Abstract
ABSTRACTOBJECTIVE To determine whether scores in an adapted version of the self-assessment Pubertal Development Scale into Portuguese match those from the gold standard in pubertal development (Tanner scale).METHODS This was a cross-sectional study with a convenience sample of 133 children and adolescents aged nine to 17 years (59 males; mean age of 13 years and six months, with standard deviation = 25 months). Youngsters completed the Pubertal Development Scale and were then examined by specialists in adolescent medicine.RESULTS Exact absolute agreement of pubertal stages were modest, but significant associations between measures (correlation; intra-class correlation coefficients of consistency) showed that the Pubertal Development Scale adequately measures changes that map onto pubertal development determined by physical examination, on par with international publications. Furthermore, scores obtained from each Pubertal Development Scale question reflected adequate gonadal and adrenal events assessed by clinical ratings, mostly with medium/high effect sizes. Latent factors obtained from scores on all Pubertal Development Scale questions had excellent fit indices in Confirmatory Factor Analyses and correlated with Tanner staging.CONCLUSIONS We conclude that self-assessment of body changes by youngsters using the Portuguese version of the Pubertal Development Scale is useful when estimates of pubertal progression are sufficient, and exact agreement with clinical staging is not necessary. The Pubertal Development Scale is, therefore, a reliable instrument for use in large-scale studies in Brazil that aim at investigating adolescent health related to pubertal developmental. The translated version and scoring systems are provided.
Highlights
Puberty involves a set of neuroendocrine changes that occur during the transition from childhood to sexual maturity[1,2]
Patients with health conditions influencing pubertal development were not excluded because our objective was to study the relationship between clinical Tanner staging and self-assessment of pubertal development, rather than to characterize puberty onset, timing, or tempo
We found that the Pubertal Development Scale (PDS) is a self-assessment instrument that captures changes in pubertal development assessed by experienced clinicians
Summary
Puberty involves a set of neuroendocrine changes that occur during the transition from childhood to sexual maturity[1,2]. Age is not a good predictor of pubertal development because the timing of puberty and individual’s puberty relative to that of others of the same age and sex and the progression speed (tempo) to full sexual maturity vary widely and depend on genetic, ethnic, nutritional, and psychosocial factors[2,3,4] Because of this variability, adequate assessment of pubertal onset and progression is crucial to detect disorders that may affect this process[2,5]. This method classifies puberty into five progressive stages[6,7], considering changes that occur independently[2] in: a) size and shape of the breasts in girls and genitals in boys, which reflect mainly activation of the hypothalamic-pituitary-gonadal axis[1]; and b) the distribution and characteristics of pubic hair in both sexes, which reflect increased output of steroids due to the expansion of the adrenal zona reticularis[8]
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