When puberty happens early

Young people are adjusting to the physical changes associated with puberty, but also managing the emotional and hormonal ...
Young people are adjusting to the physical changes associated with puberty, but also managing the emotional and hormonal changes. Photo: Getty

While children most commonly enter puberty around the ages of 9-16 years for girls and 9-14 years for boys, for some children, the onset of the physical, hormonal and sexual changes associated with puberty happens at an earlier age. Early onset puberty, otherwise known as precocious puberty, is defined when a child shows signs of puberty before the age of 8-9 years. These signs may include growth acceleration, pubic and underarm hair growth, and body odour. For girls, it can also mean the budding of breasts and commencement of menstrual bleeding; in boys, it can bring enlargement of the testes and penis.

Prevalence and causes

Australian research suggests that around 16 per cent of girls and 6 per cent of boys enter puberty as young as eight, and research suggests that average age of puberty onset has reduced across the globe. This is reflected in the number of referrals at the Quirky Kid Clinic

Typically, the causes of precocious puberty are unknown. Some medical conditions - such as pituitary and adrenal gland problems, and obesity - appear to be related to the onset of precocious puberty for some. There's also speculation that environmental factors may play a role; for example, there is some emerging research suggesting a link between environmental chemicals and the disruption of the body’s endocrine system, initiating the premature onset of puberty (however, these links are currently tentative).

Interestingly, recent research from the Murdoch Children’s Research Institute in Melbourne suggests that stress, anxiety and difficult peer relationships in the preschool years may increase children’s risk of entering precocious puberty. This latest research supports earlier findings that exposure to chronic stress can accelerate children’s progression into puberty.

Impact of early puberty

Entering puberty in adolescence is widely agreed to be a time of great change and adjustment; not only are young people adjusting to the physical changes associated with puberty, but also managing the hormonal changes.

Hormonal changes can be quite varied and dramatic, and increase children’s risk to experiencing a whole host of emotional difficulties. For example, hormones such as estradiol and gonadal sex steroids, released during puberty, have been linked to increased levels of depression, anxiety and heightened emotions among adolescents.

Unfortunately, when children enter into puberty early, the challenges and changes encountered in puberty seem to be magnified. Children who experience precocious puberty have to manage significant physical and hormonal changes earlier than their peers, and at a time when they are less likely to be both emotionally and cognitively ready. Children experiencing precocious puberty have been found to be at increased risk of emotional and behavioural problems compared with their peers.

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What can I do to support my child?

Supporting children entering puberty at any age is essential. For children who experience precocious puberty, that support needs to be consistent, ongoing and involve the child’s wider support system.

1. Seek medical advice
While the causes of precocious puberty are most often unknown, in some cases it may be triggered by medical conditions that need to be addressed. Some helpful questions to ask your medical practitioner may be whether there are any known causes for your child’s symptoms, whether there is anything to slow or delay the process, and the risks involved. Additionally, your medical practitioner may be able to provide advice on how to explain puberty to your child.

2. Educate yourself and others
Gain an understanding of the changes that your child is likely to experience so you're best able to answer any questions or concerns your child may have. Discuss what you have learnt with your family and school community to ensure the people important in your child’s life are aware of what's happening. It may also be appropriate to discuss these changes with your child’s best friend or close circle of friends to minimise your child feeling like they need to be secretive or isolated at this time.

3. Create an open, loving environment with your child
Be available to talk, listen to your child and keep your reactions calm. Children often worry about upsetting their parents with questions about sensitive topics, so keeping your reactions and emotions calm and supportive will help your child be open with you. Discussions about puberty are also likely to involve sensitive issues, so it is important to remain factual and calm to minimise your child feeling uncomfortable or too embarrassed to discuss these changes.

4. Remember your child’s developmental age
Precocious puberty can be very confusing, as your child’s physical body is maturing ahead of their emotional and cognitive development, which can often change our own or others' expectations of the child. For example, your child may be mistakenly viewed as older than they really are, and expected to behave and act like a much older child. Remind yourself, extended family and school of your child’s developmental age and the appropriate expectations for that age.

5. Seek support for emotional changes and stress 
Children who enter puberty earlier than their peers are more susceptible to changes in mood and emotional state than their peers. This can be very difficult and can often lead to children being misunderstood, isolated, and, in some cases, victimised. Help your child label their emotions, use positive coping strategies, and seek professional help if you notice marked changes to your child’s mood and anxiety levels. 

6. Get practical
For children experiencing precocious puberty, what are seemingly small, everyday activities can become stressful and anxiety provoking. For example, going to the toilet at school can be distressing for girls who have started menstruating if they're worried about there not being enough toilet paper, soap or an appropriate disposal bin. Identify all the situations and places that may become difficult for your child and make plans for each (eg. pack a personal supply of toilet paper). During the readjustment period it may be necessary to simplify your child’s daily routine to minimise stress and worry by changing or taking a break from school-based activities (eg. swimming carnival) and extracurricular activities (eg. dance lessons).

7. Be your child’s safe haven
At a time when children can be feeling different, isolated and confused, be your child’s coach and cheering squad. Demonstrate love and affection and give your child all the affirmation they need by valuing and engaging in their skills, gifts, talents and interests. Ask close family members and friends to be actively involved in your child’s life and select a teacher at your child’s school who can provide your child with the extra support they need.

Recommended resources:
  It’s not the stork: A book about girls, boys, babies, bodies, families and friends for four years and up 
  It’s perfectly normal: Growing Up, Sex and Sexual Health
  How to talk so kids will listen: To improve parent child communication

This article was prepared by Dr Kathryn Berry, a clinical psychologist at the Quirky Kid Clinic, and was first published on the Quirky Kid website.

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