too growingsoon? up

story by | elizabeth nawrot, phd

It was during coffee last week when my friend Linda confided to our small group that her daughter had started her period. But our collective sighs of reminiscence soon turned to gasps of disbelief when Linda reminded us that her daughter was in fourth grade and just 10-years-old. “Can that be normal?” she wondered. Children do seem to grow up faster these days, when the average 10-year-old has a cell phone and a FaceBook page. And this push to “come of age” is accompanied by a pull to slow down as economic and social pressures make the transition to adulthood difficult. Kids today experience an extended period of adolescence, marked by both an earlier onset and longer duration, with important consequences for their health and well-being.

the new normal?

Ten does seem young for a girl to have her first period, but it’s not considered unusual. The average age of “menarche”, or first menstruation is about twelve, with “precocious” or early puberty when menarche begins before nine. The average age has declined significantly over the last few hundred years, when it was typical for a girl to begin menstruating at seventeen. In fact, the age of puberty has continued a gradual decline in just the last 50 years, with breast development beginning on average 1–2 years sooner. Puberty is beginning sooner in boys, too, with more than half of African American and one-third of Caucasian boys showing genital development by nine. But just because children’s bodies grow up faster doesn’t mean they are becoming adults sooner.

Extended Adolescence

Even by the end of the teen years, many young people don’t consider themselves grown up. When I ask students in my Developmental Psychology class “Do you think of yourself as an adult?” their answers mirror the general population with almost half responding “yes and no”. Nearly 40% of 12 to 17-year-olds say “No,” they don’t think of themselves as adults yet. By 18–25, the percentage who consider themselves adults increases, but is still less than half, with most young people continuing to think the term “adult” applies to them sometimes “yes” and sometimes “no”.

Along with the earlier onset of puberty, a number of social and economic factors have converged to lengthen the ladder toward adulthood. For example, to be competitive in this high tech, global world kids need more education to train for better jobs with higher pay. This means more time in school, living at home or dependent on parents. Increases in divorce and single parent homes also leads to a longer period of dependence as adult children move back with their parents. More than half of college students’ today plan to live with their parents after graduation.

Finally, the overwhelming presence of the media has blurred the boundaries between child and adult. From cartoons designed for adults to provocatively dressed and primped dolls marketed to children, the mixed messages can be confusing. It’s hardly surprising that nine and 10-year-old girls talk about dieting and teenagers are getting breast implants.

dangerous curves ahead!

Being a child in a grown up body can present a number of challenges, especially for children who go through puberty early. Girls in elementary school are usually the least prepared and most distressed by the sudden onset of menstruation because they are unlikely to have discussed it with parents or friends. Because puberty naturally comes with more body fat and a curvy shape for girls, it can also lead to dissatisfaction with body image in today’s skinny-sensitive society. Early maturing girls also struggle with disruptive behavior, substance abuse, poor coping skills, and miss more days of school. Girls who experience precocious puberty may have more difficulty developing social relationships, positive self-concept, and are more likely to be depressed, aggressive, socially-withdrawn or moody.

Of course puberty means sexual development and for both girls and boys who are early maturing there is an increased risk for sexual behavior and its consequences. Younger adolescents who engage in sex are less likely to use contraceptives and therefore increase their risk for unplanned pregnancies and sexually transmitted infections [STIs]. According to one study, more than two-thirds of high school seniors report sexual activity, including oral sex. And the majority of STIs occur in people under age twenty-five.

Practical Advice And Recommendations

There is no doubt that childhood is changing, whether it’s the earlier onset of puberty or the extended stay in adolescence, and that these changes affect our children’s health and well-being into adulthood. But there are things we can do to help.

What should I do when my child starts puberty?

Early maturing girls can need special attention during puberty as their changing bodies make it difficult for them to fit in with their friends. Parents who notice their daughters’ developing curves can use this opportunity to anticipate the onset of menarche and have the “period” talk early. Linda bought her daughter a special “period purse” for her backpack that included pads and a change of panties [“just in case”]. Girls who experience true “precocious” puberty should see their pediatrician or family doctor for a routine health check-up. Some experts used to be concerned that precocious puberty was associated with shorter growth, but it turns out that most girls eventually grow to average height despite early puberty.

What is the key to a healthy adolescence?

Parents should focus on healthy diet and lifestyle at an early age, especially with the number of overweight children more than doubling in the last 20 years. Dr. Jan Bexell-Gierke, an OB/GYN physician and mother of two here in Fargo, typically sees patients 10 to 13 years-of-age with irregular or heavy periods, and she finds that this goes hand in hand with childhood obesity. “Obesity affects so much of your health throughout your lifespan.” says Dr. Gierke. “To start out at such an unhealthy weight can be difficult”. She recommends an active lifestyle and the value of eating at home. But Dr. Gierke recognizes how difficult this is. “We are all working moms, we have pizza too. But just add vegetables to the plate”.

Are there environmental products we should avoid?

Recent reports of a possible connection between early puberty and breast cancer underscores the importance of lifestyle on long-term health. Some studies advise parents to avoid estrogen or placenta containing beauty or hair care products, phthalates in plastics, and isoflavones found in some soy products. These chemicals are thought to be endocrine disruptors that can affect the body’s hormonal balance. It’s also good practice to avoid using pesticides or insecticides around children and to thoroughly wash fruits and vegetables. Some worry about hormones used in animal products, for example growth hormone used to increase cow’s milk production. But bovine growth hormone does not pass into milk and has only been used since 1993, after the trend towards early puberty.

When is it time to see a doctor?

Some experts recommend that children should see their doctor whenever secondary sexual characteristics appear. This gives an opportunity for discussions about hygiene, menstruation, feminine protection, sexual activity, contraception, and sexually transmitted infections. Dr. Gierke further advises a visit with the pediatrician or OB/GYN if your child is sexually active, begins menarche before age eight [precocious puberty], or if you or your child is concerned about obesity.

What about older teens who need help bridging the gap to adulthood?

To help them prepare for a competitive and sometimes uncertain future, support their efforts at continued education, but encourage non-academic experiences like internships, too. Non-traditional students can take advantage of diverse routes through academia like online or hybrid courses. And remember, adolescents experiencing puberty and changing schools at the same time need extra support in this time of multiple transitions.

What resources are available for more information?

An excellent book to begin talking about puberty and sex is “Ten Talks Parents Must Have with Their Children About Sex and Character” by Schwartz and Cappello. Written by a sex researcher and a parent educator, this book covers topics such as ‘those first feelings’, ‘cyberspace and sexuality’ and ‘talking about your family’s values’. It includes tools to help you talk to your kids about sex [beyond “if you have sex, I’ll kill you”], and even includes sample “sex talks”.

For parents who want a good book on health, hygiene, and puberty designed for younger kids [9-12] I recommend “The Care and Keeping of You: The Body Book for Girls” by Schaefer, from the American Girl Publishing group. Also visit the National Research Center for Women and Families website for more information about teens and family, medical care, healthy living, and puberty and sexual development in particular: www.center4research.org

Adolescence can be stressful when the road to adulthood starts so soon and lasts so long, but it doesn’t need to be overwhelming for you and your child. If you provide support and communication, and seek out the resources and expertise available in your community, the coming of age can be a coming together for you both. references

1. Precocious puberty: A comprehensive review of literature (2007). Sandra Cesario & Lisa A. Hughes. The Association of Women’s Health, Obstetric and Neonatal Nurses.

2. Reexamination of the age limit for defining when puberty is precocious in girls in the United States: Implications for evaluation and treatment (1999). Paul B. Kaplowitz & Sharon E. Oberfield. Pediatrics, vol. 104 (4), 936-941.

3. Early puberty for girls. The new ‘normal’ and why we need to be concerned. Kathleen O’Grady. Retrieved from http://www. cwhn.ca/node/39365

4. The decline in the age of menarche in the United States: Should we be concerned? (2007) Marcia E. Herman-Giddens. Journal of Adolescent Health, vol. 40 (3), 201-203.

5. Adolescence (1998). Michael Jaffe. Wiley Publishing.

6. Precocious puberty in adolescent girls: A biomarker of later psychosocial adjustment problems (2005). Line Tremblay & Jean-Yver Frigon. Child Psychiatry and Human Development,

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