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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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2

Normative Adolescent Development

Adolescence is a dynamic period of growth and change. As described in the recent National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth, adolescence is “a period of opportunity to discover new vistas, to form relationships with peers and adults, and to explore one’s developing identity. It is also a period of resilience that can ameliorate childhood setbacks and set the stage for a thriving trajectory over the life course” (NASEM, 2019, p. 1).

This chapter begins by presenting the major conclusions of The Promise of Adolescence. It then reviews research in the five domains of optimal health—(1) physical health, (2) emotional health, (3) social health, (4) spiritual health, and (5) intellectual health—as they relate to adolescent development. While not an exhaustive review of adolescent development, this chapter highlights the influences that are most relevant to each domain of optimal health.

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1 Response to MyVoice survey question: “Describe what it would look like to live your best life.” See the discussion of the MyVoice methodology in Appendix B for more detail.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

CONCLUSIONS OF THE PROMISE OF ADOLESCENCE: REALIZING OPPORTUNITY FOR ALL YOUTH (2019)

Adolescence forms the critical bridge between childhood and adulthood, making it an ideal window of opportunity to promote positive development. As noted in Chapter 1, although adolescence is often considered a “dark and stormy” time, exploration and risk taking are in fact necessary parts of growing up. They allow adolescents to form their identities; become more autonomous; and develop new cognitive, social, and emotional skills required for success in adulthood.

During adolescence, moreover, connections within and between brain regions strengthen and become more efficient, while unused connections are pruned away. These changes in the brain thus provide opportunities for positive, life-shaping development and resilience in the face of past adversity. Conversely, this plasticity also makes youth more vulnerable to adverse experiences. In that sense, adolescence represents a unique and important opportunity to support youth and promote the behaviors and skills that are critical to growth and development. Yet despite the opportunity provided by the brain’s plasticity during adolescence, for too many youth, the promise of adolescence is not being realized. Adolescents’ access to opportunities and supports varies by age, race and ethnicity, socioeconomic status, rurality/urbanity, sexual orientation and gender identity, and disability status. Long-standing disparities have created an opportunity gap that leaves many adolescents in stressful, dangerous, disadvantaged, and isolated situations that can have lifelong effects.

Youth from disadvantaged circumstances therefore need more than equal access to resources; rather, to ensure access to comparable opportunities, these youth need more resources relative to their peers from more advantaged backgrounds. Determining what resources might be necessary requires understanding how best to support adolescents as they begin to navigate the challenges and opportunities of this period of development, enabling them not only to survive but to thrive during this period.

ADOLESCENT DEVELOPMENT ACCORDING TO THE FIVE DOMAINS OF THE OPTIMAL HEALTH FRAMEWORK

As discussed in Chapter 1, the committee found only one definition of “optimal health” in our literature search. This definition, first presented by O’Donnell in 1986 and later updated in an editorial statement for the American Journal of Health Promotion, describes optimal health as “a dynamic balance of physical, emotional, social, spiritual, and intellectual health” (O’Donnell, 2009, p. vi). The five dimensions are further defined as follows (O’Donnell, 2017, p. 76):

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
  1. physical health: the condition of the body;
  2. emotional health: the ability to cope with or avoid stress and other emotional challenges;
  3. social health: the ability to form and maintain nurturing and productive relationships with family, friends, classmates, neighbors, and others;
  4. spiritual health: having a sense of purpose, love, hope, peace, and charity; and
  5. intellectual health: the necessary skills for academic achievements, career achievements, hobbies, and cultural pursuits.

An important strength of this definition is the understanding that health is not unidimensional, but comprises various dimensions of well-being that are constantly changing and interrelated. As stated by O’Donnell (2017, p. 76) in his later work, “It is not realistic to expect to reach that magic point of perfect balance and stay there. It is more realistic to seek opportunities for growth and think in terms of a process of striving for balance under changing circumstances.” Importantly, this statement allows for change in the relative importance of each dimension given the time, place, and situation. In each of the five dimensions of optimal health, then, a person’s health is constantly changing based on a variety of biological, social, and environmental factors. Though individual goals and motivations drive certain health behaviors, O’Donnell (2017) asserts that perhaps the greatest predictors of health behaviors are the physical and social environments in which people live. Hence, these avenues may provide the greatest opportunity for health promotion.

O’Donnell (2017) describes a number of reasons why the social environment is so influential. First, individual goals are influenced by socializing agents and places. Second, socialization governs the norms and pressures that people face. Third, socialization occurs primarily outside conscious thought, which often leads to a lack of awareness about how socialization influences values, priorities, and goals. Thus, the social environment is critically important because of its powerful influence on people’s daily goals, choices, and behaviors.

Although O’Donnell did not intend his definition of optimal health to serve as a model for adolescent health, the concept of seeking opportunities for growth under changing circumstances has relevance for this developmental period. While adolescence is a period of growing autonomy and independence, the adolescent experience is also highly dependent on the individual, family, community, and societal context (see Box 2-1).

Of course, this definition is not without its limitations. First, not all of the five dimensions of optimal health are easy to measure. For example, anthropometric data or medical and psychiatric diagnoses can be used

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

to measure various aspects of physical and emotional health, and school grades, educational attainment, and cognitive ability can serve as measures of intellectual health. In contrast, levels of social and spiritual health are much more difficult to measure.

Second, while the interactions among these dimensions make O’Donnell’s definition attractive, they can make the dimensions difficult to tease apart. For instance, programs and interventions aimed at promoting adolescent health and well-being often focus on more than one dimension, as in the example of social-emotional learning. As a result, assigning such programs and interventions to one particular category can be virtually impossible. These measurement challenges are well illustrated in the review of programs in Chapter 4, where the committee was unable to identify groups of programs that fit exclusively into the social and spiritual health domains; instead, quite a few programs in the category of “multiple optimal health domains” include aspects of social and spiritual health.

Third, though adolescents typically reach a number of milestones in each of O’Donnell’s five areas of optimal health, and while certain developmental progressions tend to occur during this period, adolescent development is also a highly individual process. This individuality creates some limitations in defining what constitutes normative development during this period. Defining stages and behaviors as “normative” can suggest that non-normative behaviors are negative; in the context of this report, therefore, the term “normative” is meant to align with typical developmental trajectories and milestones shared by youth of diverse backgrounds.

Finally, and in line with the aforementioned limitations, this report is, to our knowledge, the first to provide such a detailed examination of the literature on adolescent development and behavior using an optimal health lens. However, this review was constrained by the lack of definitions of “optimal health” in the peer-reviewed literature, and our use of O’Donnell’s definition should not be interpreted as an endorsement of its application to adolescent health programming.

Each of the following sections is dedicated to one of the five optimal health dimensions. Each section first provides a description of important adolescent developmental milestones and trajectories for that particular dimension, followed by a discussion of the major social and environmental influences that affect those milestones and trajectories, including but not limited to parents, peers, schools, and media.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Physical Health

Developmental Milestones and Trajectories

In adolescence, puberty drives the primary physical changes that occur. These physiological developments, which include changes in a person’s height, weight, body composition, sex characteristics, and circulatory and respiratory systems, are caused primarily by hormonal activity. Hormones prime the body to behave in a certain way once puberty begins and trigger certain behavioral and physical changes, and hormone production gradually increases until an adolescent reaches sexual maturation.

Although puberty typically follows a series of predictable physical changes, the onset and timing of these developments vary from person to person and have changed over time (Parent et al., 2016). Genetic, environmental, and health factors, including biological determinants, life stressors, socioeconomic status, nutrition and diet, amount of body fat, and presence of chronic illness, can all affect the onset and progression of puberty (Aylwin et al., 2019). Understanding the role of puberty is particularly important because pubertal hormones and the context in which they occur drive many of the motivations for novelty seeking that occur during adolescence.

Social and Environmental Influences on the Development of Physical Health

Bodily changes during puberty can have important effects on how adolescents perceive themselves and are perceived by others (NASEM, 2019). The physical changes that occur during puberty have been found to have as great an effect on an adolescent’s self-image as the way he or she is treated and responded to by others (Graber, Nichols, and Brooks-Gunn, 2010).

Because adolescents experience puberty at different times and rates, their physical development can be a source of pride or shame. Parents and peers play a large role in shaping the attitudes of adolescents about their bodies and physical activity. Parents in particular can model healthy eating and physical activity and communicate positive messages about their child’s appearance from an early age (Hart et al., 2015).

Schools have the potential to equalize access to opportunities for all students, as they provide an important environment for encouraging behaviors related to physical health, such as engaging in physical activity and eating a nutritious diet (Hills, Dengel, and Lubans, 2015). Schools can also provide a basic level of primary care services through school-based health centers (SBHCs). Indeed, research on SBHCs has demonstrated their effectiveness in delivering health promotion messages and services

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

to young people, particularly those who may not have access to these services outside of school. SBHCs therefore represent an important venue for delivering health programming (Brown and Bolen, 2018; NASEM, 2019; Parasuraman and Shi, 2014). However, many schools struggle to implement high-quality programs that can drive positive physical health outcomes because of a lack of resources and institutional support.

Ultimately, many different genetic, social, and environmental factors affect physical development. The coordination of services and supports, as well as increased equitable access to resources, can help promote optimal physical health outcomes for adolescents.

Emotional Health

Developmental Milestones and Trajectories

Emotional health refers to the ability to cope with or avoid stress and other emotional challenges. In the past, adolescents have been characterized by their rapidly fluctuating emotions. Although researchers once attributed these emotions to the “storm and stress” expected in adolescence, these emotions generally reflect the interplay between the individual’s social environments and the neurobiological and psychological changes that mark this period of development (Lerner and Steinberg, 2009).

In this report, the committee takes a strengths-based approach, viewing adolescence as an opportunity and indeed a critical time to help youth acquire positive skills related to emotion regulation. These skills interact with neurobiological and psychological changes to form the basis for the development of emotional health.

Neurobiological changes during adolescence Second only to infancy, the greatest neurobiological developments—many of which are associated with emotion regulation and decision making—occur during adolescence. Studies have found that the brain is extremely malleable during adolescence, with connections forming and reforming in response to a variety of experiences and stressors (Ismail, Fatemi, and Johnston, 2017; Selemon, 2013). This plasticity means that adolescent brains are highly adaptable to environmental demands. The onset of puberty spurs changes in the limbic system, causing greater sensitivity to rewards, threats, novelty, and peers; in contrast, the cortical regions, which are related to cognitive control and self-regulation, take longer to develop (NASEM, 2019). Theories of adolescent cognitive neuroscience suggest that this asynchronous development of these reward and control systems is responsible for adolescents’ biased decision making and sensation seeking (Casey, 2015; Steinberg, 2014).

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Psychological development during adolescence In adolescence, youth must learn to identify, understand, and express emotions in healthy ways, also referred to as emotion regulation. A primary component of emotion regulation is the ability to handle emotions internally rather than externally. This includes recognizing how emotions impact thoughts and behaviors, learning to delay or reduce impulsive reactions to intense emotions, making decisions about situations based on how one might react emotionally, and engaging in cognitive reframing to change one’s perspective on a particular situation (DeSteno, Gross, and Kubzansky, 2013).

Self-esteem (value judgments about oneself) is another critical aspect of psychological development and identity formation. Self-esteem is often at its lowest point in early adolescence, tending to improve in middle to late adolescence as teenagers become more emotionally mature. Differences between how one views oneself and how one believes one “should” be can lead to low self-esteem. Persistently low self-esteem is related to negative outcomes, including depression, delinquency, and other adjustment problems, in multiple optimal health domains (Allwood et al., 2012).

Adolescents are also at particularly high risk for developing many mental health conditions, including major depression, eating disorders, substance use disorders, and anxiety disorders (Herpertz-Dahlmann, Bühren, and Remschmidt, 2013; Merikangas et al., 2010). Beyond genetics, risk factors for these mental health conditions include exposure to, perceptions of, and reactions to stressors; elevated emotional and physiological reactivity; and developmental variation in the utilization of emotion regulation strategies (Carthy et al., 2010; Green et al., 2010; McLaughlin et al., 2011, 2012).

Social and Environmental Influences on the Development of Emotional Health

Pubertal hormones released during adolescence make youth particularly sensitive to stress (NASEM, 2019). These biological processes, combined with the heightened interpersonal stressors that occur during adolescence, are associated with disruptions in adolescents’ ability to regulate their emotions effectively (McLaughlin, Garrad, and Somerville, 2015). Fortunately, an adolescent’s social and environmental contexts can help mitigate the effects of stress. Adolescents who feel secure and protected in their immediate environments—home, community, and school—tend to handle stress more effectively than youth who feel unsupported, unsafe, or unprotected. Chronically stressful environments put youth at higher risk for depression, anxiety, alcohol or other drug use, teen pregnancy, and violence (NASEM, 2019). To handle stress and difficult situations effectively, adolescents must develop resilience—the capacity to recover quickly from difficulties. Resil-

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

ience is developed through interactions within families, schools, neighborhoods, and the larger community (Zimmerman et al., 2013), which allow adolescents to practice dealing with stressful situations in safe and supportive environments. However, just as social support can help mitigate stress, adolescents who lack social support may be unable to develop confidence and effective stress management techniques (Compas, 2009).

Although disengagement from parents is common during adolescence, research has shown that parental relationships continue to influence important emotional outcomes (Branje, Laursen, and Collins, 2012). Research also has shown that family environments that support adolescents’ expressions of autonomy are associated with a greater sense of agency and confidence in their own abilities, positive self-concept, and a sense of self-worth (McElhaney and Allen, 2012; Noller and Atkin, 2014). In cases where parents do not play central roles in adolescents’ lives, natural mentors can serve as attachment figures and mitigate the risk for adverse outcomes (Dang et al., 2014; Thompson, Greeson, and Brunsink, 2016).

As illustrated earlier in Box 2-1, peers play a particularly important role in emotional development during adolescence. By middle to late adolescence, youth report relying more on either best friends or romantic partners than on parents for emotional support (Farley and Kim-Spoon, 2014). Although these interpersonal relationships can increase stressors and negative emotions, they can also, when of high quality, protect against the negative effects of such stressors and emotions (Farley and Kim-Spoon, 2014; Thompson and Leadbeater, 2013).

Schools also have the capacity to promote adolescent resilience by providing students with a sense of mutual responsibility and belonging (Epstein, 2011). Likewise, schools can help identify adolescents in need and provide services that can help. As with physical health, this role of schools is especially important for adolescents who may not have regular access to health care outside of school. In addition to such informal services as positive social interactions and emotional skill building, schools can provide formal services, such as counseling, that can improve both adolescents’ social-emotional well-being and their academic performance (Brown and Bolen, 2018; Walker et al., 2010) (see Box 2-2).

Finally, social media have implications for adolescents’ emotional health. Teenagers can use social media to express their emotions and opinions online, to seek social support, or to compare themselves with others. Research has found that adolescents who experience a greater number of positive reactions to their social media profile also experience higher self-esteem and satisfaction with their life (Ahn, 2011). On the other hand, misinterpreted communications, social rejection, and cyberbullying can have a range of negative emotional effects (Chou and Edge, 2012).

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Social Health

Developmental Milestones and Trajectories

Social health refers to the ability to form and maintain nurturing and productive relationships with others. As noted previously, adolescence is a period marked by increased autonomy. During normative adolescent development, most adolescents establish a level of independence and self-sufficiency that is marked by individuating from their family and beginning the important process of transferring dependencies from parental to peer relationships (McElhaney and Allen, 2012). An adolescent’s social network can include friends, acquaintances, romantic partners, teams, and virtual communities. This social network continues to grow as adolescents seek out new experiences and engage in their community (Farley and Kim-Spoon, 2014).

Early adolescence tends to be marked by the most intense involvement in peer groups, with conformity and concerns about acceptance at their peak (Cowie, 2019). Although early adolescents experiment with romantic relationships, these experiences tend to be brief. Typically, early adolescents choose partners who align with the expectations of their social networks, reflecting their preoccupation with peers’ perceptions of them (Cowie, 2019).

In middle adolescence, peer groups tend to become more gender-mixed. Adolescents begin to exhibit less conformity and greater acceptance of individual differences in this period, which is marked by a dramatic shift in multiple aspects of relationships, including number of relationships, length of relationships, and choices of partners (Bowker and Ramsay, 2018; Little and Welsh, 2018). They also begin what is more traditionally thought of as dating.

By late adolescence, one-on-one friendships and romantic relationships are often prioritized above relations with peer groups. Accordingly, the manifestation of romantic relationships between older adolescents reflects a greater interdependence between the partners than is the case in the romantic relationships of young adolescents (Bowker and Ramsay, 2018; Little and Welsh, 2018).

Social and Environmental Influences on the Development of Social Health

Compared with other age groups, adolescents are particularly influenced by the social norms of many groups, including family, friends, peers, virtual communities, and the broader society (McDonald, Fielding, and Louis, 2013).

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

The family is the first and primary social group to which most people belong, and parents represent important role models for the development of prosocial behavior (Hurd, Wittrup, and Zimmerman, 2018). As adolescents continue to develop more agency, this socialization process moves from being unidirectional (i.e., parent to child) to a more bidirectional, mutually beneficial process, characterized by discussion and negotiation of attitudes, beliefs, and practices (Smetana, Robinson, and Rote, 2015).

As discussed earlier, peer norms become particularly influential during adolescence. Positive peer modeling and awareness of peer norms have been found to be protective against violence, substance misuse, and unhealthy sexual risk (Viner et al., 2012). In contrast, social isolation, peer rejection, and bullying are associated with numerous unhealthy risk behaviors and adverse health outcomes, such as increased delinquency, depression, numbers of suicide attempts, and low self-esteem (Smokowski and Evans, 2019).

Schools also play a prominent role in the development of social health. In school, youth learn to relate with peers and form relationships with adult role models. For adolescents, a strong sense of attachment, bonding, and belonging; a feeling of being cared about; and a perception of teacher fairness are key factors in developing positive relationships with their teachers and their schools. Adolescents also tend to feel more motivated and engaged in school when they have strong, supportive relationships with their peers and teachers (Bakadorova and Raufelder, 2017; Wang and Eccles, 2013).

Perhaps the greatest social environmental influence on today’s adolescents is social media. Social media add another layer to adolescent identity development, as adolescents must shape their virtual identities by determining what information to disclose online and where to disclose it (Boz, Uhls, and Greenfield, 2016). Social media platforms have also changed the ways in which adolescents relate to one another, increased the amount of time youth stay connected to one another, and redefined the meaning of friendship. Research has found that youth use such technologies as social media platforms to mediate their relationships with friends, romantic partners, and broader groups of peers (Nesi, Choukas-Bradley, and Prinstein, 2018) (see Box 2-3).

Although there are correlations between sociodemographics and particular social media communities, overall social media use is consistent across levels of household income and parents’ educational attainment. Overall, 88 percent of teens report having access to a desktop or laptop computer at home, ranging from 75 percent among those from households with an annual income of $30,000 or less to 96 percent among those from households with an annual income of $75,000 or more. Moreover, as mentioned in Box 2-3, 95 percent of all teens report having access to a smartphone, a figure that has increased by 22 percent since 2014–2015. Interestingly, there is even less variation in smartphone relative to computer access by

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

income, ranging from 93 percent of teens from households with an annual income of $30,000 or less to 97 percent among teens from households with an annual income of $75,000 or more (Anderson and Jiang, 2018).

As noted earlier, adolescents are particularly vulnerable to the effects of social media, both positive and negative (Walrave et al., 2016). For example, social media can expose adolescents to unhealthy risk behaviors and portray these behaviors as normative, which may increase the likelihood of their engaging in those behaviors. In addition, social media can magnify existing peer influences on behavior. For instance, adolescents may post

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

photos of themselves drinking alcohol that others interpret as desirable. Furthermore, for teens who are already engaging in unhealthy risk behaviors, social media may provide a way to find and interact with others who share these interests or further normalize these behaviors within a given community (Ahn, 2011). In contrast, given their ubiquity and influence on behavior, social media may also represent an important opportunity for future health promotion efforts.

Spiritual Health

Developmental Milestones and Trajectories

O’Donnell defines spiritual health as having a sense of purpose, love, hope, peace, and charity. In this report and consistent with this definition, spirituality refers not only to one’s religious beliefs but also to the morals, values, character development, and goal setting that contribute to a person’s identity.

Spirituality and religiosity are perhaps the most well-recognized influences on spiritual health. The way in which adolescents choose to engage in spiritual or religious practices varies widely. Among those youth who identify with a particular religious group, some maintain a minor, often cultural affiliation with a religious institution, while others regularly engage with religious practices at home and in religious institutions (Barry, Nelson, and Abo-Zena, 2018).

In line with the broader definition of spiritual health adopted in this report, adolescence is also characterized by identity formation, a process during which youth explore their environments to better understand how they see themselves fitting into the world. While some youth develop identities that align with those of their families, others may explore other identities and values in seeking to develop a personal identity (Hall, 2018a).

An important part of an adolescent’s identity development is the formation of a value system, which strongly influences behaviors, plans for the future, interests, and interpersonal relationships (Levesque, 2018). While value systems were traditionally shaped by religious or institutional values, cultural and technological changes have given today’s youth opportunities to learn and explore more diverse ideas and opinions in establishing who they are and what they believe (Berzonsky, 2018).

As they establish these values, adolescents also begin to seek out information that informs their attitudes and beliefs about civic and global issues. At the same time, they often become involved in their community through volunteering, participating in school clubs or community organizations, and voting. This time spent learning and engaging in civic issues helps them focus on their emerging role in society (Allen, Bogard, and Yanisch, 2018).

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Social and Environmental Influences on the Development of Spiritual Health

Identity and spiritual development are grounded in interpersonal relationships. How a person expresses his or her identity is strongly based in particular contexts.

Religion and spirituality can help adolescents discover a higher sense of purpose, which is associated with greater psychological well-being, a more unified identity, a greater sense of meaning, and fewer health-compromising behaviors (Burrow and Hill, 2011; Sumner, Burrow, and Hill, 2018). Other research has found that a sense of purpose beyond oneself is related to academic performance and persistence among high school students (Yeager et al., 2014). In addition, studies show that more religious/spiritual adolescents report less depression, anxiety, and other psychiatric concerns compared with their less religious/spiritual peers (Yonker, Schnabelrauch, and DeHaan, 2012).

Families play an important role in the development of spiritual identity, as early engagement in religion and spirituality is often mediated by parents and other close adults (Kim and Esquivel, 2011). Beyond engaging with family in religious or spiritual activities, adolescents may also become more interested in their cultural heritage and question the meaning of their family culture as they begin to form their own cultural identity. In developing this cultural identity, adolescents often express themselves by educating others, participating in cultural activities and social groups, or incorporating cultural pride into their self-presentation (Barry, Nelson, and Abo-Zena, 2018).

In addition to religious organizations, other community venues can serve as important sources for youth’s identity and spiritual development. For instance, having a pride center allows lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) teens from different neighborhoods or schools to gather in a communal space, share their experiences, and support each other (Higa et al., 2014) (see Box 2-4 for more information about LGBTQ youth). In addition, community centers can hold events specifically oriented toward youth that can facilitate social support around shared interests or aspects of identity.

Intellectual Health

Developmental Milestones and Trajectories

The final domain of optimal health is intellectual, which encompasses the skills that lead to academic achievements, career achievements, hobbies, and cultural pursuits. During adolescence and into adulthood, the regions

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

of the brain that regulate executive functioning and oversee critical abilities for decision making gradually develop (Giedd, 2015; Johnson, Blum, and Giedd, 2009). In addition, improved abstract thinking allows youth to process information, use evidence to draw conclusions, and engage in strategic problem solving and deductive reasoning (Kuhn, 2009).

Social and Environmental Influences on the Development of Intellectual Health

While the school environment itself has perhaps the greatest overall influence on intellectual health, parents, peers, and others also have important impacts in this domain.

Research shows that parenting styles contribute to intellectual health outcomes. Compared with other parenting styles, authoritative parenting, characterized by frequent involvement and supervision, is associated with greater academic achievement (Pinquart, 2016). In particular, research shows that parents’ engagement and involvement in their children’s schools are associated with better academic outcomes (LaRocque, Kleiman, and Darling, 2011). In addition, adolescent perceptions of closeness and trust with their parents predict better academic competence, engagement, and achievement (Murray, 2009).

The adolescent’s peer group can also influence academic achievement and identity. Research shows that high-quality peer relationships are associated with academic engagement and achievement, reflecting a desire to be like high-achieving friends or a shared social identity that affects student behaviors (Juvonen, Espinoza, and Knifsend, 2012; Martin and Dowson, 2009).

Dropping out of high school is strongly associated with poor intellectual health, as it can lead to numerous adverse outcomes, including low wages, unemployment, incarceration, and poverty (Wilson et al., 2011). Dropout rates vary by state, ethnic background, and socioeconomic status (Cataldi and KewalRamani, 2009). The National Center for Education Statistics (2019a) reports that Asian/Pacific Islander students had the highest public school graduation rates in 2016–2017 at 91 percent, followed by white students at 89 percent, and significantly lower rates among Hispanic/Latino (80%), black (78%), and American Indian/Alaska Native (72%) students. Generally, males are more likely than females to drop out of high school (National Center for Education Statistics, 2019b). However, teenage pregnancy and parenthood significantly increase the risk of dropout for adolescent girls, with only 50 percent of teenage mothers in the United States earning a high school diploma by age 22 (Perper, Peterson, and Manlove, 2010).

The single greatest predictor of gaps in academic achievement by race and income is the segregation of schools by family income (NASEM, 2019).

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Schools in neighborhoods with lower socioeconomic status, where students are more likely to be people of color, typically are less well funded, have less-qualified teachers, and have fewer resources relative to schools in wealthier areas. All of these factors can affect academic outcomes for students. As income inequality continues to rise, so does income segregation among schools, which denies youth from low-income families equal opportunities for success. For this reason, The Promise of Adolescence (NASEM, 2019) report emphasizes that children from adverse circumstances need more rather than equal resources if society is truly going to reduce disparities in educational outcomes.

Regarding social media, many studies indicate that educators can take advantage of these technology platforms to engage effectively with students, such as by having them complete online courses, tests, or assignments; watch instructional videos; conduct research; and participate virtually in classroom activities, as well as by fostering communication between students and teachers (Ahn, 2011; Greenhow, Sonnevend, and Agur, 2016). Such technology platforms can also help to engage more effectively with students with disabilities (see Box 2-5 for more information about adolescents with disabilities).

As with other aspects of optimal health, however, these technologies can have adverse effects on intellectual health. For example, multitasking on social media may come at the expense of academic work and put youth at higher risk of exposure to inaccurate information. Much attention has been given to the spread of misinformation online, and a 2018 study reported in Science found that such misinformation spreads faster than the truth (Vosoughi, Roy, and Aral, 2018). Adolescents are particularly vulnerable in this regard, since their developing cognitive skills may make it more difficult for them to judge information. Promoting digital literacy for adolescents can therefore provide them with the necessary tools to avoid and interpret misinformation.

CONCLUSIONS

This chapter has defined and applied O’Donnell’s optimal health framework to the context of normative adolescent development and highlighted how that development is influenced by the physical and social environments. Based on the evidence presented in this chapter, the committee drew the following conclusions.

CONCLUSION 2-1: Adolescents face variations in access to opportunities and supports that often relate to age, race and ethnicity, socioeconomic status, rurality/urbanity, sexual orientation, sex and gender, and disability.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

CONCLUSION 2-2: The physical and social environments, including parents and family, peers, schools, neighborhoods, and media, have a major influence on adolescent development and well-being.

CONCLUSION 2-3: Adolescents from disadvantaged backgrounds need more resources relative to their peers from more advantaged backgrounds to ensure their access to comparable opportunities.

The next chapter addresses normative adolescent risk taking and describes the current landscape of adolescent alcohol use, tobacco use, and sexual behavior, as well as their related health outcomes.

REFERENCES

Ahn, J. (2011). The effect of social network sites on adolescents’ social and academic development: Current theories and controversies. Journal of the American Society for Information Science and Technology, 62(8), 1435–1445.

Allen, L., Bogard, K., and Yanisch, T. (2018). Civic and citizenship attitudes. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 600–606). Basel, Switzerland: Springer International.

Allwood, M.A., Baetz, C., DeMarco, S., and Bell, D.J. (2012). Depressive symptoms, including lack of future orientation, as mediators in the relationship between adverse life events and delinquent behaviors. Journal of Child & Adolescent Trauma, 5(2), 114–128.

Anaby, D., Hand, C., Bradley, L., DiRezze, B., Forhan, M., DiGiacomo, A., and Law, M. (2013). The effect of the environment on participation of children and youth with disabilities: A scoping review. Disability and Rehabilitation, 35(19), 1589–1598.

Anderson, M., and Jiang, J. (2018). Teens, Social Media & Technology 2018. Washington, DC: Pew Research Center.

Austin, A., Herrick, H., and Proescholdbell, S. (2016). Adverse childhood experiences related to poor adult health among lesbian, gay, and bisexual individuals. American Journal of Public Health, 106(2), 314–320.

Aylwin, C.F., Toro, C.A., Shirtcliff, E., and Lomniczi, A. (2019). Emerging genetic and epigenetic mechanisms underlying pubertal maturation in adolescence. Journal of Research on Adolescence, 29(1), 54–79.

Baams, L., Dubas, J.S., and van Aken, M.A.G. (2017). Comprehensive sexuality education as a longitudinal predictor of LGBTQ name-calling and perceived willingness to intervene in school. Journal of Youth and Adolescence, 46(5), 931–942.

Bakadorova, O., and Raufelder, D. (2017). The interplay of students’ school engagement, school self-concept and motivational relations during adolescence. Frontiers in Psychology, 8(2171).

Barry, C.T., Sidoti, C.L., Briggs, S.M., Reiter, S.R., and Lindsey, R.A. (2017). Adolescent social media use and mental health from adolescent and parent perspectives. Journal of Adolescence, 61, 1–11.

Barry, C.M., Nelson, L.J., and Abo-Zena, M.M. (2018). Religiousness in adolescence and emerging adulthood. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 3101–3126). Basel, Switzerland: Springer International.

Bernert, D.J., Ding, K., and Hoban, M.T. (2012). Sexual and substance use behaviors of college students with disabilities. American Journal of Health Behavior, 36(4), 459–471.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Berzonsky, M.D. (2018). Identity processes. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 1828–1836). Basel, Switzerland: Springer International.

Blum, R.W., Kelly, A., and Ireland, M. (2001). Health-risk behaviors and protective factors among adolescents with mobility impairments and learning and emotional disabilities. Journal of Adolescent Health, 28(6), 481–490.

Bowker, A., and Ramsay, K. (2018). Friendship characteristics. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 1487–1494). Basel, Switzerland: Springer International.

Boyle, C.A., Boulet, S., Schieve, L.A., Cohen, R.A., Blumberg, S.J., Yeargin-Allsopp, M., Visser, S., and Kogan, M.D. (2011). Trends in the prevalence of developmental disabilities in U.S. children, 1997–2008. Pediatrics, 127(6), 1034–1042.

Boz, N., Uhls, Y.T., and Greenfield, P.M. (2016). Cross-cultural comparison of adolescents’ online self-presentation strategies: Turkey and the United States. International Journal of Cyber Behavior, Psychology and Learning, 6(3), 1–16.

Branje, S., Laursen, B., and Collins, W.A. (2012). Parent–child communication during adolescence. In A.L. Vangelisti (Ed.), The Routledge Handbook of Family Communication (pp. 283–298). New York, NY: Routledge.

Brown, M.B. and Bolen, L.M. (2018). School-based health centers. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 2506–2512). Basel, Switzerland: Springer International.

Burrow, A.L. and Hill, P.L. (2011). Purpose as a form of identity capital for positive youth adjustment. Developmental Psychology, 47(4), 1196–1206.

Carthy, T., Horesh, N., Apter, A., Edge, M.D., and Gross, J.J. (2010). Emotional reactivity and cognitive regulation in anxious children. Behavioral Research and Therapy, 48(5), 384–393.

Casey, B.J. (2015). Beyond simple models of self-control to circuit-based accounts of adolescent behavior. Annual Review of Psychology, 66, 295–319.

Cataldi, E.F. and KewalRamani, A. (2009). High school dropout and completion rates in the United States: 2007 compendium report. (NCES 2009-064). U.S. Department of Education, Institute of Education Sciences, National Center for Education Statitistics. Washington, DC. Available: http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2009064.

Chou, H-T.Z. and Edge, N. (2012). “They are happier and having better lives than I am”: The impact of using Facebook on perceptions of others’ lives. Cyberpsychology, Behavior, and Social Networking, 15(2), 117–121.

Compas, B.E. (2009). Processes of risk and resilience during adolescence. In R.M. Lerner and L. Steinberg (Eds.), Handbook of Adolescent Psychology (Vol. 1). Hoboken, NJ: John Wiley & Sons.

Cowie, H. (2019). From Birth to Sixteen: Children’s Health, Social, Emotional and Linguistic Development (2nd ed.). New York, NY: Routledge.

Dang, M.T., Conger, K.J., Breslau, J., and Miller, E. (2014). Exploring protective factors among homeless youth: The role of natural mentors. Journal of Health Care for the Poor and Underserved, 25(3), 1121–1138.

Day, J.K., Fish, J.N., Grossman, A.H., and Russell, S.T. (2019). Gay-straight alliances, inclusive policy, and school climate: LGBTQ youths’ experiences of social support and bullying. Journal of Research on Adolescence, 1–13.

DeSteno, D., Gross, J.J., and Kubzansky, L. (2013). Affective science and health: The importance of emotion and emotion regulation. Health Psychology, 32(5), 474–486.

Dimock, M. (2019). Defining Generations: Where Millennials End and Generation Z Begins. Washington, DC: Pew Research Center.

Epstein, J.L. (2011). School, Family, and Community Partnerships: Preparing Educators and Improving Schools (2nd ed.). Philadelphia, PA: Westview Press.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Everett, B.G. (2019). Optimal adolescent health to improve behavioral outcomes for LGBTQ youth. Paper Commissioned by the Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth. Available: https://www.nap.edu/resource/25552/Optimal%20Adolescent%20Health%20to%20Improve%20Behavioral%20Outcomes%20for%20LGBTQ%20Youth.pdf.

Farley, J.P. and Kim-Spoon, J. (2014). The development of adolescent self-regulation: Reviewing the role of parent, peer, friend, and romantic relationships. Journal of Adolescence, 37(4), 433–440.

Gage, N.A., Lierheimer, K.S., and Goran, L.G. (2012). Characteristics of students with high-incidence disabilities broadly defined. Journal of Disability Policy Studies, 23(3), 168–178.

Giedd, J.N. (2015). The amazing teen brain. Scientific American, 312(6), 32–37.

Goldbach, J.T., Tanner-Smith, E.E., Bagwell, M., and Dunlap, S. (2014). Minority stress and substance use in sexual minority adolescents: A meta-analysis. Prevention Science, 15(3), 350–363.

Graber, J.A., Nichols, T.R., and Brooks-Gunn, J. (2010). Putting pubertal timing in developmental context: Implications for prevention. Developmental Psychobiology, 52(3), 254–262.

Green, J.G., McLaughlin, K.A., Berglund, P.A., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M., and Kessler, R.C. (2010). Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey Replication II: Associations with persistence of DSM-IV disorders. Archives of General Psychiatry, 67(2), 124–132.

Greenhow, C., Sonnevend, J., and Agur, C. (2016). Education and Social Media: Toward a Digital Future. Cambridge, MA: The MIT Press.

Halfon, N., Houtrow, A., Larson, K., and Newacheck, P.W. (2012). The changing landscape of disability in childhood. The Future of Children, 22(1), 13–42.

Hall, S.P. (2018a). Identity status. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 1836–1844). Basel, Switzerland: Springer International Publishing.

Hall, W.J. (2018b). Psychosocial risk and protective factors for depression among lesbian, gay, bisexual, and queer youth: A systematic review. Journal of Homosexuality, 65(3), 263–316.

Hart, L.M., Cornell, C., Damiano, S.R., and Paxton, S.J. (2015). Parents and prevention: A systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders. International Journal of Eating Disorders, 48(2), 157–169.

Herpertz-Dahlmann, B., Bühren, K., and Remschmidt, H. (2013). Growing up is hard: Mental disorders in adolescence. Deutsches Ärzteblatt International, 110(25), 432.

Higa, D., Hoppe, M.J., Lindhorst, T., Mincer, S., Beadnell, B., Morrison, D.M., Wells, E.A., Todd, A., and Mountz, S. (2014). Negative and positive factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. Youth & Society, 46(5), 663–687.

Hills, A.P., Dengel, D.R., and Lubans, D.R. (2015). Supporting public health priorities: Recommendations for physical education and physical activity promotion in schools. Progress in Cardiovascular Diseases, 57(4), 368–374.

Horner-Johnson, W., and Sauvé, L. (2019). Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth with Disabilities. Paper commissioned by the Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth. Available: https://www.nap.edu/resource/25552/Applying%20Lessons%20of%20Optimal%20Adolescent%20Health%20to%20Improve%20Behavioral%20Outcomes%20for%20Youth%20with%20Disabilities.pdf.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Hurd, N.M., Wittrup, A., and Zimmerman, M.A. (2018). Role models. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 3179–3186). Basel, Switzerland: Springer International.

Iezzoni, L.I. (2011). Eliminating health and health care disparities among the growing population of people with disabilities. Health Affairs, 30(10), 1947–1954.

Ismail, F.Y., Fatemi, A., and Johnston, M.V. (2017). Cerebral plasticity: Windows of opportunity in the developing brain. European Journal of Paediatric Neurology, 21(1), 23–48.

Johnson, S.B., Blum, R.W., and Giedd, J.N. (2009). Adolescent maturity and the brain: The promise and pitfalls of neuroscience research in adolescent health policy. Journal of Adolescent Health, 45(3), 216–221.

Jones, S.E., and Lollar, D.J. (2008). Relationship between physical disabilities or long-term health problems and health risk behaviors or conditions among U.S. high school students. Journal of School Health, 78(5), 252–257.

Juvonen, J., Espinoza, G., and Knifsend, C. (2012). The role of peer relationships in student academic and extracurricular engagement. In S.L. Christenson, A.L. Reschly, and C. Wylie (Eds.), Handbook of Research on Student Engagement (pp. 387–401). Boston, MA: Springer.

Kann, L., McManus, T., Harris, W.A., Shanklin, S.L., Flint, K.H., Queen, B., Lowry, R., Chyen, D., Whittle, L., Thornton, J., Lim, C., Bradford, D., Yamakawa, Y., Leon, M., Brener, N., and Ethier, K.A. (2018). Youth risk behavior surveillance—United States, 2017. Morbidity and Mortality Weekly Report Surveillance Summaries, 67(8).

Kim, S., and Esquivel, G.B. (2011). Adolescent spirituality and resilience: Theory, research, and educational practices. Psychology in the Schools, 48(7), 755–765.

Krahn, G.L., Fujiura, G., Drum, C.E., Cardinal, B.J., and Nosek, M.A. (2009). The dilemma of measuring perceived health status in the context of disability. Disability and Health Journal, 2(2), 49–56.

Kramer, J., Olsen, S., Mermelstein, M., Balcells, A., and Liljenquist, K. (2012). Youth with disabilities’ perspectives of the environment and participation: A qualitative meta-synthesis. Child: Care, Health, and Development, 38(6), 763–777.

Kuhn, D. (2009). Adolescent thinking. In R.M. Lerner and L. Steinberg (Eds.), Handbook of Adolescent Psychology (vol. 1, pp. 152–186). Hoboken, NJ: John Wiley & Sons.

Kull, R.M., Greytak, E.A., Kosciw, J.G., and Villenas, C. (2016). Effectiveness of school district antibullying policies in improving LGBT youths’ school climate. Psychology of Sexual Orientation and Gender Diversity, 3(4), 407–415.

LaRocque, M., Kleiman, I., and Darling, S.M. (2011). Parental involvement: The missing link in school achievement. Preventing School Failure, 55(3), 115–122.

Lerner, R.M. and Steinberg, L. (2009). The scientific study of adolescent development: Past, present, and future. In R.M. Lerner and L. Steinberg (Eds.), Handbook of Adolescent Psychology (2nd ed., pp. 1–12). Hoboken, NJ: John Wiley & Sons, Inc.

Levesque, R.J.R. (2018). Identity formation. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 1826–1828). Basel, Switzerland: Springer International.

Liang, B., Commins, M., and Duffy, N. (2010). Using social media to engage youth: Education, social justice, and humanitarianism. Prevention Researcher, 17(5), 13–16.

Lindsay, S. (2014). A qualitative synthesis of adolescents’ experiences of living with spina bifida. Qualitative Health Research, 24(9), 1298–1309.

Little, K., and Welsh, D. (2018). Romantic experiences. In R.J.R. Levesque (Ed.), Encyclopedia of Adolescence (pp. 3186–3194). Basel, Switzerland: Springer International.

Madden, C. (2017). Hello Gen Z: Engaging the Generation of Post-Millennials. Sydney, Australia: Hello Clarity.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Martin, A.J., and Dowson, M. (2009). Interpersonal relationships, motivation, engagement, and achievement: Yields for theory, current issues, and educational practice. Review of Educational Research, 79(1), 327–365.

McCreanor, T., Lyons, A., Griffin, C., Goodwin, I., Barnes, H.M., and Hutton, F. (2013). Youth drinking cultures, social networking, and alcohol marketing: Implications for public health. Critical Public Health, 23(1), 110–120.

McDonald, R.I., Fielding, K.S., and Louis, W.R. (2013). Energizing and de-motivating effects of norm-conflict. Personality and Social Psychology Bulletin, 39(1), 57–72.

McElhaney, K.B., and Allen, J.P. (2012). Sociocultural Perspectives on Adolescent Autonomy (1st ed.). USA: Oxford University Press.

McKay, T., Lindquist, C.H., and Misra, S. (2017). Understanding (and acting on) 20 years of research on violence and LGBTQ + communities. Trauma, Violence, & Abuse, 20(5), 665–678.

McLaughlin, K.A., Hatzenbuehler, M.L., Mennin, D.S., and Nolen-Hoeksema, S. (2011). Emotion dysregulation and adolescent psychopathology: A prospective study. Behaviour Research and Therapy, 49(9), 544–554.

McLaughlin, K.A., Green, J.G., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M., and Kessler, R.C. (2012). Childhood adversities and first onset of psychiatric disorders in a national sample of U.S. adolescents. Archives of General Psychiatry, 69(11), 1151–1160.

McLaughlin, K.A., Garrad, M.C., and Somerville, L.H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. Dialogues in Clinical Neuroscience, 17(4), 403–410.

Merikangas, K.R., He, J-P., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., and Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

Mitra, M., Clements, K.M., Zhang, J., Iezzoni, L.I., Smeltzer, S.C., and Long-Bellil, L.M. (2015). Maternal characteristics, pregnancy complications, and adverse birth outcomes among women with disabilities. Medical Care, 53(12), 1027–1032.

Moreno, M.A. (2019). Adolescent health and media. Paper Commissioned by the Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth. Available: https://www.nap.edu/resource/25552/Adolescent%20Health%20and%20Media.pdf.

Moreno, M.A., Gower, A.D., Jenkins, M.C., Kerr, B., and Gritton, J. (2018). Marijuana promotions on social media: Adolescents’ views on prevention strategies. Substance Abuse Treatment, Prevention, and Policy, 13(1), 23.

Mosher, W., Hughes, R.B., Bloom, T., Horton, L., Mojtabai, R., and Alhusen, J.L. (2018). Contraceptive use by disability status: New national estimates from the National Survey of Family Growth. Contraception, 97(6), 552–558.

Murchison, G.R., Agénor, M., Reisner, S.L., and Watson, R.J. (2019). School restroom and locker room restrictions and sexual assault risk among transgender youth. Pediatrics, 143(6), 1–10.

Murray, C. (2009). Parent and teacher relationships as predictors of school engagement and functioning among low-income urban youth. Journal of Early Adolescence, 29(3), 376–404.

MyVoice. (2019). Youth perspectives on being healthy and thriving. Report Commissioned by the Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth. Available: https://www.nap.edu/resource/25552/Youth%20Perspectives%20on%20Being%20Healthy%20and%20Thriving.pdf.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

National Academies of Sciences, Engineering, and Medicine (NASEM). (2019). The Promise of Adolescence: Realizing Opportunity for all Youth. Washington, DC: The National Academies Press.

National Center for Education Statistics. (2019a). Public High School Graduation Rates: 2016-2017. Available: https://nces.ed.gov/fastfacts/display.asp?id=805.

National Center for Education Statistics. (2019b). Dropout Rates. Available: https://nces.ed.gov/fastfacts/display.asp?id=16.

Nesi, J., Choukas-Bradley, S., and Prinstein, M.J. (2018). Transformation of adolescent peer relations in the social media context: Part 2—application to peer group processes and future directions for research. Clinical Child and Family Psychology Review, 21, 295–319.

Noller, P. and Atkin, S. (2014). Family Life in Adolescence. Berlin, Germany: Walter de Gruyter GmbH.

O’Donnell, M.P. (1986). Definition of health promotion. American Journal of Health Promotion, 1(1), 4–5.

O’Donnell, M.P. (2009). Definition of health promotion 2.0: Embracing passion, enhancing motivation, recognizing dynamic balance, and creating opportunities. American Journal of Health Promotion, 24(1), iv.

O’Donnell, M.P. (2017). Health Promotion in the Workplace (5th ed.). Troy, MI: Art & Science of Health Promotion Institute.

Parasuraman, S.R., and Shi, L. (2014). The role of school-based health centers in increasing universal and targeted delivery of primary and preventive care among adolescents. Journal of School Health, 84(8), 524–532.

Parent, A-S., Franssen, D., Fudvoye, J., Pinson, A., and Bourguignon, J-P. (2016). Current changes in pubertal timing: Revised vision in relation with environmental factors including endocrine disruptors. Puberty from Bench to Clinic, 29, 174–184. Basel, Switzerland: Karger Publishers.

Perper, K., Peterson, K., and Manlove, J. (2010). Diploma attainment among teen mothers. Fact Sheet. Child Trends, 2010-01.

Pinquart, M. (2016). Associations of parenting styles and dimensions with academic achievement in children and adolescents: A meta-analysis. Educational Psychology Review, 28(3), 475–493.

Proulx, C.N., Coulter, R.W.S., Egan, J.E., Matthews, D.D., and Mair, C. (2019). Associations of lesbian, gay, bisexual, transgender, and questioning–inclusive sex education with mental health outcomes and school-based victimization in U.S. high school students. Journal of Adolescent Health, 64(5), 608–614.

Rider, G.N., McMorris, B.J., Gower, A.L., Coleman, E., and Eisenberg, M.E. (2018). Health and care utilization of transgender and gender nonconforming youth: A population-based study. Pediatrics, 141(3), e20171683.

Russell, S.T., Everett, B.G., Rosario, M., and Birkett, M. (2014). Indicators of victimization and sexual orientation among adolescents: Analyses from youth risk behavior surveys. American Journal of Public Health, 104(2), 255–261.

Ryan, C., Russell, S.T., Huebner, D., Diaz, R., and Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205–213.

Saewyc, E.M. (2014). Adolescent pregnancy among lesbian, gay, and bisexual teens. In A.L. Cherry and M.E. Dillon (Eds.), International Handbook of Adolescent Pregnancy: Medical, Psychosocial, and Public Health Responses (pp. 159–169). Boston, MA: Springer U.S.

Seemiller, C., and Grace, M. (2018). Generation Z: A Century in the Making. Abingdon, UK: Routledge.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×

Selemon, L.D. (2013). A role for synaptic plasticity in the adolescent development of executive function. Translational Psychiatry, 3, e238.

Smetana, J.G., Robinson, J., and Rote, W.M. (2015). Socialization in adolescence. Handbook of Socialization: Theory and Research, 60–84.

Smokowski, P.R., and Evans, C.B.R. (2019). Bullying and Victimization Across the Lifespan: Playground Politics and Power. Cham: Switzerland: Springer.

Steinberg, L. (2014). Age of Opportunity: Lessons from the New Science of Adolescence. Boston, MA: Houghton Mifflin Harcourt.

Sumner, R., Burrow, A.L., and Hill, P.L. (2018). The development of purpose in life among adolescents who experience marginalization: Potential opportunities and obstacles. American Psychologist, 73(6), 740–752.

Thompson, A.E., Greeson, J.K.P., and Brunsink, A.M.. (2016). Natural mentoring among older youth in and aging out of foster care: A systematic review. Children and Youth Services Review, 61, 40–50.

Thompson, R.S.Y., and Leadbeater, B.J. (2013). Peer victimization and internalizing symptoms from adolescence into young adulthood: Building strength through emotional support. Journal of Research on Adolescence, 23(2), 290–303.

Tonkin, B.L., Ogilvie, B.D., Greenwood, S.A., Law, M.C., and Anaby, D.R. (2014). The participation of children and youth with disabilities in activities outside of school: A scoping review. Canadian Journal of Occupational Therapy, 81(4), 226–236.

Toomey, R.B. and Russell, S.T. (2016). The role of sexual orientation in school-based victimization: A meta-analysis. Youth & Society, 48(2), 176–201.

Tornello, S.L., Riskind, R.G., and Patterson, C.J. (2014). Sexual orientation and sexual and reproductive health among adolescent young women in the United States. Journal of Adolescent Health, 54(2), 160–168.

U.S. Department of Health and Human Services. (2005). The Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General.

Viner, R.M., Ozer, E.M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., and Currie, C. (2012). Adolescence and the social determinants of health. The Lancet, 379(9826), 1641–1652.

Vosoughi, S., Roy, D., and Aral, S. (2018). The spread of true and false news online. Science, 359(6380), 1146–1151.

Walker, S.C., Kerns, S.E.U., Lyon, A.R., Bruns, E.J., and Cosgrove, T.J. (2010). Impact of school-based health center use on academic outcomes. Journal of Adolescent Health, 46(3), 251–257.

Walrave, M., Ponnet, K., Vanderhoven, E., Haers, J., and Segaert, B. (2016). Youth 2.0: Social Media and Adolescence. New York, NY: Springer.

Wang, M-T., and Eccles, J.S. (2013). School context, achievement motivation, and academic engagement: A longitudinal study of school engagement using a multidimensional perspective. Learning and Instruction, 28, 12–23.

Whitehill, J.M., Brockman, L.N., and Moreno, M.A. (2013). “Just talk to me”: Communicating with college students about depression disclosures on Facebook. Journal of Adolescent Health, 52(1), 122–127.

Wilson, S.J., Tanner-Smith, E.E., Lipsey, M.W., Steinka-Fry, K., and Morrison, J. (2011). Dropout prevention and intervention programs: Effects on school completion and dropout among school aged children and youth. Campbell Systematic Reviews, 8, 61.

Wong, C.A., Merchant, R.M., and Moreno, M.A. (2014). Using social media to engage adolescents and young adults with their health. Healthcare, 2(4), 220–224.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Wu, J.P., McKee, K.S., McKee, M.M., Meade, M.A., Plegue, M.A., and Sen, A. (2017). Use of reversible contraceptive methods among U.S. women with physical or sensory disabilities. Perspectives on Sexual and Reproductive Health, 49(3), 141–147.

Yeager, D.S., Henderson, M.D., D’Mello, S., Paunesku, D., Walton, G.M., Spitzer, B.J., and Duckworth, A.L. (2014). Boring but important: A self-transcendent purpose for learning fosters academic self-regulation. Journal of Personality and Social Psychology, 107(4), 559–580.

Yonker, J.E., Schnabelrauch, C.A., and DeHaan, L.G. (2012). The relationship between spirituality and religiosity on psychological outcomes in adolescents and emerging adults: A meta-analytic review. Journal of Adolescence, 35(2), 299–314.

Zimmerman, M.A., Stoddard, S.A., Eisman, A.B., Caldwell, C.H., Aiyer, S.M., and Miller, A. (2013). Adolescent resilience: Promotive factors that inform prevention. Child Development Perspectives, 7(4), 215–220.

Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 34
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 45
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 46
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 47
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 48
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 49
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 50
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
Page 51
Suggested Citation:"2 Normative Adolescent Development." National Academies of Sciences, Engineering, and Medicine. 2020. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/25552.
×
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Adolescence is a critical growth period in which youth develop essential skills that prepare them for adulthood. Prevention and intervention programs are designed to meet the needs of adolescents who require additional support and promote healthy behaviors and outcomes. To ensure the success of these efforts, it is essential that they include reliably identifiable techniques, strategies, or practices that have been proven effective.

Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century identifies key program factors that can improve health outcomes related to adolescent behavior and provides evidence-based recommendations toward effective implementation of federal programming initiatives. This study explores normative adolescent development, the current landscape of adolescent risk behavior, core components of effective programs focused on optimal health, and recommendations for research, programs, and policies.

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