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    Children During Adolescence [10 - 16 Years]
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EXECUTIVE SUMMARY

This study presents longitudinal data on physical growth pattern and sexual maturity in 6829 children (3517 boys and 3312 girls) from rural and urban slum areas, covering the age groups of 10 to 16 years followed up at six Monthly intervals. Physical growth parameters studied included height, weight, chest circumference, mid-arm circumference, bi-acromial and bi-cristal diameters. Observations on earlier physical growth of these children (at 5-7 years of age) were also available, which enabled the linking of growth during adolescence to earlier growth status.

Children from rural areas, boys as well as girls were shorter and weighed less compared to children from urban slum areas. The average height of girls from rural areas in this study was similar to that of boys at ages 13.5 to 14.5 years. At all other age points, the height of girls was less than boys. In the urban slums, girls were taller than boys especially between the ages of 11 to 14 years. In urban slums as well as rural areas, adolescent girls had higher body weight than boys at 1 to 12 years of age. The children in this study were categorized into four nutritional groups using weight for age (Gomez classification) at 5-7 years of age. Grade II and grade III malnutrition were combined as there were very few children in grade III malnutrition. Physical growth during adolescence was studied in these three nutritional groups. The normal children, boys as well as girls from all centres had higher weight and height throughout adolescence in comparison to children who had grade I and grade II or III malnutrition.

The children were about 16 years of age at the time of completion of this study and hence, all had not attained full maturity. Boys were observed for appearance of pubic hair, axillary hair, facial hair, change of voice and genitalia development and girls for appearance of pubic hair, axillary hair, onset of menarche and breast development. Large variations from centre to centre were observed in age at appearance of sexual characteristics and the order in which these appeared. Pubic hair was the first sexual characteristic to appear in majority of the boys as well as girls in all the centres. The mean age at stage II, III and IV of genitalia development in boys varied from 10.7 to 12.9 years, 11.7 to 13.7 years and 13.8 to 14.3 years respectively. The mean age at stage II, III and IV of breast development in girls varied between 11.3 to 12.3 years, 12.3 to 13.2 years and 13.3 to 14.1 years respectively. The percentage of girls who had attained menarche by the age of 15 years; ranged from 16.9 to 70.1 per cent between centres. The children in whom the sexual characteristics had appeared earlier than others, had higher mean body weight and height as compared to those of children at the same age points. Thus the study shows early childhood nutritional status has an influence on subsequent growth and development.

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