Variations in the Pattern of Pubertal Changes in Boys
TL;DR: Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development, finding that boys' genitalia begin to develop only about 6 months later than the girls' breasts and Pubic hair appears about 1½ years later in boys than in girls.
Abstract: Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development. The genitalia began to develop between the ages 9½ years and 13½ years in 95% of boys (mean = 11.6 ± 0.09) and reached maturity at ages varying between 13 and 17 (mean = 14.9 ± 1.10). The age at which pubic hair first appeared was not accurately determined, but its development through the later stages was studied. It reached the equivalent of an adult female distribution at a mean age of 15.2 ± 0.01 years. On average the genitalia reached the adult stage 3.0 years after they first began to develop; but some boys completed this development in as little as 1.8 years while others took as much as 4.7 years. Some boys complete the whole process in less time than others take to go from Stage G2 to Stage G3. The genitalia begin to develop before pubic hair is visible in photographs in practically all boys. The 41 boys in whom it could be studied reached their maximum rate of growth (peak height velocity) at a mean age of 14.1 ± 0.14 years. Very few boys (about 5%) reached peak height velocity before their genitalia were in Stage 4 and over 20% did not do so until their genitalia were adult. Peak height velocity is reached, on the average, nearly 2 years later in boys than in girls, but the boys9 genitalia begin to develop only about 6 months later than the girls9 breasts. Pubic hair appears about 1½ years later in boys than in girls.
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TL;DR: New charts for height, weight, height velocity, and weight velocity are presented for clinical (as opposed to population survey) use, based on longitudinal-type growth curves, using the same data as in the British 1965 growth standards.
Abstract: New charts for height, weight, height velocity, and weight velocity are presented for clinical (as opposed to population survey) use. They are based on longitudinal-type growth curves, using the same data as in the British 1965 growth standards. In the velocity standards centiles are given for children who are early- and late-maturing as well as for those who mature at the average age (thus extending the use of the previous charts). Limits of normality for the age of occurrence of the adolescent growth spurt are given and also for the successive stages of penis, testes, and pubic hair development in boys, and for stages of breast and pubic hair development in girls.
2,990 citations
Cites background from "Variations in the Pattern of Pubert..."
...It is essential that standards for pubic hair and penis (or genitalia) growth are given separately, since often the two develop with different timings (Marshall and Tanner, 1970)....
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TL;DR: In this paper, a self-reported measure of pubertal status was used to assess the transition from childhood to adolescence in a longitudinal study of 335 young adolescent boys and girls.
Abstract: Puberty is a central process in the complex set of changes that constitutes the transition from childhood to adolescence. Research on the role of pubertal change in this transition has been impeded by the difficulty of assessing puberty in ways acceptable to young adolescents and others involved. Addressing this problem, this paper describes and presents norms for a selfreport measure of pubertal status. The measure was used twice annually over a period of three years in a longitudinal study of 335 young adolescent boys and girls. Data on a longitudinal subsample of 253 subjects are reported. The scale shows good reliability, as indicated by coefficient alpha. In addition, several sources of data suggest that these reports are valid. The availability of such a measure is important for studies, such as those based in schools, in which more direct measures of puberty may not be possible.
2,602 citations
Cites background or methods from "Variations in the Pattern of Pubert..."
...According to the age norms established by Marshall and Tanner (1969, 1970) , most boys show few pubertal changes until they are about 12 years old, in contrast to girls, who first show changes a year or two earlier....
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...Several studies have demonstrated that development of these characteristics using the scale is related to endocrine increases (Gupta et al., 1975), height (Tanner, 1974), and other pubertal changes ( Marshall and Tanner, 1969, 1970 )....
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TL;DR: Although the cross-validation meets statistical standards for acceptance, caution is warranted with regard to implementation and it is recommended that maturity offset be considered as a categorical rather than a continuous assessment.
Abstract: Purpose: The range of variability between individuals of the same chronological age (CA) in somatic and biological maturity is large and especially accentuated around the adolescent growth spurt. Maturity assessment is an important consideration when dealing with adolescents, from both a research perspective and youth sports stratification. A noninvasive, practical method predicting years from peak height velocity (a maturity offset value) by using anthropometric variables is developed in one sample and cross-validated in two different samples. Methods: Gender specific multiple regression equations were calculated on a sample of 152 Canadian children aged 8-16 yr (79 boys; 73 girls) who were followed through adolescence from 1991 to 1997, The equations included three somatic dimensions (height, sitting height, and leg length), CA, and their interactions. The equations were cross-validated on a Combined sample of Canadian (71 boys, 40 girls measured from 1964 through 1973) and Flemish children (50 boys, 48 girls measured from 1985 through 1999). Results: The coefficient of determination (R2) for the boys' model was 0.92 and for the girls' model 0.91 the SEEs were 0.49 and 0.50, respectively, Mean difference between actual and predicted maturity offset for the verification samples was 0.24 (SD 0.65) yr in boys and 0,001 (SD 0.68) yr in girls. Conclusion: Although the cross-validation meets statistical standards or acceptance, caution 1, warranted with regard to implementation. It is recommended that maturity offset be considered as a categorical rather than a continuous assessment. Nevertheless, the equations presented are a reliable, noninvasive and a practical solution for the measure of biological maturity for matching adolescent athletes.
1,791 citations
TL;DR: Data suggest that girls seen in a sample of pediatric practices from across the United States are developing pubertal characteristics at younger ages than currently used norms, and practitioners may need to revise their criteria for referral of girls with precocious puberty.
Abstract: Objective. To determine the current prevalence and mean ages of onset of pubertal characteristics in young girls seen in pediatric practices in the United States. Methods. A cross-sectional study was conducted by 225 clinicians in pediatric practices belonging to Pediatric Research in Office Settings, a practice-based research network. After standardized training in the assessment of pubertal maturation, practitioners rated the level of sexual maturation on girls 3 through 12 years who were undergoing complete physical examinations. Results. Data were analyzed for 17 077 girls, of whom 9.6% were African-American and 90.4% white. At age 3, 3% of African-American girls and 1% of white girls showed breast and/or pubic hair development, with proportions increasing to 27.2% and 6.7%, respectively, at 7 years of age. At age 8, 48.3% of African-American girls and 14.7% of white girls had begun development. At every age for each characteristic, African-American girls were more advanced than white girls. The mean ages of onset of breast development for African-American and white girls were 8.87 years (SD, 1.93) and 9.96 years (SD, 1.82), respectively; and for pubic hair development, 8.78 years (SD, 2.00) and 10.51 years (SD, 1.67), respectively. Menses occurred at 12.16 years (SD, 1.21) in African-American girls and 12.88 years (SD, 1.20) of age in white girls. Conclusions. These data suggest that girls seen in a sample of pediatric practices from across the United States are developing pubertal characteristics at younger ages than currently used norms. Practitioners may need to revise their criteria for referral of girls with precocious puberty, with attention to racial differences.
1,556 citations
TL;DR: These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.
Abstract: During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States. In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.
1,494 citations
Cites background from "Variations in the Pattern of Pubert..."
...As reviewed by Eveleth and Tanner (65), this points to a geographical difference that can involve genetic or ethnic factors as well as environmental factors....
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...The most obvious decrease in melatonin secretion, however, occurs after onset of puberty, between Tanner stages II and III (251)....
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...As mentioned in an editorial comment by Reiter and Lee (76), that bias may be important because the increase in testicular volume or size is critical in the evaluation of the G2 stage of Tanner....
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...Thelarche is the first appearance of breast development defined as Tanner B2 stage (2)....
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...In the pioneering work of Marshall and Tanner (19), which provided age references for male pubertal development in 1970, the mean age for G2 stage was found to be 11.6 yr in the United Kingdom....
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References
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TL;DR: The extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study is described.
Abstract: In Great Britain some girls begin to menstruate in their 10th or 11th years, while others who are equally healthy may not experience menarche until they 'are 14, 15, or even older. Menarche is, however, only a single event in the combination of physical changes which constitute puberty. The adolescent growth spurt, the development of the breasts, and the growth of the pubic hair occur more or less concurrently, and take, on the average, about 3 years from beginning to completion, with menarche occurring usually in the latter half of this period (Tanner, 1962). At present we lack detailed information about the rate at which girls progress through the stages of puberty and about the relation of one event to another. Only longitudinal studies (i.e. studies in which the same individuals are examined repeatedly over a period of time) can provide this information, which would be helpful both to the clinician in distinguishing the normal from the abnormal, and to the neuro-endocrinologist in constructing hypotheses about the mechanisms by which puberty is controlled. Present knowledge is based on studies carried out on small numbers of children in the United States a generation ago, together with some German studies of a similar period (for literature see Tanner, 1962). The only recent European study in which the events of puberty have been followed longitudinally is the Harpenden Growth Study, which began 19 years ago in England and is still in progress. Anthropometric measurements have been taken, and the development of the breasts and pubic hair have been recorded photographically at 3monthly intervals throughout puberty. Though these data may be subject to certain biases, discussed below, they provide information available from no other source. This paper describes the extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study. We discuss: (a) variation in the chrono-
5,078 citations
TL;DR: The solution to the alternatives of plotting against chronological or developmental age at adolescence is adopted and centiles plotted against chronological age over the whole age span are given.
Abstract: (C) Whole-year Velocity Standards: Chronological Age-based and Individual Type We now consider how to construct velocity standards, to answer our second question 'Has this child's rate of growth been within normal limits ?' We are again confronted with the alternatives of plotting against chronological or developmental age at adolescence and we have adopted the same solution as before. First we give, in the conventional manner, centiles plotted against chronological age, over the whole age span. These are calculated simply from two measurements a year apart, without using further longitudinal data. They depend on a two-occasion longitudinal study, nothing further. At adolescence these standards are greatly scattered by the phase-difference effect. If we know nothing about a boy except that he is 12 years old and grew 3 cm. during the last year, we must plot 3 cm. at 11 * 5 years and interpret this according to the chronological age centiles. If, however, we know that he is midpubescent, or that his skeletal age is 14 * 0 years, then in theory we could make a more effective interpretation if we had the appropriate standards. We have to remember, however, that in one important respect velocity standards differ from distance ones. In velocity standards a child does not have the same strong tendency to stay in the same centile position from one age to another; there is always a contrary tendency to a move from the outer centile positions towards a more central position in the subsequent year. Though a child can follow the 60th or even 70th centile of velocity from the pre-school years till maturity and end up a large but normal adult, a child who follows the 97th centile
2,463 citations
TL;DR: The extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study is described.
Abstract: In Great Britain some girls begin to menstruate in their 10th or 11th years, while others who are equally healthy may not experience menarche until they 'are 14, 15, or even older. Menarche is, however, only a single event in the combination of physical changes which constitute puberty. The adolescent growth spurt, the development of the breasts, and the growth of the pubic hair occur more or less concurrently, and take, on the average, about 3 years from beginning to completion, with menarche occurring usually in the latter half of this period (Tanner, 1962). At present we lack detailed information about the rate at which girls progress through the stages of puberty and about the relation of one event to another. Only longitudinal studies (i.e. studies in which the same individuals are examined repeatedly over a period of time) can provide this information, which would be helpful both to the clinician in distinguishing the normal from the abnormal, and to the neuro-endocrinologist in constructing hypotheses about the mechanisms by which puberty is controlled. Present knowledge is based on studies carried out on small numbers of children in the United States a generation ago, together with some German studies of a similar period (for literature see Tanner, 1962). The only recent European study in which the events of puberty have been followed longitudinally is the Harpenden Growth Study, which began 19 years ago in England and is still in progress. Anthropometric measurements have been taken, and the development of the breasts and pubic hair have been recorded photographically at 3monthly intervals throughout puberty. Though these data may be subject to certain biases, discussed below, they provide information available from no other source. This paper describes the extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study. We discuss: (a) variation in the chrono-
1,649 citations
TL;DR: The objectives of the present study were to determine the degree of generality in adolescent physical growth by means of a factorial analysis of the intercorrelations among various measures of maturation and assign each young person a Maturity Score which would be based on the best single measure or combination of measures of the hypothetical factor.
Abstract: One of the goals of the Guidance Study has been to determine the relative contributions of the various bio-social factors associated with normal or deviating personality development. One such factor is physiological maturity, but before its relationship to personality could be studied, a method of assessing progress along the hypothetical maturational continuum had to be evolved. This paper concerns the derivation and interrelationships of indices which could be used to this end. In this study both external and indirect signs of an individual's progress toward maturity were considered. The search for indicators of growth rests on the belief that maturity is largely determined by endocrine factors evidenced in various discernible phenomena. With this in mind, many workers in the field have used "growth indices" to classify subjects as "early," "average," or "late" maturers. Usually one such measure, e.g., age at menarche, is utilized, perhaps with others then related to it. The scores of individuals on many variables must be studied, however, before it is possible to estimate the relative validity of any one variable. One of the objectives of the present study, therefore, was to determine the degree of generality in adolescent physical growth by means of a factorial analysis of the intercorrelations among various measures of maturation. A second objective was to use the general factor, if one should be found in such an analysis, as a criterion from which the relative efficiencies of the single measures of maturation could be evaluated. Our final goal was to assign each young person a Maturity Score which would (a) be based on the best single measure or combination of measures of the hypothetical factor, and (b) fall along a continuous rather than dichotomous dimension. The development of the separate measures or indices of maturation is described in Section I. The factorial analysis and the derivation of maturity 1 This study was carried out under the direction of Dr. Jean Walker Macfarlane of the Guidance Study at the Institute of Child Welfare. Special acknowledgment is due to Gene Rolfe La Forge, Marjorie P. Honzik, and Nancy Bayley for their suggestions and criticisms. The charts were drawn by Katherine Eardley. The clerical work and statistical analyses were made available by a grant-in-aid from the U.S. Public Health Service. The data collection was made possible by financial assistance from the Laura Spellman Rockefeller Fund, the General Education Board, the Rockefeller Foundation, and the University of California. * Deceased.
158 citations
TL;DR: The 59 boys reported on in this paper are, like the girls in the earlier study, regular participants in the long-term study of growth and development under way at the Fels Research Institute for the Study of Human Development.
Abstract: IN A PREVIOUS paper 1 a description was given of certain physical changes accompanying adolescence in girls. The value of such information to the pediatrician was discussed, with particular reference to the normal range of individual variation in sexual maturation. In the present study a similar report is made for boys. The general literature on adolescent bodily changes and various studies of female adolescence were cited in the earlier publication. In addition, a number of studies have dealt specifically with male adolescent development. 2 These range from concise descriptions of developmental processes to broad discussions of the relation of sexual maturation to behavior in adolescence. MATERIALS AND METHODS The 59 boys reported on in this paper are, like the girls in the earlier study, 1 regular participants in the long-term study of growth and development under way at the Fels Research Institute for the Study of Human Development. 3 The
101 citations