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Protocol - Assessment of Pubertal Development - Child and Adolescent Female

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Description

The mother of the female participant uses the Tanner staging drawings to assess her breast development and pubertal hair.

Specific Instructions

The Sickle Cell Disease Genitourinary Working Group notes that patients and research participants with chronic diseases, like sickle cell disease, can have a delay in the start of puberty and with that relative short stature. Investigators should track height and stage of puberty carefully as the participant enters adolescence

Protocol

Avon Longitudinal Study of Parents and Children (ALSPAC), Growing and Changing (8), Mother/Daughter Questionnaire (97- 157 Months)

We would like to assess the stage of your daughter’s physical development using the drawings on the next pages. These indicate various stages of puberty commonly used by doctors to assess the growth and development of girls.

We need to know which drawings most closely match your daughter’s stage of development at the moment.

Not all children follow the same pattern of development. Just pick the stage that is closest, based on both the picture and the description.

The drawings below show different amounts of female pubic hair. A girl can go through each of these five stages shown. Please look at each of the drawings. It is also important to read the description. 

Put a tick in the box to the right of the drawing that is the closest to the amount of pubic hair your daughter has.

1 [ ]

There is no pubic hair

2 [ ]

There is a little long, lightly coloured hair. This hair may be straight or a little curly.

3 [ ]

The hair is darker in this stage. It is coarser and more curled. It has spread out and thinly covers a bigger area.

4 [ ]

The hair is now as dark, curly, and coarse as that of an adult woman. However, the area that the hair covers is not as large as that of an adult woman. The hair has not spread out to the legs.

5 [ ]

The hair is like that of an adult woman. It also covers the same area as that of an adult woman. The hair usually forms a triangular pattern as it spreads out to the legs.

6 [ ]

Not sure

The drawings below show stages of the way breasts develop. A girl can go through each of the five stages shown, although some girls skip some stages. Please look at each of the drawings. It is also important to read the descriptions.

Put a tick in the box to the right of the drawing that is closest to your daughter’s current breast stage.

1 [ ]

The nipple is raised a little in this stage. The rest of the breast is still flat.

2 [ ]

This is the breast bud stage. In this stage the nipple is raised more than in stage 1. The breast is a small mound. The dark area around the nipple (areola) is larger than in stage 1.

3 [ ]

The areola and the breast are both larger than in stage 2. The areola does not stick out away from the breast.

4 [ ]

The areola and the nipple make up a mound that sticks up above the shape of the breast. (Note: This stage may not happen at all for some teenagers. Some teenagers develop from stage 3 to stage 5 with no stage 4.)

5 [ ]

This is the mature adult stage. The breasts are fully developed. Only the nipple sticks out in this stage. The areola has moved back in the general shape of the breast.

6 [ ]

Not sure

NOTE: Your daughter’s pubic hair stage may or may not be the same as her stage of breast development.

NOTE: Your pubic hair stage may or may not be the same as your stage of breast development.

Availability

Available

Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Child, Adolescent

Participants

Mothers of young women aged 8-13 years old.

Selection Rationale

The Avon Longitudinal Study of Parents and Children (ALSPAC) provides Tanner stage drawings that have been widely used for decades with adolescent males and females to determine their own perceptions of pubertal development.

Language

English

Standards
StandardNameIDSource
Logical Observation Identifiers Names and Codes (LOINC) Assess pubertal dev female proto 62644-0 LOINC
Human Phenotype Ontology Puberty and gonadal disorders HP:0008373 HPO
Derived Variables

None

Process and Review

The PhenX Sickle Cell Disease Genitourinary Working Group (WG) reviewed this protocol in May 2022. Guidance from the WG includes:

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Protocol Name from Source

Avon Longitudinal Study of Parents and Children (ALSPAC), Growing and Changing (8), Mother/Daughter Questionnaire - 97 - 157 Months

Source

University of Bristol, Department of Social Medicine. (n.d.). Avon Longitudinal Study of Parents and Children. Mother/Daughter Questionnaire: Growing and Changing. Oakfield Grove, Bristol, UK: Author. Questions B1-B5 and C1-C5.

General References

Jenner, M. R., Kelch, R. P., Kaplan, S. L., & Gr?mbach, M. M. (1972). Hormonal changes in puberty. IV. Plasma estradiol, LH, and FSH in prepubertal children, pubertal females, and in precocious puberty, premature thelarche, hypogonadism, and in a child with a feminizing ovarian tumor. Journal of Clinical Endocrinology and Metabolism, 34(3), 521-530.

Maliqueo, M., Sir-Peterman, T., Perez, V., Echiburu, B., Ladron de Guevara, A., Galvez, C., Crisosto, N., & Azziz, R. (2009). Adrenal function during childhood and puberty in daughters of women with Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism, 94, 3282-3288.

Marshall, W., & Tanner, J. (1969). Variations in the pattern of pubertal changes in girls. Archives of Disease in Childhood, 44, 291-303.

Sizonenko, P. C., Burr, I. M., Kaplan, S. L., & Gr?mbach, M. M. (1970). Hormonal changes in puberty. II. Correlation of serum luteinizing hormone and follicle stimulating hormone with stages of puberty and bone age in normal girls. Pediatric Research, 4(1), 35-45.

Protocol ID

100103

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX100103_Female_Child_Breast_Development_Stage
PX100103020000 Put a tick in the box to the right of the more
drawing that is closest to your daughter's current breast stage. show less
N/A
PX100103_Female_Child_Pubic_Hair_Development_Stage
PX100103010000 Cross the box that is closest to your more
current pubic hair stage. show less
N/A
Reproductive Health
Measure Name

Assessment of Pubertal Development

Release Date

August 15, 2023

Definition

Separate male- and female-specific protocols to assess stage of puberty. Stage of puberty can be assessed by pubic hair, female breast development, and the size and shape of the male testes.

Purpose

The purpose of these protocols is to assess stage of puberty.

Keywords

assessment of pubertal development - child and adolescent female, assessment of pubertal development - female, Reproductive health, puberty, breast development, testes development, Tanner staging, Avon Longitudinal Study of Parents and Children, ALSPAC

Measure Protocols
Protocol ID Protocol Name
100101 Assessment of Pubertal Development - Teenage Female
100102 Assessment of Pubertal Development - Teenage Male
100103 Assessment of Pubertal Development - Child and Adolescent Female
100104 Assessment of Pubertal Development - Child and Adolescent Male
Publications

There are no publications listed for this protocol.