ABFM Adolescent Medicine key terms

A five-stage scale describing pubertal development of breast, genital, and pubic hair changes, used to judge whether an adolescent's physical maturation falls within the expected range for age.

The period of accelerated linear growth during puberty, peaking about two years earlier in girls than boys, which shifts nutritional and emotional needs and can worsen scoliosis or asthma temporarily.

The maximum rate of linear growth during the pubertal spurt, roughly 9 cm per year in girls and 10 cm per year in boys, used to time evaluation of short or tall stature.

A radiologic estimate of skeletal maturation, usually from a hand and wrist film, compared with chronologic age to distinguish constitutional delay from pathologic causes of abnormal growth.

Absence of breast budding by about age 13 in girls or testicular enlargement by about age 14 in boys, prompting evaluation for constitutional delay, chronic illness, or endocrine disease.

A benign pattern in which an adolescent is short and matures late but has a bone age behind chronologic age and a family history of similar late blooming, usually needing reassurance rather than treatment.

Onset of secondary sexual characteristics before about age 8 in girls or 9 in boys, requiring evaluation for central or peripheral causes and consideration of GnRH analog therapy.

Benign enlargement of male breast tissue, common in mid-puberty from hormonal fluctuation and usually resolving within one to two years; persistent, asymmetric, or rapid enlargement warrants evaluation.

Low hemoglobin from inadequate iron intake during rapid growth plus menstrual losses or poor diet, causing fatigue and poor school performance; screened with risk assessment and treated with iron and diet counseling.

Irregular, heavy, absent, or painful menses in teens, often from anovulatory cycles in the first years after menarche but sometimes signaling bleeding disorders, pregnancy, or endocrine disease.

Failure to menstruate by about age 15, or by 13 without secondary sexual development, prompting evaluation for anatomic, chromosomal, and endocrine causes such as outflow obstruction or gonadal dysgenesis.

A disorder of androgen excess and ovulatory dysfunction presenting with acne, hirsutism, and irregular menses; diagnosis in teens is cautious because normal pubertal anovulation mimics it.

Follicular inflammation of the face, chest, and back driven by androgens, sebum, and bacteria; treatment is stepped from topical agents to systemic therapy, and scarring or severe disease warrants early referral.

Clinical back examination, often with the forward bend test, performed during the adolescent growth spurt to detect spinal curvature early enough for bracing or referral to be effective.

A normal shift toward later sleep and wake times in puberty that conflicts with early school start times, causing chronic sleep deprivation, daytime sleepiness, and worsened mood and grades.

Advice on consistent bedtimes, limiting screens and caffeine before bed, and avoiding weekend catch-up sleep, used first-line for adolescent insomnia and daytime fatigue.

The practice of granting teens private time and protecting their health information within legal limits, which improves disclosure and engagement while requiring clear explanation of when parents must be informed.

A structured psychosocial interview covering home, education and employment, activities, drugs, sexuality, and suicide and mood, used to screen adolescents efficiently for risk and resilience.

The developmental task of building a coherent sense of self through exploration of values, roles, and relationships, typically intensifying in adolescence and shaping later occupational and social choices.

The gradual process of gaining autonomy and a separate sense of self while maintaining supportive family ties; conflict during this process is common and usually not pathologic.

A cognitive pattern of early adolescence in which teens feel uniquely observed and judged by others, contributing to self-consciousness, risk-taking, and sensitivity to peer feedback.

The cognitive stage emerging in adolescence that allows abstract reasoning, hypothetical planning, and consideration of consequences, which supports informed consent discussions and health decision-making.

A teen's perception and feelings about their physical appearance, which can be distorted by media and peers and contributes to disordered eating, low self-esteem, and requests for cosmetic or hormonal interventions.

Use of a validated tool such as the PHQ-A at preventive visits, paired with direct interview, to detect depression early given its high prevalence and frequent somatic or irritable presentation.

Direct, nonjudgmental questioning about suicidal thoughts, plan, intent, and access to lethal means, followed by safety planning and appropriate referral, whenever warning signs or screening results suggest risk.

Conditions such as anorexia nervosa, bulimia nervosa, and binge eating disorder marked by disturbed eating and body image, often presenting with weight change, amenorrhea, or mood symptoms and requiring early multidisciplinary care.

A syndrome of low energy availability in athletes causing menstrual dysfunction, low bone density, and impaired performance, often driven by restrictive eating and overtraining rather than by an obvious eating disorder.

Brief validated questioning such as the CRAFFT about alcohol and drug use, followed by brief intervention or referral, delivered confidentially as part of routine adolescent preventive care.

The pressure and modeling exerted by friends and social groups on attitudes and behavior, which can promote risk behavior or positive norms and is central to adolescent social development.

Patterns of parental warmth and control, classified as authoritative, authoritarian, permissive, or neglectful; authoritative parenting is associated with the best adolescent adjustment and health outcomes.

A teen's sense of closeness, trust, and support from caregivers, repeatedly identified as a strong protective factor against substance use, early sexual activity, and emotional distress.

The capacity to adapt well to adversity through internal strengths and external supports such as caring adults, school engagement, and problem-solving skills, which clinicians can assess and help build.

Engagement with online platforms that can support identity and connection but also expose teens to cyberbullying, sleep disruption, and unrealistic appearance norms, warranting counseling about balanced use.

Repeated intentional harm through digital channels, associated with depression, school avoidance, and self-harm; clinicians should ask directly and involve school and family supports.

Legal provisions allowing adolescents to consent to certain services, such as sexually transmitted infection testing or mental health care, without a parent, with scope varying by state and condition.

The legal duty of clinicians to report suspected child abuse, neglect, or statutory sexual activity to designated authorities, overriding usual confidentiality and requiring transparent explanation to the teen.

An approach that recognizes the prevalence of adverse childhood experiences, avoids retraumatizing interactions, and emphasizes safety, trust, and choice in history-taking and examination.

Clinics or programs located in schools that deliver preventive, mental health, and reproductive care to adolescents where they already spend time, improving access for underserved youth.

The planned process of moving an adolescent with chronic conditions from pediatric to adult care, including self-management teaching and early planning to prevent gaps in treatment.