to the beginning of puberty, but most notably\u00a0a major rush of <strong>estrogen<\/strong> for girls and <strong>testosterone<\/strong> for boys. Hormones play an\u00a0<em>organizational role\u00a0<\/em>(priming the body to behave in a certain way once puberty begins) and an\u00a0<em>activational role\u00a0<\/em>(triggering certain behavioral and physical changes). During puberty, the adolescent\u2019s hormonal balance shifts strongly towards an adult state; the process is triggered by the pituitary gland, which secretes a surge of hormonal agents into the bloodstream and initiates a chain reaction.<\/p>\n<p>Puberty occurs over two distinct phases, and the first phase, <strong>adrenarche<\/strong>, begins at 6 to 8 years of age and involves increased production of adrenal androgens that contribute to a number of pubertal changes\u2014such as skeletal growth. The second phase of puberty, <strong>gonadarche<\/strong>, begins several years later and involves increased production of hormones governing physical and sexual maturation.<\/p>\n<h3>Sexual Maturation<\/h3>\n<div id=\"attachment_5789\" style=\"width: 289px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5789\" class=\"wp-image-5789\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2016\/02\/10030826\/Screen-Shot-2019-08-09-at-11.08.13-PM.png\" alt=\"Drawing of woman showing changes of acne appearance, armpit hair, breast develop, uterus grows bigger, menarche, pubic hair grows, body shape rounds.\" width=\"279\" height=\"494\" \/><\/p>\n<p id=\"caption-attachment-5789\" class=\"wp-caption-text\"><strong>Figure 4.<\/strong>\u00a0Major physical changes in females during puberty.<\/p>\n<\/div>\n<p>During puberty, primary and secondary sex characteristics develop and mature. <strong>Primary sex\u00a0characteristics<\/strong> are organs specifically needed for reproduction\u2014the uterus and ovaries in females and testes in males. <strong>Secondary sex\u00a0characteristics<\/strong> are physical signs of sexual maturation that do not directly involve sex organs, such as the development of breasts and hips in girls, and the development of facial hair and a deepened voice in boys.\u00a0Both sexes experience the development of pubic and underarm hair, as well as increased development of sweat glands.<\/p>\n<p>The male and female <strong>gonads<\/strong> are activated by the surge of the hormones discussed earlier, which puts them into a state of rapid growth and development. The testes primarily release testosterone and the ovaries release estrogen; the production of these hormones increases gradually until sexual maturation is met.<\/p>\n<p>For girls, observable changes begin with nipple growth and pubic hair. Then the body increases in height while fat forms particularly on the breasts and hips. The first menstrual period (<strong>menarche<\/strong>) is followed by more growth, which is usually completed by four years after the first menstrual period began.\u00a0Girls experience menarche usually around 12\u201313 years old.\u00a0For boys, the usual sequence is the growth of the testes, initial pubic-hair growth, growth of the penis, first ejaculation of seminal fluid (<strong>spermarche<\/strong>), appearance of facial hair, a peak growth spurt, deepening of the voice, and final pubic-hair growth. (Herman-Giddens et al, 2012). Boys experience spermarche, the first ejaculation, around 13\u201314 years old.<\/p>\n<h3>Physical Growth: The Growth Spurt<\/h3>\n<p>During puberty, both sexes experience a rapid increase in height and weight (referred to as a <strong>growth spurt<\/strong>) over about 2-3 years resulting from the simultaneous release of growth hormones, thyroid hormones, and androgens.\u00a0Males experience their growth spurt about two years later than females. For girls, the growth spurt begins between 8 and 13 years old (average 10-11), with adult height reached between 10 and 16 years old. Boys begin their growth spurt slightly later, usually between 10 and 16 years old (average 12-13), and reach their adult height between 13 and 17 years old. Both nature (i.e., genes) and nurture (e.g., nutrition, medications, and medical conditions) can influence both height and weight.<\/p>\n<p>Before puberty, there are nearly no differences between males and females in the distribution of fat and muscle. During puberty, males grow muscle much faster than females, and females experience a higher increase in body fat and bones become harder and more brittle. An adolescent\u2019s heart and lungs increase in both size and capacity during puberty; these changes contribute to increased strength and tolerance for exercise.<\/p>\n<h3>Reactions Toward Puberty and Physical Development<\/h3>\n<p>The accelerated growth in different body parts happens at different times, but for all adolescents, it has a fairly regular sequence. The first places to grow are the extremities (head, hands, and feet), followed by the arms and legs, and later the torso and shoulders. This non-uniform growth is one reason why an adolescent body may seem out of proportion. Additionally, because rates of physical development vary widely among teenagers, puberty can be a source of pride or embarrassment.<\/p>\n<p>Most adolescents want nothing more than to fit in and not be distinguished from their peers in any way, shape, or form (Mendle, 2015). So when a child develops earlier or later than his or her peers, there can be long-lasting effects on mental health. Simply put,\u00a0beginning puberty earlier than\u00a0peers presents great challenges, particularly for girls.\u00a0The picture for early-developing boys isn&#8217;t as clear, but evidence suggests that they, too, eventually might suffer ill effects from maturing ahead of their peers. The biggest challenges for boys, however, seem to be more related to late development.<\/p>\n<p>As mentioned in the Khan Academy video about physical development, early maturing boys tend to be stronger, taller, and more athletic than their later maturing peers. They are usually more popular, confident, and independent, but they are also at a greater risk for substance abuse and early sexual activity (Flannery, Rowe, &amp; Gulley, 1993; Kaltiala-Heino, Rimpela, Rissanen, &amp; Rantanen, 2001). Additionally, more recent research\u00a0found that while early-maturing boys initially had lower levels of depression than later-maturing boys, over time they showed signs of increased anxiety, negative self-image, and interpersonal stress. (Rudolph, Troop-Gordon, Lambert, &amp; Natsuaki, 2014).<\/p>\n<p>Early maturing girls may be teased or overtly admired, which can cause them to feel self-conscious about their developing bodies. These girls are at increased risk of a range of psychosocial problems including depression, substance use and early sexual behavior (Graber, 2013). These girls are also at a higher risk for eating disorders, which we will discuss in more detail later in this module (Ge, Conger, &amp; Elder, 2001; Graber, Lewinsohn, Seeley, &amp; Brooks-Gunn, 1997; Striegel-Moore &amp; Cachelin, 1999).<\/p>\n<p>Late-blooming boys and girls (i.e., they develop more slowly than their peers) may feel self-conscious about their lack of physical development. Negative feelings are particularly a problem for late maturing boys, who are at a higher risk for depression and conflict with parents (Graber et al., 1997) and more likely to be bullied (Pollack &amp; Shuster, 2000).<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Physical development in adolescence | Behavior | MCAT | Khan Academy\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/DWKWjpVsGng?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>Video 1.\u00a0<\/strong><em>Development in Adolescence\u00a0<\/em>provides an overview of physical changes during adolescence and psychosocial impacts.<\/p>\n<h2><\/h2>\n<p>&nbsp;<\/p>\n","protected":false},"author":185983,"menu_order":1,"template":"","meta":{"_candela_citation":"[]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-296","chapter","type-chapter","status-publish","hentry"],"part":74,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapters\/296","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/wp\/v2\/users\/185983"}],"version-history":[{"count":3,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapters\/296\/revisions"}],"predecessor-version":[{"id":466,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapters\/296\/revisions\/466"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/parts\/74"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapters\/296\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/wp\/v2\/media?parent=296"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/pressbooks\/v2\/chapter-type?post=296"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/wp\/v2\/contributor?post=296"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/child\/wp-json\/wp\/v2\/license?post=296"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}