Growth and Development, Ages 11 to 14 Years

Overview

How do children grow and develop between ages 11 and 14?

The ages 11 through 14 years are often referred to as early adolescence. These years are an exciting time of many varied and rapid changes. Your child grows taller and stronger and also starts to feel and think in more mature ways. You may feel amazed as you watch your child begin to turn into an adult. But this can be a confusing time for both kids and parents. Both must get used to the new person the child is becoming.

From ages 11 through 14, a child develops in four main areas:

• Physical development. Adolescence is a time of change throughout the body. A growth spurt usually occurs near the time of puberty. Girls begin to develop breasts and start their periods. Boys grow facial hair. Both boys and girls grow pubic hair. Boys may lag behind girls in height during these years, but they usually end up taller.
• Cognitive development. This is how the brain develops the abilities to think, learn, reason, and remember. Kids this age typically focus on the present, but they are starting to understand that what they do now can have long-term effects. They are also beginning to see that issues are not just clear-cut and that information can be interpreted in different ways.
• Emotional and social development. As they start to move from childhood into adulthood, adolescents feel the urge to be more independent from their families. Often, friends replace parents as a source of advice. When at home, adolescents may prefer spending time alone to being part of the family. Still, family support is important to help them build a strong sense of self.
• Sensory and motor development. Kids this age may be a little awkward or clumsy. Their brains need time to adjust to longer limbs and bigger bodies. Getting regular moderate exercise can improve coordination and help your child build healthy habits.

When are routine medical visits needed?

Yearly doctor visits are important to detect problems and to make sure your adolescent is growing and developing normally. During these visits, the doctor will do a physical exam and give your child any needed shots. The doctor will also ask questions about your child's friends, school, and activities to see how he or she is doing.

It is a good idea to give an adolescent some time alone with the doctor. This gives your child a chance to ask questions that he or she may not feel comfortable asking you.

Adolescents should also have yearly dental checkups to make sure their teeth are strong and healthy.

When should you call your doctor?

Call your doctor anytime you have a concern about your child's physical or emotional health, such as:

• A delay in growth or sexual development-for example, if puberty has not begun by age 14.
• A big change in appetite or weight.
• Body image problems, such as a girl believing she is overweight when she is actually very thin. This can be a sign of an eating disorder.
• Signs of mental health issues, including depression, mood swings, fighting, missing school, or failing classes.
• Drug, alcohol, or tobacco use.

A call or visit to your child's doctor can help you keep a healthy outlook and know how to recognize a true problem. This may help relieve tension between you and your child.

How can you help your child during these years?

Being the parent of an adolescent can be challenging. Even if your child pushes you away at times, you still play a very big role in your child's life. Try to stay positive and keep the lines of communication open. While it is good to let your child make decisions, realize that adolescents need and want limits that are fair and firm.

To promote healthy development:

• Help your child build healthy eating habits and a healthy body image. Serve balanced meals, and keep lots of fruits, vegetables, and other healthy foods in the house. Be a model of good eating and exercise habits for your child.
• Urge your child to get some exercise every day.
• Help your adolescent get enough rest. Set limits on phone, computer, and TV use after a set evening hour.
• Encourage mature thinking. Involve your child in setting house rules. Talk about current issues together. Brainstorm different ways to solve problems, and discuss their possible outcomes.
• Talk about sex and other adult issues in an open and natural way. Make this an ongoing conversation. It is best to begin this discussion before puberty so the child knows what to expect. If you don't feel able to do this, ask for help from your doctor, a trusted friend or family member, or a counselor. Don't let your child rely on information from TV or other kids.

Throughout these years, it is important to let adolescents know they are loved and accepted, no matter what happens, even if at times you don't agree with what they do or how they act.

Frequently Asked Questions

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What to Expect

Rapidly changing bodies, confusion, excitement, new social situations, and increased reasoning abilities make ages 11 to 14 a thrilling and sometimes challenging time for children and parents. Watching your child gradually mature is an amazing process. It also can be puzzling for parents who may wonder during this transition, "Do I have a child or an adult?" Since neither is the case, you must continually renegotiate your relationship with and learn about your evolving adolescent.

Although each adolescent develops at his or her individual pace, general growth and development patterns can be grouped into four main categories.

• Physical development. Growth spurts occur during the adolescent years (starting at about age 11 in girls and at about age 13 in boys). This rapid growth usually precedes or accompanies puberty, when sex characteristics begin developing. It is important to reassure your child that his or her physical development is okay, regardless of whether the changes of puberty seem to be occurring earlier or later than average.
• Cognitive development. This is the process by which the brain develops the abilities to think, learn, reason, and remember. Adolescents typically think in concrete ways but are gradually beginning to grasp abstract and symbolic concepts. Although they understand long-term consequences, they often do not accept that they can be personally affected by them. For example, adolescents may know that too much sun exposure can cause premature aging and skin cancer, but many do not accept that this can happen to them.
• Emotional and social development. In trying to establish their individuality, adolescents typically distance themselves from parents and prefer being with friends, hanging out in their rooms, or listening to music. It is important to continue to include them in family events even if you meet with resistance. Family activities help adolescents to develop a strong sense of self. This is especially important at a time when the emotional and social effects of puberty can impact their self-image.
• Sensory and motor development. Adolescents may be somewhat awkward or clumsy. Their brains need time to adjust to longer limbs and bigger bodies. To help improve coordination and establish healthy habits, encourage regular moderate exercise.

Common Concerns

The years 11 through 14 are exciting and confusing. Many parents have concerns about how their children will handle the many physical and emotional changes that usually happen during this time. Some of these common concerns include:

• Your child's transition into middle school or junior high. The fear of the unknown and the anticipation of more homework and uncomfortable social situations can be terrifying for some adolescents and young teens. Listen to your child's concerns and ask whether you can help. For example, you may be able to help relieve your child's anxieties about joining a school-related activity, such as band or a team sport, by making sure he or she has the right equipment and knows exactly when and where the practices will be held.
• How your child will handle the challenges of puberty. The way puberty affects your child may in part depend on the timing of puberty-whether your child starts puberty early, late, or at about the average age. It can help if you explain the effects of puberty before physical changes start to happen. Try offering your adolescent age-appropriate books about puberty. Share some of your own experiences, and reassure your child that it is normal to feel uncertain at times.
• Confusion about what matters to your adolescent. Although you may remember some of the anxiety of the adolescent years, the specific causes of these anxieties constantly change. Being involved in your child's life-by going to school events and encouraging friends to meet at your house while you are home-can help you to understand his or her world.
• How to talk about sex. Approach the subject before the information is needed, but don't expect your child to want to talk about it. Offer information gradually, rather than overwhelming your adolescent with too many facts at one time. Be aware that children have easy access to many Web sites with sexual or pornographic content. Keep the computer in a shared area where you can see what your child is doing online.
• Whether your child will avoid tobacco, drugs, and alcohol. Do not smoke, drink, or take drugs if you expect your child to avoid using them. Set firm, fair, and consistent limits for your child. Help him or her understand the immediate and long-term consequences of substance use, such as falling grades and poor health during adulthood. Give your child a chance to practice how to respond when a harmful substance is offered, such as stating, "No, thanks," and moving on to another subject. Look for community programs led by youth (peer education). And talk to your child right away if he or she has signs of substance use.

Promoting Healthy Growth and Development

During this time of trial and error, parents need to offer open, positive communication while providing clear and fair rules and consistent guidance. You significantly influence your adolescent's habits and attitudes, choices, and adjustments to physical changes. But realize that your child's way of doing things does not have to exactly match your own.

Help your child identify important issues and be prepared for increasing responsibilities. Allow your child the freedom to figure things out in his or her own way within the boundaries you have set. Parents walk a fine line between respecting a teen's need for independence and privacy and making sure that he or she does not make mistakes that have lifelong consequences.

Promote your adolescent's physical development by doing the following:

• Help your adolescent build healthy eating habits. Support your teen in making healthy choices by talking about what things make it easier or harder to eat well. For more information on eating well and managing weight, see the topic Healthy Eating for Children.
• Promote a healthy body image. Help your adolescent recognize that the media often produce unrealistic and unattainable images of the ideal body. Stress the importance of being healthy, rather than looking "skinny" or "buff." Be aware of the things you say about how you and other people look.
• Recognize changing sleep patterns. Rapidly growing and busy adolescents need a lot of sleep. Beginning sometime in adolescence, your child's natural sleeping pattern may gradually shift. Many adolescents start going to bed later at night and sleeping in. This pattern can make it hard to get up for school. To help your adolescent get enough rest, discourage phone and computer use and TV watching after a certain evening hour.
• Help your teen who is using drugs or alcohol. If you believe your adolescent is using drugs or alcohol, it is important to talk about it. Discuss how he or she gets the alcohol, tobacco, or drugs and in what kind of setting they are used. Seek advice from a doctor if the behavior continues. For more information, see the topic Teen Alcohol and Drug Abuse.

  Dealing with teen substance use

Promote your adolescent's healthy emotional and social development by doing the following:

• Address problems and concerns. Building trust gradually will help your adolescent feel safe in talking with you about sensitive subjects. When trying to talk with your adolescent about problems or concerns, schedule a "date" in a private and quiet place. Be ready to deflect questions you aren't prepared to answer and make sure to follow through. For example, you may say, "You know, this is so important that I need a little time to think about it. Can we discuss it later?" Then set a specific time and place to further discuss that issue.
• Prevent involvement in violence. Be a good role model for how to handle disagreements, such as by talking calmly. Help your child come up with ways to defuse potentially violent situations, such as making a joke or acknowledging another person's point of view. Praise him or her for successfully avoiding a confrontation, such as by saying, "I'm proud of you for staying calm." Closely supervise the Web sites and computer games that your child uses. For more information on teen violence, see the Other Places to Get Help section of this topic.
• Recognize the warning signs of suicide. To reduce suicide risk, prepare your child for the emotional upheavals that sometimes occur between the ages of 11 and 14 years. Offer suggestions on how to handle feelings of inadequacy or sadness, such as keeping a journal, volunteering, and getting adequate rest and exercise. If your child shows signs of depression, such as withdrawing from others and being sad much of the time, talk about it and get help from a doctor if it does not improve. Also call your doctor if your child ever mentions suicide or if you are concerned for his or her safety. After puberty, depression occurs twice as often in girls as in boys.

  Growth and development: Helping your child build self-esteem

Promote your adolescent's cognitive development by doing the following:

• Help your child develop more mature ways of thinking. Let your child make as many of his or her own decisions as possible. This includes involving your adolescent in setting household rules and schedules. Talk about current issues together, whether it be school projects or world affairs. Brainstorm different ways to solve problems, and discuss their possible outcomes. Consider giving an allowance, to help teach your child about financial responsibility.

Promote your adolescent's sensory and motor development by doing the following:

• Encourage your child to exercise every day. Vigorous exercise, such as running, biking, or playing soccer or basketball, helps your adolescent to stay lean and to have a healthy heart.¹ Vigorous exercise also helps your child feel good. If your child is not used to exercise, encourage light to moderate exercise, such as walking, at first. Be careful about expecting too much too soon. Too much exercise at first can make your child tired, and he or she may not want to exercise as much.¹ Gradually build up exercise to make it more likely that your child will stay with it. For more information on exercise, see the topic Fitness.

When to Call a Doctor

Your child's doctor can help you discuss difficult issues with your adolescent if you ever are having trouble doing so on your own. Keep in mind that important subjects, such as sex, should be addressed long before you think your child will face them.

Call a doctor if your adolescent has possible health problems or issues that may need treatment. Such problems or issues may include:

• A significant delay in physical or sexual development-for example, if puberty has not begun by age 14.
• Becoming sexually active. Teens who are sexually active need to be educated about birth control and sexually transmitted diseases (STDs). Also, females will usually have a Pap test.
• Being overweight. A doctor can help guide weight loss and proper nutrition.
• A significant change in appetite or weight. These may signal an eating disorder.
• Severe acne that may be helped by medicine.
• Struggling to understand or use spoken or written language. Having learning problems in school could be a sign of a learning disability.
• Showing signs of attention deficit hyperactivity disorder (ADHD)-such as inattention, impulsivity, and/or hyperactivity-that are causing problems at home or school.

Call a doctor or a mental health professional if your teen develops behavioral problems or signs of mental health problems. Signs may include:

• Expressing a lack of self-worth.
• Acting physically aggressive.
• Dropping out of school or failing classes.
• Drinking alcohol or using drugs or tobacco.
• Having serious relationship problems with friends and family that affect home or school life.
• Showing signs of depression, such as a lack of interest in normal activities and withdrawing from others.
• Regularly experiencing severe mood swings, such as being happy and excited one minute and sad the next.

Also be aware that these problems can sometimes be warning signs of suicide.

For more information, see the topic Anorexia Nervosa, Binge Eating Disorder, Teen Alcohol and Drug Abuse, or Depression in Children and Teens.

Routine Checkups

Your child needs routine yearly checkups when he or she is 11 through 14 years of age. These checkups are important to detect problems and to see if your child is growing and developing as expected. The doctor will do a physical exam, suggest any needed shots (immunizations), and ask questions about your child's social, academic, relationship, and mental health status. For information about recommended shots, see the topic Immunizations.

Beginning in adolescence, most doctors like to spend some time alone with your child during the visit. Although many state laws are vague about adolescents' and teens' rights to medical confidentiality, most doctors will clarify expectations with you and your child. Ideally, you will all agree that anything your child discusses privately with the doctor will remain confidential, with few exceptions. This gives your child an opportunity to talk to the doctor about any issue he or she may not feel comfortable in sharing with you.

Adolescents and teens also need to have regular dental checkups and to be encouraged to brush and floss regularly. For more information about dental checkups, see the topic Basic Dental Care.

Other Places To Get Help

Online Resources

Organizations

Related Information

• Acne Vulgaris
• Anabolic Steroid Abuse
• Anger, Hostility, and Violent Behavior
• Anorexia Nervosa
• Attention Deficit Hyperactivity Disorder (ADHD)
• Bulimia Nervosa
• Depression in Children and Teens
• Dyslexia
• Early Disease Detection
• Elbow Injuries
• Environmental Illness
• Fitness
• Growth and Development, Ages 15 to 18 Years
• Gynecomastia
• Healthy Eating for Children
• Leg Injuries
• Menarche
• Menstrual Cramps
• Protecting Your Skin From the Sun
• Stress Management
• Suicidal Thoughts or Threats
• Talking With Children About Sex
• Teen Alcohol and Drug Abuse
• Toe, Foot, and Ankle Injuries
• Weight Management

References

Citations

1. Gutin B, et al. (2005). Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. American Journal of Clinical Nutrition, 81(4): 746-750.

Other Works Consulted

• Bashe P (2003). American Academy of Pediatrics: Caring for Your Teenager. New York: Bantam.

• American Cancer Society (2007). Child and teen tobacco use. Available online: http://www.cancer.org/docroot/PED/content/PED_10_2X_Child_and_Teen_Tobacco_Use.asp.

• Cuijpers P (2002). Effective ingredients of school-based drug prevention programs: A systematic review. Addictive Behaviors, 27(6): 1009-1023.

• Dixon SD, Stein MT (2006). Encounters With Children: Pediatric Behavior and Development, 4th ed. Philadelphia: Mosby Elsevier.

• Frankowski BL, Committee on Adolescence (2004). Sexual orientation and adolescents. Pediatrics, 113(6): 1827-1832.

• Kaplan DW, Love-Osborne K (2007). Adolescence. In WW Hay Jr et al., eds., Current Pediatric Diagnosis and Treatment, 18th ed., chap. 3, pp. 102-143. New York: McGraw-Hill.

• Marcell AV (2007). Adolescence. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 60-65. Philadelphia: Saunders Elsevier.

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