Abstract 560

Purpose: to assess the accuracy with which children and adolescents can rate their own stage of pubertal development.

Method: 98 children (34 boys) attending a pediatric resident clinic for well child care or minor illness circled the drawing "most like you" for pubic hair (PH, boys and girls) and for breast stage (Br, girls only). Drawings emphasized the salient features of each Tanner stage. Results were correlated with staging during physical examination by the MD on the same day. Additional participants included the Pediatric Residents at Le Bonheur Children's Medical Center, the nurses of the resident clinic, Valerie Jameson and Robert Walling.

Results: Boys more accurately recognized start of PH, (91% accuracy) than did girls (71%). Girls recognized start of breast growth at 74% accuracy. In girls, discrimination between stages 2 and 3 was more accurate for Br (83%) than PH (61%). Boys discriminated between PH stages 2 and 3 at 75% accuracy. Both boys and girls accurately rated the difference between early/middle versus late puberty (girls PH 88%, girls Br 92%, and boys PH 92%). Overall, children and adolescents self-staged with accuracy of 71% (±1 stage 89%). Overall accuracy was only 56% for girls PH (±1 stage 89%).

Conclusion: Understanding the accuracy of self-staging can be useful in research studies where pubertal staging by physical examination may not be possible. The investigator must be aware that some children will over-rate or under-rate their pubertal stage for individual reasons and that increased body fat may confound the accuracy of staging.