Adolescence is the transitional period of growth, development, and maturation that begins at the end of childhood (about 10 years of age). The onset of puberty can begin as early as age 8 or as late as age 15 in girls and as early as age 9.5 years and as late as age 15 in boys. It is the defining marker of the start of adolescence. The end of adolescence generally occurs between the ages of 17 and 21 years and is marked by the individual reaching full physical and developmental maturity or young adulthood. This developmental phase involves significant physical, hormonal, cognitive, emotional, and social changes. A neurodevelopmental perspective of adolescence holds that most changes occur occurs in three overlapping stages: early, middle, and late. Early adolescence marks the onset of puberty, middle adolescence is characterized by peak growth and physical maturation, and late adolescence marks the end of puberty and the integration of all functional skills. The concept of adolescence is primarily a product of Western culture where youth are viewed as needing a time to mature from being children to taking on the responsibilities, values, and norms exhibited by the adults in their culture.

A neurodevelopmental view of adolescent development involves examining how the human grows and matures with respect to the component skills necessary to perform various age-appropriate tasks. Those components are referred to as the functional domains. The developmental or maturational process of youth occurs across several distinct functional domains, is not always even, but is sequential; however, there is individual variation in the manifestation of that process. The skills learned and mastered are commonly divided into several functional domains: physical, motor, visual, auditory, perceptual, language, cognitive, psychosocial, and specific integrative-adaptive. All basic skills in these domains are mastered by the end of childhood in the normally developing individual. Physical and psychological trauma, as well as deficits in any of the functional domains, can impede normal development.

Physical Growth and Development

The physical growth of young adolescents involves significant changes in the height, weight, and brain development that are exceeded only during two other time periods: when the fetus is in utero and between the ages of 1 and 3 years. Although 75% of brain growth (in weight) has developed by age 2, the process of central nervous system maturation takes place over a lifetime.

Motor Skills Development

The motor skills domain includes all fine and gross motor skills. Fine motor skills include precise, specific, and fine neuromotor responses such as pincer grasp and the ability to write legibly, cut paper designs with scissors, button, fasten, sew, draw match-to-sample designs, and control motor responses (i.e., tics, tremors, fidgeting, jerky motions, uncontrolled motions). Gross motor skills usually refer to whole body movement, including coordination of skeletal muscles, postural control, balance, coordination of motor planning, agility, muscular strength, and endurance (examples of such skills include the ability to hop, skip, jump, walk, run, crawl, walk a balance beam, walk a straight line toe to toe--forwards and backwards--throw, catch, and hit an object with another object).

Visual Skills Development

Visual skills include visual acuity, the ability to make discriminations between visual stimuli, the ability to track moving or still objects, color vision, extraocular muscle control, which includes resting balance of the eyes, control of eye movement, and visuomotor coordination (looking in different directions and seeing).

Communication Skills Development

Auditory Skills Development

The auditory domain refers to an individual's ability to have "normal" hearing acuity, the ability to A neurodevelopmental view of adolescent development involves examining how the human grows and matures with respect to the component skills necessary to perform various age-appropriate tasks. Those components are referred to as the functional domains. The developmental or maturational process of youth occurs across several distinct functional domains, is not always even, but is sequential; however, there is individual variation in the manifestation of that process. The skills learned and mastered are commonly divided into several functional domains: physical, motor, visual, auditory, perceptual, language, cognitive, psychosocial, and specific integrative-adaptive. All basic skills in these domains are mastered by the end of childhood in the normally developing individual. Physical and psychological trauma, as well as deficits in any of the functional domains, can impede normal development.

Physical Growth and Development

The physical growth of young adolescents involves significant changes in the height, weight, and brain development that are exceeded only during two other time periods: when the fetus is in utero and between the ages of 1 and 3 years. Although 75% of brain growth (in weight) has developed by age 2, the process of central nervous system maturation takes place over a lifetime.

Motor Skills Development

The motor skills domain includes all fine and gross motor skills. Fine motor skills include precise, specific, and fine neuromotor responses such as pincer grasp and the ability to write legibly, cut paper designs with scissors, button, fasten, sew, draw match-tosample designs, and control motor responses (i.e., tics, tremors, fidgeting, jerky motions, uncontrolled motions). Gross motor skills usually refer to whole body movement, including coordination of skeletal muscles, postural control, balance, coordination of motor planning, agility, muscular strength, and endurance (examples of such skills include the ability to hop, skip, jump, walk, run, crawl, walk a balance beam, walk a straight line toe to toe--forwards and backwards--throw, catch, and hit an object with another object).

Visual Skills Development

Visual skills include visual acuity, the ability to make discriminations between visual stimuli, the ability to track moving or still objects, color vision, extraocular muscle control, which includes resting balance of the eyes, control of eye movement, and visuomotor coordination (looking in different directions and seeing).

Communication Skills Development

Auditory Skills Development

The auditory domain refers to an individual's ability to have "normal" hearing acuity, the ability to process what one hears, and the ability to employ selective discrimination of sounds and auditory cues.

Language Skills Development

The language domain skills (or the ability to communicate) involve two major areas: receptive and expressive language skills. Receptive language is the ability to understand spoken, signed, or written language and the ability to discriminate meanings and understand semantics and syntax. Expressive language refers to the ability to communicate effectively through spoken, signed, or written language.

The resultant neurobiological changes in childhood and adolescence are immense. For example, changes in the brain dealing with speech and language skills accelerate and peak in early adolescence; acquisition skills for a second language diminish after that.

Cognitive Skills Development

Cognitive skills refer to multiple facets of brain function including (1) the ability to pay and sustain attention that is required to focus selectively and generally on events, actions, and information in the environment; (2) the ability to be alert, which involves mental processing speed, and the ability to respond effectively to environmental cues and stimuli that cause or allow appropriate behavioral adaptation, which facilitates optimal positive outcomes and minimizes negative outcomes; (3) the ability to employ memory skills that include acquiring, storing, and recalling information; (4) the ability to use thinking skills, which means that the individual has knowledge of specifics (store, recall, retrieve), is able to comprehend information (oral, written, and through all senses), and can apply, analyze, synthesize, and evaluate that information; (5) the ability to solve problems and make decisions; and (6) the ability to perform multiple cognitive and functional tasks simultaneously.

Perceptual Motor Skills Development

Perceptual motor skills refer to the ability of the individual to experience a stimulus, process that information in the brain, and employ specific cognitive skills to determine the correct response and then execute the response. Such action requires the integration of stimulus-specific responses from the functional domains, such as visuospatial discrimination, which includes (1) eye-hand coordination, (2) stereognosis, (3) judgment of speed, (4) discrimination of the direction of the movement of people or their body parts or objects, and (5) spatial orientation of moving objects. Additional perceptual motor skills include temporal sequencing (the awareness of sequential ordering; awareness of time and sequence of events), proprioceptive sense, kinesthetic sense, and reaction time (time elapsed between stimulus perception and initial neuromotor response). Successful maturation of this domain means that the individual is able to synthesize all the other domains ( physical, cognitive, visual, language domains), which results in the adolescent having the ability to perceive, interpret, plan, and execute an appropriate neuromotor response to stimuli in the environment, and includes coordination, balance, agility, reaction time, and visuomotor responses. Because the perceptual and motor systems are mutually calibrated, any actions by the adolescent are constantly being fine tuned. The ability to see, hear, think, and move are important but are significantly affected by a person's level of perceptual motor development. This ability begins at birth--children begin to learn to coordinate and integrate their physical, cognitive, visual, auditory, and language skills from birth. Being able to perform the basic motor skills but not being able to plan complex motor functions and not having a well-developed visual skill of tracking can result in awkward or clumsy behavior.

Psychosocial Skills Development

Psychosocial skills include the emotional and social functional skills required to allow an adolescent to cope with others and how he or she perceives the world emotionally. Emotional skills include the adolescent's ability to exhibit emotions appropriate to situation or circumstances, the ability to monitor emotion, and the ability to regulate emotions. Social skills include the ability to initiate, develop, and sustain friendships; the ability to develop healthy interpersonal relationships with others; the ability to establish and maintain mutually beneficial intimate relationships; the ability to be empathetic; and the ability to be altruistic. Social skills also include the adolescent's ability to adopt the moral values of his or her culture and of the greater society. Youth who are moral can use appropriate judgment to discriminate right from wrong and develop a sense of morality.

Integrative and Adaptive Skills Development

The final functional domain is the task-specific integrative and adaptive skills development domain. This domain involves the ability to coordinate, integrate, and adapt various domains to meet the specific demands of a given task or situation.

Addressing adolescent development from a neurodevelopmental perspective helps one to understand the complexities of the maturational process of normal growth and development. Although this section is geared toward normal development, it is easier to realize how deficits in one functional domain can affect the function of other domains. During the first 10 years of life, most of the changes in the developing human evolve around physical, visual, motor, and language development; skills acquisition is the primary focus. During adolescence, new skills are acquired, but the focus shifts to refinement and expansion.

Adolescents who experience normal development will be able to integrate all functions of each domain and use those skills to successfully adapt to the demands of the environment in which they live. Youth who experience the complex process of maturation and growth normally achieve mastery and integration of these processes by late adolescence (ages 17-21 years).

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