Physical growth and development: current concepts.

The process we call puberty is complex and still poorly understood. Some of the hormonal effects have been discussed, but much work remains before the specific mechanisms are defined. Genetic and nutritional influences affect puberty and further complicate the study of this population. Knowledge of the developmental sequence and SMR scale is useful in clinical practice. Understanding the changes that an adolescent is experiencing will help in the early diagnosis of abnormalities in growth and development. This knowledge will also serve as a guide in providing useful anticipatory guidance.