Pre-teens and puberty: common concerns

Dr Asha Pemberton

teenhealth.tt@gmail.com

Adolescence marks a time of great changes in physical development. It is the time when young people question the changes in their bodies, wonder if they are “normal” and often compare themselves to their friends or images seen on social media. While the majority of tweens and teens will proceed through puberty normally, some will experience concerns. Those issues can range from simple questions about the progress of puberty to medical diagnoses or the psychological impact of puberty on self-esteem and body image. It is therefore very important for parents and young people to understand common concerns and issues related to physical development. This assists them in being more comfortable asking questions and seeking support when needed.

Beginning too early or too late

Young people who experience pubertal development too early or too late may get teased and develop body image concerns. Some research demonstrates that boys who mature earlier tend to be more socially popular and independent, but are also at a greater risk for early sexual activity and other impulsive behaviours.

Early developing girls may face increased bullying, which can contribute to being self-conscious. They are also at higher risk for depression and due to their more adult bodies are vulnerably to victimisation and abuse by adult predators. For young people who experience conflicts about their gender identity, early puberty can unleash extreme emotional reactions, anxiety and depression.

Conversely, girls and boys who develop more slowly than peers may feel self-conscious about their lack of physical development. This can lead to negative feelings and in some cases difficulties keeping up in sport and activity due to smaller physical stature.

For young people who show no signs of pubertal development whatsoever, there may be serious medical conditions that require prompt diagnosis and treatment. There should be no delay in seeking health care evaluation.

Body image and self care

While it is normal to feel a little self-conscious about appearance from time to time, parents should become concerned when tweens and teens constantly compare themselves to peers and images they see and then put undue pressure on themselves to achieve an idealised and often unrealistic appearance.

In addition, if they start displaying behaviours of constant concealing, odd eating behaviours, refusal to engage in activities and even outright reclusiveness, these can indicate conditions which require management, including body dysmorphic disorder or eating disorders.

Parents can help teens gain a healthy sense of body image by highlighting and focussing on positive traits and strengths that have nothing to do with their bodies or appearance. Model that you appreciate your own body and its imperfections and that overall qualities that make you unique.

General physical changes

It is impossible not to notice the general changes of puberty, which include skin changes (acne), strong body odour and changes in height and body shape. Teenagers go through phases of being clumsy due to their limbs growing at a faster rate than their midline core.

Acne is another major cause of anxiety for teens. Some acne is a normal part of physical development and can be easily treated by topical over-the-counter creams. Sometimes acne should be treated with prescription medication which requires consultation by a health professional.

General hygiene such as daily baths, brushing and flossing teeth and nail care should be taught and reinforced for all teens so that they can manage their hygiene, oral care and menstrual changes. Parents should be proactive and upfront about these changes their tweens will experience so that they have correct and factual information and also feel empowered to manage themselves.

The changes of pubertal progress differently for every young person. In addition, the psychological changes of adolescence do not always mirror pubertal development. This means that some teens may be physically mature but still display more childlike behaviours or interests.

Some teens may progress more slowly in puberty but have more advanced thinking and planning skills. This is why for each teen, their parents and family need to adapt care to their specific needs. Of overall importance, however, is understanding puberty, removing all shame and myth and teaching young people how to care and protect their developing bodies and minds.