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Maturation

Maturation refers to progress toward the biologically mature state that occurs concurrently with physical growth and behavioral development. Growth refers to the increase in size of the body as a whole and to changes in body dimensions and composition, organs, and related systems, while development refers to the acquisition of behaviors—cognitive, social, emotional, affective, and moral—appropriate for and expected by the culture within which the individual lives. Although the three processes, growth, maturation, and development, dominate the first two decades of life, they have implications into adulthood. This entry examines the biological maturation of children and adolescents, exploring maturity status and timing, and then details maturity-related implications across the life span.

Defining Maturity

Biological maturation is viewed in terms of status, tempo, and timing. Status refers to the state of maturation at the time of observation, whereas tempo refers to the rate at which maturation progresses. Timing refers to the chronological age (CA) at which specific maturational events occur. CA is the basic reference in studies of growth and maturation. It is calculated as the difference between date of measurement/observation and date of birth and is ordinarily expressed as a decimal of the whole year. Individuals ordinarily refer to their CA when asked how old they are.

Growth in height is used in estimates of maturity status and timing. Estimates of tempo and timing require measurements of the same individual followed over sufficient intervals of time during childhood and especially adolescence (i.e., longitudinal data).

Overt indicators of growth—height and weight—and maturation—secondary sex characteristics—are outcomes of biological processes occurring at the cellular level. Both growth and maturation are regulated primarily by interactions of the hypothalamus (organ located at the base of the brain) and several endocrine glands (pituitary, gonads, adrenal), commonly labeled as the hypothalamic–pituitary–gonadal–adrenal axes. In addition, genetics, nutrition, living conditions, and other factors play an important role.

Interactions among maturation, growth, and behavior vary within and among individuals and during childhood and adolescence. Interindividual variation is considerable. Differential timing of pubertal maturation and the adolescent growth spurt affects size attained (growth), physical performance and behavior, and also peer and child–adult relationships. Variation in maturity timing is also indicated as a factor affecting health status during adolescence and in adulthood.

Maturity Status

Maturity status is the state of maturation at the CA of observation. Indicators of skeletal and pubertal maturation are used most often, while dental maturation (erupted teeth, calcification) is another indicator, although it generally proceeds independently of other indicators.

Skeletal Maturation

Skeletal maturation is estimated as a skeletal age (SA), or bone age, based on a standard radiograph (X-ray) of the bones of the hand and wrist. Each bone passes through a series of changes from initial formation, or ossification (which begins before birth in some bones), to the mature state. Changes in each bone of the hand–wrist as it passes from immaturity to maturity are the basis for assessing SA. Key indicators of changes in each bone have been defined from infancy through adolescence and are the basis for estimating SA. The process entails matching the bones of the hand–wrist as viewed on a standard X-ray as closely as possible with specific criteria for each bone described in the method of assessment that is used. The criteria for each bone generally correspond to successive levels of skeletal maturity at specific CAs. The ratings for each bone are subsequently converted to SA.

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