Physical and Psychological Transition: Development Childhood Adulthood World Health Organization

Adolescence, transitional phase of growth
and development between childhood and adulthood. The World Health

Organization (WHO) defines an adolescent as any person between ages 10 and 19. This
age range falls within WHO’s definition of young people, which refers to individuals
between ages 10 and 24.
https://www.britannica.com/science/adolescence
WRITTEN BY:
 Mihalyi Csikszentmihaly
In many societies, however, adolescence is narrowly equated with puberty and the cycle

of physical changes culminating in reproductive maturity. In other societies adolescence
is understood in broader terms that encompass psychological, social, and moral terrain
as well as the strictly physical aspects of maturation. In these societies the
term adolescence typically refers to the period between ages 12 and 20 and is roughly
equivalent to the word teens.
During adolescence, issues of emotional (if not physical) separation from parents arise.
While this sense of separation is a necessary step in the establishment of personal
values, the transition to self-sufficiency forces an array of adjustments upon many
adolescents. Furthermore, teenagers seldom have clear roles of their own in society but
instead occupy an ambiguous period between childhood and adulthood. These issues
most often define adolescence in Western cultures, and the response to them partly
determines the nature of an individual’s adult years. Also during adolescence, the
individual experiences an upsurge of sexual feelings following the latent sexuality of
childhood. It is during adolescence that the individual learns to control and direct sexual
urges.
Some specialists find that the difficulties of adolescence have been exaggerated and that
for many adolescents the process of maturation is largely peaceful and untroubled.
Other specialists consider adolescence to be an intense and often stressful
developmental period characterized by specific types of behaviour.
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Physical And Psychological Transition

Stereotypes that portray adolescents as rebellious, distracted, thoughtless, and daring
are not without precedent. Young persons experience numerous physical and social
changes, often making it difficult for them to know how to behave. During puberty
young bodies grow stronger and are infused with hormones that stimulate desires
appropriate to ensuring the perpetuation of the species. Ultimately acting on those
desires impels individuals to pursue the tasks of earning a living and having a family.
Historically, many societies instituted formal ways for older individuals to help young
people take their place in the community. Initiations, vision quests, the
Hindu samskara life-cycle rituals, and other ceremonies or rites of passage helped young
men and women make the transition from childhood to adulthood. An outstanding
feature of such coming-of-age rites was their emphasis upon instruction in proper dress,
deportment, morality, and other behaviours appropriate to adult status.
The Kumauni hill tribes of northern India offer a vivid example of a culture that

traditionally celebrates distinct stages in every child’s life. When a girl reaches puberty,
her home is decorated with elaborate representations of the coming of age of a certain
goddess who, wooed by a young god, is escorted to the temple in a rich wedding
procession. Anthropologist Lynn Hart, who lived among the Kumauni, noted that each
child grows up at the centre of the family’s attention knowing that his or her life echoes
the lives of the gods. Although Kumauni teenagers may act in ways that bewilder their
elders, tribal traditions ease the passage through this stage of life, helping young people
to feel a connection to their community.
Social Constraints
From a biological perspective, adolescence should be the best time of life. Most physical
and mental functions, such as speed, strength, reaction time, and memory, are more
fully developed during the teenage years. Also in adolescence, new, radical, and
divergent ideas can have profound impacts on the imagination.
Perhaps more than anything else, teenagers have a remarkable built-in resiliency, seen
in their exceptional ability to overcome crises and find something positive in negative
events. Studies have found that teens fully recover from bad moods in about half the
time it takes adults to do so. Despite this resilience, however, for some teens these years
are more stressful than rewarding—in part because of the conditions and restrictions
that often accompany this period in life.
Restrictions on physical movement
Teenagers spend countless hours doing things they would prefer not to do, whether it be
working or spending hours behind school desks processing information and concepts
that often come across as abstract or irrelevant. Even excellent students say that most of
the time they are in school they would rather be “somewhere else.” Many Western
adolescents prefer to spend their time with friends in settings with minimal adult
supervision.
The layouts of contemporary American communities—especially suburban ones—cause
some teens to spend as many as four hours each day just getting to and from school,
activities, work, and friends’ houses, yet getting from place to place is not something
they have control over until they obtain a driver’s license (an event that became a
major rite of passage for adolescents in much of the developed world). But even with
access to a car, many teenagers lack appropriate places to go and rewarding activities in
which to participate. Many engage with digital devices or digital media or spend time
with peers in their free time.
A group of teenaged students on a school bus.© Digital Vision/Getty Images

Adolescents generally find that activities involving physical movement—sports, dance,
and drama, for example—are among the most pleasurable and gratifying. Ironically, the
opportunities for participation in such activities have dwindled, largely because budget
concerns have led schools to cut many nonacademic subjects such as physical education.
In some American public schools, extracurricular activities have been greatly curtailed
or no longer exist.
Absence of meaningful responsibility
In the 1950s the increasingly important teenage market became a driving force
in popular music (especially rock music), film, television, and clothing. Indeed, in those
countries experiencing the post-World War II economic boom, adolescence was
transformed by the emergence of teenagers as consumers with money to spend. In the
contemporary developed world, adolescents face a bewildering array of consumer
choices that
include television programs, movies, magazines, CDs, cosmetics, computers and
computer paraphernalia, clothes, athletic shoes, jewelry, and games. But while many
teenagers in these relatively affluent countries have no end of material amusements and
distractions, they have few meaningful responsibilities, in sharp contrast both to their
counterparts in countries struggling merely to survive and to earlier generations.
Alexander the Great (356–323 BCE) was still a teenager when he set out to conquer a
large part of the known world at the head of his father’s Macedonian armies. Lorenzo de’
Medici (1449–92) was an adolescent when his father sent him to Paris to work out
subtle financial deals with the king of France. On a less exalted level, until a few
generations ago, boys as young as age five or six were expected to work
in factories or mines for 70 or more hours a week. In almost all parts of the world, girls
were expected to marry and take on the responsibilities of running a household as early
as possible.
In 1950 German-born American psychoanalyst Erik H. Erikson described adolescence in

modern Western societies as a “moratorium,” a period of freedom from responsibilities
that allows young people to experiment with a number of options before settling on a
lifelong career. Such a moratorium may be appropriate in a culture marked by rapid
changes in vocational opportunities and lifestyles. If young people are excluded from
responsibilities for too long, however, they may never properly learn how to manage
their own lives or care for those who depend on them.
Of course some adolescents create astonishing opportunities for themselves. William

Hewlett and David Packard were teens when each began experimenting with electronic
machines, and they founded the Hewlett-Packard Company when they were only in
their mid 20s. As an adolescent, Microsoft Corporation cofounder Bill Gates was already
formulating the business strategy that just a few years later would dumbfound
the IBM colossus and make him one of the wealthiest men in the world. By and large,
however, most teens play a waiting game, expecting to start “really living” only after they
leave school. As useful as these years can be in preparing teens for their future roles in
society, this isolation from “real” life can be enormously frustrating. In order to feel alive
and important, then, many teenagers express themselves in ways that seem senseless to
the rest of the population.
Isolation from adults
In many public schools in the United States, student-teacher ratios of between roughly

12 and 25 (depending on whether the school is private or public) mean that the
classroom atmosphere is influenced considerably more by peers than by teachers. At
home teenagers spend at least several hours each day without parents or other adults
present. Moreover, during the little time when adolescents are at home with their
parents, the family typically watches television or the children disappear to study, play
games, listen to music, or communicate with friends on computers, phones, or other
devices.
Estrangement from parents has clear effects. Teens who do little and spend little time
with their parents are likely to be bored, uninterested, and self-centred. Lack of positive
interaction with adults is particularly problematic in urban settings that had once
enjoyed a lively “street-corner society,” where men traditionally shared their experiences
with younger ones in a setting that was casual and relaxed. This vital facet in the
socialization of young men has largely disappeared to the detriment of individual lives
and communities. In its place, peer influence can be counterproductive by reinforcing a
sense of underachievement or sanctioning deviant behaviour.
Deviance
With little power and little control over their lives, teens often feel that they have
marginal status and therefore may be driven to seek the respect that they feel they lack.
Without clear roles, adolescents may establish their own pecking order and spend their
time pursuing irresponsible or deviant activities. For example, unwed teen motherhood
is sometimes the result of a desire for attention, respect, and control, while
most gang fights and instances of juvenile homicide occur when teenagers (boys and
girls alike) feel that they have been slighted or offended by others. Such deviance can
take many forms. Insecurity and rage often lead to vandalism, juvenile delinquency, and
illegal use of drugs and alcohol. Violence and crime, of course, are as old as humankind.
Contemporary juvenile violence is often driven by the boredom young people experience
in a barren environment. Even the wealthiest suburbs with the most lavish amenities
can be “barren” when viewed from an adolescent’s perspective. Ironically, suburban life
is meant to protect children from the dangers of the big city. Parents choose such
locations in the hope that their children will grow up happy and secure. But safety
and homogeneity can be quite boring. When deprived of meaningful activities and
responsible guidance, many teens find that the only opportunities for “feeling alive” are
stealing a car, breaking a school window, or ingesting a mind-altering drug. A middle-
class adolescent caught with jewelry that he had stolen from a neighbour’s house
claimed that the act of stealing had been fun. Like other teenagers, by “fun” he meant
something exciting and slightly dangerous that takes nerve as well as skill. In parts
of Asia and Africa, similarly, rebel groups have conscripted teens who go on to find
excitement and self-respect behind machine guns. Millions of them have died
prematurely as a result.
Behavioral scientists have gained valuable insight into the conditions that cause teenage
strife. In many cases, adults are in the position to alleviate some of the frictions that
make intergenerational relations more strained than they need to be. Research indicates
that those adolescents who have the opportunity to develop a relationship with an adult
role model (parental or otherwise) are more successful than their peers in coping with
the everyday stresses of life.
Mihalyi CsikszentmihalyiThe Editors of Encyclopaedia Britannica
UN
Adolescents – defined by the United Nations as those between the ages of 10 and 19 –
number 1.2 billion in the world today, making up 16 per cent of the world's population. As
children up to the age of 18, most adolescents are protected under the Convention on the
Rights of the Child
Adolescent learners Adolescence is a distinct stage that marks the

transition between childhood and adulthood. The Swiss developmental psychologist
Jean Piaget described adolescence as the period during which individuals’ cognitive abilities
fully mature. According to Piaget, the transition from late childhood to adolescence is
marked by the attainment of formal operational thought, the hallmark of which is abstract
reasoning. Advances in the field of neuroscience have shown that the frontal cortex changes
dramatically during adolescence. It is this part of the brain that controls higher-level
cognitive processes such as planning, metacognition, and multitasking. Adolescent learners
thrive in school environments that acknowledge and support their growing desire
for autonomy, peer interaction, and abstract cognitive thinking, as well as the increasing
salience of identity-related issues and romantic relationships. (Source:Seel 2012).
Recognizing adolescence
Adolescence is a period of life with specific health and developmental needs and rights . It is1
also a time to develop knowledge and skills, learn to manage emotions and relationships, and
acquire attributes and abilities that will be important for enjoying the adolescent years and
assuming adult roles. 23
All societies recognize that there is a difference between being a child and becoming an adult.
How this transition from childhood to adulthood is defined and recognized differs between
cultures and over time. In the past it has often been relatively rapid, and in some societies it still
is. In many countries, however, this is changing.
The period between childhood and adulthood is growing longer and more distinct. Puberty is
starting earlier in many countries, although in general the timing of menarche has levelled off in
high income countries at 12–13 years. At the same time, key social transitions to adulthood are
postponed until well after biological maturity. Young people spend more years in education and
training, their expectations have changed, and contraception is increasingly available to prevent
pregnancy. As a result, young people take on adult roles and responsibilities later, such as
family formation and employment.
Gap between biological maturity and social transitions to adulthoodInfographic showing age at
first sex, marriage, childbirth (USA)
How people understand what is taking place during adolescence and how they think and talk
about adolescents, as problems or as social capital, for example, is important for what they do
and how they do it. This section, therefore, outlines the characteristics of adolescence and
explains why adolescence is a special period requiring explicit attention in policies and
programmes.
Defining terms. The World Health Organization (WHO) defines adolescents as those people
between 10 and 19 years of age. The great majority of adolescents are, therefore, included in
the age-based definition of “child”, adopted by the Convention on the Rights of the Child, as a
4
person under the age of 18 years. Other overlapping terms used in this report are youth (defined
by the United Nations as 15–24 years) and young people (10–24 years), a term used by WHO
and others to combine adolescents and youth.
While these terms are sometimes used interchangeably and may be defined differently in
56
different countries, with “adolescence”, for example, starting at 12 years or “youth” continuing
into the mid-30s, this report focuses primarily on the second decade of life. When data on youth
or young people are included, this is usually because available data have been aggregated in
ways that do not distinguish the adolescent years specifically. 7
Age—not the whole story

Age is a convenient way to define adolescence. But it is only one characteristic that delineates
8
this period of development. Age is often more appropriate for assessing and comparing
9
biological changes (e.g. puberty), which are fairly universal, than the social transitions, which
vary more with the socio-cultural environment.
The biological changes during adolescence do not all start at 10 years or stop at 20 years.
Some important endocrine changes start before age 10—for example, the production of adrenal
androgens—and some neurodevelopmental changes that take place during adolescence
continue into the early twenties. Still, in general the most profound and rapid pubertal changes
10
take place during the second decade.

Of course, a 10-year-old is very different from a 19-year-old. To accommodate the different
phases of development in the second decade of life, adolescence is often divided into early (10–
13 years), middle (14–16 years) and late (17–19 years) adolescence. 11
StagesSawyer SM et al. Adolescence: a foundation for future health

In addition to age, other important variables are sex—adolescent girls tend to reach biologically
defined developmental milestones up to two years ahead of adolescent boys—and gender,
since expectations and societal norms differ significantly between adolescent boys and
adolescent girls in most societies.
Why focus
Adolescence: physical changes

Adolescence is one of the most rapid phases of human development. Although the order of
12
many of the changes appears to be universal, their timing and the speed of change vary among
and even within individuals. Both the characteristics of an individual (e.g. sex) and external
factors (e.g. inadequate nutrition, an abusive environment) influence these changes. 13-15
Many biological changes take place during the adolescent years. Most obvious are the physical
changes, for example, increases in height, acquisition of muscle mass, the distribution of body
fat and the development of secondary sexual characteristics.
Underlying these physical changes is a wide spectrum of endocrine changes (gonadarche and
andrenarche), including hormones that affect gonadal maturation and the production of gonadal
sex steroids. The growth spurt during early and mid-adolescence is regulated by the complex,
inter-related production of a number of hormones. It takes place later and over a longer period
16
in boys than girls. Hormonal changes, such as the regulation of oxytocin and vasopressin, also
may affect how adolescents interact with others. 17
Tanner stagesPatton GC, Viner R. Adolescent health: pubertal transitions in health.

Internal and external influences at work. All of these biological changes can be affected by
factors internal to the adolescent, such as chronic illness and under-nutrition, and by external
factors, such as stress within the family.
Similar factors may affect girls and boys differently. For example, high body mass index (BMI)
may be associated with earlier puberty in girls but delayed puberty in boys. Similarly, early
18 19
puberty may affect obesity in adolescent girls and boys differently.

20
Adolescence: neurodevelopmental
changes
Important neuronal developments are also taking place during the adolescent years. These
developments are linked to hormonal changes but are not always dependent on
them. Developments are taking place in regions of the brain, such as the limbic system, that
21
are responsible for pleasure seeking and reward processing, emotional responses and sleep
regulation. At the same time, changes are taking place in the pre-frontal cortex, the area
responsible for what are called executive functions: decision-making, organization, impulse
control and planning for the future. The changes in the pre-frontal cortex occur later in
adolescence than the limbic system changes. 22 23
Diagram of neural
Show more links.
This is not to suggest that young adolescents are incapable of decision-making or planning for
their futures. In fact, some of the changes in social and emotional processing that take place
during adolescence may increase adolescents’ ability to adjust to changing social contexts. 24
However, neurodevelopment does have implications for the exploration and experimentation
that takes place during adolescence, because biological maturity precedes psychosocial
maturity and, to some extent, there is disconnect between adolescents’ physical capacities, their
sensation seeking and their capacity for self-control. This disconnect underlies some of the risk-
25
behaviours and subsequent health problems outlined in Sections 3 and 4 of this report. Of
course, most adolescents are able to explore and experiment in ways that contribute to their
development and do not take up behaviours that undermine their health.
We now know that the adolescent brain has significant neural plasticity, that is, it is still able to
change. This means that there is the potential in adolescence to ameliorate the impact of
negative experiences earlier in life, for example, child abuse, and to promote positive
developments that will enhance intellectual ability and emotional functioning.
Adolescence: psychological and social

changes
Psychosocial changes. Linked to the hormonal and neurodevelopmental changes that are taking
place are psychosocial and emotional changes and increasing cognitive and intellectual
capacities. Over the course of the second decade, adolescents develop stronger reasoning
skills, logical and moral thinking, and become more capable of abstract thinking and making
rational judgements. Also, they are more able to take other people’s perspectives into
consideration and often want to do something about the social issues that they encounter in
their lives.
At the same time, adolescents are developing and consolidating their sense of self. With this
increasing self-identity, including their development of sexual identity, comes growing concern
about other people’s opinions, particularly those of their peers.
A photomontage
Also, adolescents want greater independence and responsibility. They increasingly want to
assert more autonomy over their decisions, emotions and actions and to disengage from
parental control. Their social and cultural environment importantly affects how adolescents
26 27
express this desire for autonomy .

Younger adolescents may be particularly vulnerable when their capacities are still developing
and at the same time they begin to move outside the confines of their families and start taking
independent decisions—ranging from who they spend time with to what food they eat
Changes in the external environment. Changes taking place in the adolescent’s environment both
affect and are affected by the internal changes of adolescence. These external influences,
which differ among cultures and societies, include social values and norms and the changing
roles, responsibilities, relationships and expectations of this period of life (see Section 5). These
changes affect adolescents in their immediate environment of family, school and community but
reflect a range of wider societal changes, including increasing urbanization, globalization and
access to digital media and social networks.
While adolescents experience similar biological, cognitive and psychosocial developmental
processes, the timing and influence of these processes depend on both individual
characteristics and the environments in which they live, learn, play and work.
Implications for health and behaviour

In many ways adolescent development drives the changes in the disease burden between
childhood to adulthood—for example, the increase with age in sexual and reproductive health
problems, mental illness and injuries.
Adolescents’ neurodevelopmental changes and evolving capacities affect how they perceive
risk, how they act on communication about risky behaviours, how they think about the present
and the future, and what influences their ideas and actions.
The changes during puberty affect the incidence and clinical manifestations of a number of
diseases. These include polycystic ovarian syndrome, eating disorders, depression, epilepsy,
28
type 1 diabetes and other autoimmune diseases. At the same time, while the changes during
29
puberty may have an impact on chronic illnesses, chronic conditions in turn influence
adolescent development. Furthermore, the developmental processes taking place affect both
30
the causes and the responses to disability during the adolescent years.
Spinal cordVideo on working with young people living with disabilities
In addition, the social and emotional changes during adolescence heighten risks for behavioural
problems such as substance abuse, self-harm and socially disruptive behaviours. For example,
early onset of puberty has been linked to subsequent emotional and behavioural problems in
adolescent girls and boys. 31-33
The appearance of certain health problems in adolescence, including substance use disorders,
mental disorders and injuries, likely reflects both the biological changes of puberty and the
social context in which young people are growing up. Other conditions, such as the increased
incidence of certain infectious diseases, for example, schistosomiasis, may simply result from
the daily activities of adolescents during this period of their lives.
Malaria
Many of the health-related behaviours that arise during adolescence have implications for both
present and future health and development. For example, alcohol use and obesity in early
adolescence not only compromise adolescent development, but they also predict health-
compromising alcohol use and obesity in later life, with serious implications for public health
34 35
It is perhaps not surprising that nearly 100% of the respondents to the WHO global community
consultation with adolescents felt that their health was an important issue. However, what is
interesting about the responses is that over one-quarter emphasized that their health now was
important for their future ability to develop their full potential and because it has implications for
their health in adulthood.
Implications for policies and programmes

The changes that take place during adolescence suggest nine observations with implications for
health policies and programmes:
1. Adolescents need explicit attention. Adolescents are not simply big children or small
adults. Unique developmental processes take place during this period. Adolescents have
specific characteristics that need to be taken into consideration in policies and programmes
and in the strategies to reach this section of the population with health promotion, prevention,
treatment and care.
2. Adolescents are not all the same. During adolescence the components of physical and
psychosocial development take place at different speeds and duration, even if the sequence
is universal. Policies and programmes need to take into consideration the heterogeneity of
adolescents, including the differing developmental phases and abilities of younger and older
adolescents and of adolescent girls and boys.
3. Some adolescents are particularly vulnerable. The environments in which some
adolescents live, learn and grow can undermine their physical, psychosocial and emotional
development—for example, where adolescents lack parental guidance and support, face
food shortages, or are surrounded by violence, exploitation and abuse. Policies and
programmes need to specifically and explicitly address these adolescents to protect, respect
and fulfil their rights to the highest attainable standard of health.
4. Adolescent development has implications for adolescent health Developmental changes
during adolescence have broad implications for health and disease and for the initiation of
health-related behaviours during adolescence. Prevention efforts need to direct interventions
to factors that negatively affect development and increase health-compromising behaviours.
Service delivery programmes and providers need the awareness and skills to diagnose and
respond to health problems related to the developmental changes taking place.
5. Adolescent development has health implications throughout life. Adolescence provides
opportunities to make up, both physically and mentally, for developmental deficits in the first
decade of life. At the same time, health interventions are needed in adolescence to build on
the investments made during the first decade, in order to maintain positive momentum for
transitions to adulthood and health throughout life.
6. The changes during adolescence affect how adolescents think and act. Recent findings
about neurodevelopment have implications for policies and programmes in a range of
sectors. For example, understanding the impact of emotionally charged situations on
adolescent behaviour (so-called “hot cognition”) supports policies for graduated driving
licenses.
Graduated driving licenses in Australia/New Zealand
Realizing that adolescents are more motivated by reward than punishment calls into question
correctional approaches to deviant behaviour during adolescence. Appreciating that
adolescents are more focused on the present than the future has implications for health
education messages. The fact that adolescent brains are in some ways designed to
encourage risk-taking supports efforts to reduce the harm associated with health-
compromising behaviours rather than simply trying to prevent all risk-taking—use of
condoms is a good example. And the changes taking place in the circadian rhythm of
adolescents has implications for school start times.
Fighting the Clock: Later School Start, The Forum, Harvard School of Public Health
7. Adolescents need to understand the processes taking place during adolescence. Adolescents
may have concerns about the normal developmental processes that are taking place,
ranging from the physical manifestations of menarche and spermarche to volatile feelings
and emotions. The health sector can be an important source of correct information and offer
opportunities for adolescents to discuss their concerns with trained service providers or
peers, through health facilities or in other settings such as schools.
8. To contribute positively, adults need to understand the processes taking place during
adolescence. How adolescents are supported during this period of rapid development
determines whether they can take advantage of the opportunities and avoid the threats that
are inherent in this period of first-time experiences. To provide the support that is needed,
the significant adults in their lives, including parents, teachers, service providers and other
duty-bearers, need to understand the changes taking place during the adolescent years.
9. Public health and human rights converge around concepts of adolescent
development. There are important parallels between current scientific understanding of the
changes during adolescence and a range of human rights principles, including evolving
capacities and best interests of the child. These principles can guide health-sector decisions on
issues of importance to adolescent health, for example, prevention interventions (e.g. harm
reduction) and the provision of services (e.g. informed consent by mature minors). A human
rights-based approach also helps support good practices in public health, for example, non-
discrimination, ensuring the participation of adolescents (Article 12) and promoting 36
intersectoral collaboration (i.e. the indivisibility of human rights).
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Policies to support adolescents’ health

1. World social security report 2010/2011. Geneva, International Labour Organization, 2010.
2. Legislation and regulation. Geneva, World Health Organization, 2014

(http://www.who.int/heli/tools/legis_regul/en/index.html, accessed 6 February 2014).
3. The Health and Environment Linkages Initiative. Legislation and regulation. Geneva, World Health Organization, 2005
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4. Sixty-fifth World Health Assembly. Resolution WHA65.6. Annex 2: Comprehensive implementation plan on maternal, infant and young child
nutrition. Geneva, World Health Organization, 2012.
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160:18–24.
7. Buijzen et al. Explaining the link between television viewing and childhood obesity: a test of three alternative hypotheses. Journal of Children
and Media, 2008, 2:67–74.
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synthesis. BMC Public Health, 2013, 13:756
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13. WHO report on the global tobacco epidemic. Geneva, World Health Organization, 2013.
14. Marketing of foods high in fat, salt and sugar to children: update 2012–2013. Copenhagen, WHO Regional Office for Europe, 2013.
15. An examination of the implementation of the WHO recommendations on the marketing of foods and non-alcoholic beverages to children;
with a focus on media advertising regulation, in selected African states. Geneva, World Health Organization, Department of Prevention of Non-
Communicable Diseases, [unpublished].
16. Personal communication, Godfrey Xuereb, 2014.
17. Recommendations from a Pan American Health Organization Expert Consultation On The Marketing Of Food And Non-Alcoholic Beverages
To Children In the Americas. Pan American Health Organization, Washington, DC, 2011
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2013. Manila, World Health Organization, Western Pacific Regional Office, 2014.
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Adolescence, transitional phase of growth

and development between childhood and adulthood. The World Health

In many societies, however, adolescence is narrowly equated with puberty and the cycle

Physical And Psychological Transition

The Kumauni hill tribes of northern India offer a vivid example of a culture that

Restrictions on physical movement

A group of teenaged students on a school bus.© Digital Vision/Getty Images

Absence of meaningful responsibility

In 1950 German-born American psychoanalyst Erik H. Erikson described adolescence in

Of course some adolescents create astonishing opportunities for themselves. William

Isolation from adults

In many public schools in the United States, student-teacher ratios of between roughly

Mihalyi CsikszentmihalyiThe Editors of Encyclopaedia Britannica

Adolescent learners Adolescence is a distinct stage that marks the

Age—not the whole story

take place during the second decade.

StagesSawyer SM et al. Adolescence: a foundation for future health

Adolescence: physical changes

Tanner stagesPatton GC, Viner R. Adolescent health: pubertal transitions in health.

puberty may affect obesity in adolescent girls and boys differently.

Adolescence: psychological and social

express this desire for autonomy .

Implications for health and behaviour

Implications for policies and programmes

intersectoral collaboration (i.e. the indivisibility of human rights).

5. Moving young. New York, United Nations Population Fund, 2006.

Mortality, morbidity and disability in adolescence

Adolescents’ health-related behaviours

What determines differences in health and disease?

23. Social determinants of health. Geneva, World Health Organization, 2014.

Towards adolescent-responsive health systems

97. Free C. E-health and M-health for adolescents. Unpublished.

98. Free C. E-health and M-health for adolescents. Unpublished.

142. Free C. E-health and M-health for adolescents. Unpublished.

Strategic information to guide the health sector response

Policies to support adolescents’ health

2. Legislation and regulation. Geneva, World Health Organization, 2014

16. Personal communication, Godfrey Xuereb, 2014.

Working with other sectors

24. FRESH Focusing resources on effective school health

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