**1. Introduction**

Adolescence is a product of the modern world. It has developed into a distinct stage of life as a result of a shift in many societies requiring a highly trained work force. When this is not needed, young people usually acquire skills needed to work as they grow up. As they go through puberty, they acquire additional responsibilities, usually with the oversight of parents or in apprenticeship to others outside of the family. Young women usually marry close to the time of the onset of fertility. However, with increasing education needs, there is an increasing gap between physical maturation and the ability to take on adult responsibilities. Young people who join the workforce early can be at a disadvantage compared to those who can complete more education. Young women have increasing control over their fertility in these societies, which also gives them these extra years to become more educated.

These factors lead to a cohort of young people who have adult bodies without having adult responsibilities. They have the luxury of time to contemplate, to take risks, and to define themselves in new ways. All of this has led to the phenomenon of adolescence, which encompasses and goes beyond the physical changes of puberty.

This is not to say that adolescent development has not previously existed; it is rather that societies' awareness of this developmental stage of life has only recently emerged or been modified because of the societal changes that have occurred and the effects of globalization.

As a definable period of adolescence is created in a society, it is accompanied by new societal issues—children separating emotionally from their parents while still being reliant

Adolescent Psychosocial Developmentand Evaluation: Global Perspectives 181

in fertility and mortality rates, now have low growth rates and an aging population. Countries that had a later initiation of decline in fertility and mortality rates, such as those in Latin America, the Caribbean, East Asia, and some parts of the Middle East and South Asia, continue to have moderate population growth. In most of Sub-Saharan Africa and some parts of the Middle East and South Asia, there has not yet been a decline in fertility and mortality rates, and so in these parts of the world, young and youthful populations are seen (Brown et al., 2002). These differences result in a contrast in the age structure and agedependency ratios of individual countries and impact the economic and social structure of a

When it comes to health care, pediatricians in developed countries have been given the responsibility to care for adolescents (American Academy of Pediatrics, 1978). This is largely due to the fact that adolescents continue to grow and develop, a hallmark of pediatrics. Although the physical development is the first and earliest to be completed, adolescents continue to undergo cognitive and emotional development well into their 20's. The age limit of Pediatrics varies across the world. Many developed countries have extended the age limit to 18 or even 21 years, while other countries, mostly developing countries, have lower age

Adolescents are generally the healthiest of the population, with their leading causes of death being accidents, homicide, and suicide (Brown et al., 2002). HIV/AIDS is the leading cause of death in some parts of the world (Brown et al., 2002). All of these causes are preventable, and so when it comes to adolescent health, an adolescent's contact with a healthcare provider, for whatever reason, can be seen as an opportunistic time to address these matters. Risk-taking behaviors exacerbate the problems that may be faced during adolescence, and in some developing countries, work-related disability and mortality is an additional problem (Brown et al., 2002). When discussing adolescent health, much attention is frequently given to the problems that may be encountered such as risky behaviors. It is important to note, however, that it is only a minority of adolescents who are involved with serious problems as substance use, teenage pregnancy, and acts of violence (United Nations [UN], n.d.). Most adolescents actually go through this stage of life without much turbulence. It is a time when many adolescents gain personal growth, development, and independence and attain certain

Some of the problems that face adolescents differ depending on where they live. For example, substance use, eating disorders, and lack of exercise are more prevalent in developed countries. There are gender gaps when it comes to education, with generally more males attending secondary school in comparison to females. In fact, two thirds of children who never went to school or dropped out are girls. In South Asia, for example, 52% of boys but only 33% of girls are enrolled in secondary school. In contrast, girls in Latin America and the Caribbean have higher secondary school enrollment rates than boys, 56% and 52% respectively (UN, n.d.). This is important to address because the more education a girl receives, the more likely she is to postpone marriage and motherhood (UNICEF, 2011). It has also been found that knowledge and skills obtained through formal education is less advanced in students coming from developing countries in comparison to those students

country in varying ways (Assaad & Roudi-Fahimi, 2007; Brown et al., 2002).

skills. Adolescence can and should be viewed as a time of opportunity.

from developed countries (Nugent, 2005).

limits.

on them, experimentation with drugs and alcohol, sexual expression outside of traditional marriage, body image issues, and others. Healthcare practitioners can provide anticipatory guidance to parents and their adolescents, gathering data with sensitive, non-judgmental questioning. All of this must be based on an understanding of adolescent development.
