Physical/Biologic Development: Early
Essential Tenets of Adolescent Growth
ADOLESCENCE
PHYSICAL GROWTH AND DEVELOPMENT
LEONCIA NATIVIDAD-OLONAN, MD, FPPS
DEPARTMENTS OF PEDIATRICS and PHARMACOLOGY
UNIVERSITY OF SANTO TOMAS
FACULTY OF MEDICINE AND SURGERY
Physical/Biologic Development: Early
Adolescence
For both sexes, growth acceleration begins but peak
growth velocities are not reached until SMR 3-4
Boys typically peak 2-3 years later than girls and
continue their linear growth for 2-3 years after
girls have stopped
Asymmetric growth spurt begins distally with
enlargement of the hands and feet, followed by
the arms and legs and finally by the trunk and
chest
Pubertal growth accounts for 20-25% of final adult
height
Physical/Biologic Development: Early
Adolescent Boys
Testicular enlargement the first visible sign of
puberty and hallmark of SMR 2; begins as early
as 9.5 years old
Penile enlargement occurs during SMR 3
Peak growth occurs when testicular volume reaches
9-10 cm3, during SMR 4
Enlargement of seminiferous tubules, epididymis,
seminal vesicles and prostate
Gynecomastia occurs in 40-65% of pubertal boys
during SMR 2-3
Adolescence
and Development
Physical/Biologic Development
Cognitive/Moral Development
Psychosocial Development
Physical/Biologic Development: Early
Adolescence
Development of underarm odor and faint genital hair
Pulsatile release of GnRH, LH & FSH during sleep
Increase in gonadal androgen and estrogen
Development of acne
Elongation of the optic globe
Dental changes eruption of permanent molars
Rapid enlargement of the larynx, pharynx and lungs
Physical/Biologic Development: Middle
Adolescence
Growth accelerates during middle adolescence
Average girl growth spurts peaks at 11.5 years
Average boy growth spurts peaks at 13.5 years
Doubling in heart size & lung vital capacity
Increase in BP, blood volume & hematocrit
Physiologic changes in sleep patterns and
requirements
Acne & body odor
Puberty is the biologic process in which a child
becomes an adult
- includes appearance of secondary sexual
characteristics and development of
reproductive capacity
- onset: 8-12 yrs old; 2 yrs earlier for girls
Physical/Biologic Development: Early
Adolescent Girls
Appearance of breast buds first visible sign of
puberty and hallmark of SMR 2 in girls; occurs
between 8 to 12 years of age
Enlargement of the ovaries, uterus, labia and clitoris
Thickening of the endometrium and vaginal mucosa
Physical/Biologic Development: Middle
Adolescence
Male : increase in lean body mass
widening of the shoulders
spermarche
penis lengthens & widens
Female : subcutaneous fat accumulates
widening of the hips
appearance of clear vaginal discharge
menarche (begins 2 21/2 years after
thelarche); usually during SMR 3 4;
after the peak height velocity has been
attained; onset is determined by genetics,
adiposity, chronic illness and competitive
exercise
 Physical/Biologic Development: Late
Adolescence
Final stages of breast, penile & pubic hair
development occur at 17-18 yrs of age in 95%

of late teens
Growth of facial & chest hair
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