Teenagers. Adolescents. Adolescence. Puberty. These terms are often used interchangeably, but there are important differences. Teenagers and adolescents are similar terms, and refer to the same span in years of age. However, adolescence is the time that youth engage in the developmental tasks of adolescence. These tasks include establishing an adult identity, seeking independence from adults, and establishing economic self-sufficiency; these tasks may begin before the teen years, and might not be completed until the late teens or early twenties.

Puberty includes the biologic changes that adolescents encounter, which include the adolescent growth spurt. There are many other changes associated with puberty, which we will discuss in detail below.

Of note there is a great amount of variation in the rate of changes that may occur. Some adolescents may experience these signs of maturity sooner or later than others. It is important to remember that these changes happen at different times for everyone. Being smaller or bigger than other girls is normal as each child experiences puberty at her own time.

On average, females begin puberty between 8 to 11 years of age.

Changes During Puberty

Females experience puberty as a sequence of events, but their pubertal changes usually begin before males of the same age. Each girl is different and may progress through these changes differently. The following is a list of changes that occur during puberty:

• Beginning of puberty: 8 to 11 years
• First pubertal change: usually breast development
• One to one and a half years later, height spurt; about one year after that, menstrual period
• Pubic hair development: shortly after breast development, but occasionally at the same time or may precede breast development
• Hair under the arms: 12 years of age

There are specific stages of development that females go through when developing secondary sexual characteristics. The following is an overview of the changes that occur:

• In girls, the initial puberty change is the development of breast buds, in which a small mound is formed by the elevation of the breast and papilla (nipple). The areola (the circle of different colored skin around the nipple) increases in size at this time.
• The breasts then continue to enlarge.
• Eventually, the nipples and the areolas will elevate again, forming another projection on the breasts.
• At the adult state, only the nipple remains elevated.
• Pubic hair development is similar for both girls and boys. The initial growth of hair produces long, soft hair that is only in a small area around the genitals. This hair then becomes darker and coarser as it continues to spread.
• The pubic hair eventually looks like adult hair, but in a smaller area. It may spread to the thighs and sometimes up the stomach.

The following are additional changes that may occur for the female as she experiences puberty:

• There may be an increase in hair growth, not only in the pubic area, but also under the arms and on the legs. Some women may decide to shave this hair.
• Body shape will begin to change. There may be not only an increase in height and weight, but the hips may get wider. There may also be an increase in fat in the buttocks, legs and stomach. These are normal changes that may occur during puberty.
• Body size will increase, with the feet, arms, legs, and hands initially growing faster than the rest of the body. This may cause an adolescent girl to experience a time of feeling clumsy.
• As the hormones of puberty increase, adolescents may experience an increase in oily skin and sweating. This is a normal part of growing. It is important to wash daily, including the face. Acne may develop.
• Adolescent girls will also experience menstruation, or menstrual periods. Typically one to two years after the first menstrual period the girl may start ovulating, that is, releasing an egg from the ovary. If the egg is fertilized with a sperm from a male, it could potentially grow into a baby inside the uterus. If the egg is not fertilized, the tissues inside the uterus are not needed and are shed through the vagina as fluid. The fluids are bloody and are usually released monthly. After a girl begins to menstruate, she is able to get pregnant.

Normal Adolescent Mental Development

The teenage years bring many changes, not only physically, but also mentally and socially. Children in these years increase their ability to think abstractly and eventually make plans and set long-term goals. Each child may progress at different rates, and show a different view of the world. In general, the following are some of the abilities that may be evident in your teenager:

• Developing the ability to think abstractly; this includes the ability to understand current actions could influence the future
• Concerns with philosophy, politics and social issues
• Thinking long-term
• Setting goals
• Comparing oneself to one's peers
• Some adolescents may experience signs of maturity sooner or later than others. It is important to remember that these changes happen at different times for everyone.
• Body changes and mental changes may not happen at the same time.

Relationships With Others

As your adolescent begins to struggle for independence and control, many changes may occur. The following are some of the issues that may be involved with your adolescent during these years:

• She wants independence from parents.
• Peer influence and acceptance is very important.
• Romantic relationships become very important.
• She may be in love.
• She may develop long-term commitment in a relationship.