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Original ArticleOpen Access
Self-Assessment of Sexual Maturation in Thai Children by Tanner Photograph Suttipong Wacharasindhu, MRCP. (UK),
PriNgam P 
,
Kongchonrak T
,
Kongchonrak T Assessment of sexual maturation in adolescence is crucially important in clinical practice,
because the possibility of concealed disease during the earlier period of child development needs
to be detected. However, to undress children sometimes is problematic and unethical in several
countries. Therefore, in this study the authors evaluated the concordance between children's self-
assessment by Tanner photograph with a written description, and examination by pediatricians. One
hundred and ninety four children (100 girls, 94 boys), aged 7-15 years, were recruited in this study.
The outcome demonstrated that the two processes of investigation were in good concord: the weight
kappa of 0.76 and 0.79 for the breast stage (B) and pubic hair stage (PH), respectively, in girls. In
boys, the weight kappa were 0.59 and 0.73 for genital stage (G) and pubic hair (PH) stage, respec-
tively. However, the weight kappa for genital stage was improved after the subjects were provided
more time to examine themselves before choosing the photograph. ln girls, the mean chronological
age (CA) for B stage II, III, IV was 10.4เธ‘ 1.3, 12.5เธ‘ 1.3, 13.6เธ‘0. 7 years and for PH stage II, III, IV
was 11.9เธ‘1.4, 12.9เธ‘1.2, 13.5เธ‘0.9 years. The normal CA for the onset of puberty in girls was be-
tween 7.8-13.0 years. In boys, the mean CA for G stage II, III, IV
wa~
11.3เธ‘1.7, 12.4เธ‘1.2, 13.2เธ‘1.2
years, and for PH II, III, IV was 12.2เธ‘1.3, 13.1เธ‘1.0, 13.9เธ‘1.7 years. The normal CA for the onset
of puberty in boys was 7.9-14.7 years. In addition, the authors constructed the normal value for
penile length in Thai boys, aged between 9-15 years, to be used as a reference. Therefore, this study
demonstrated a good concordance between the self-assessment by Tanner photograph and examina-
tion by pediatricians. This can be applied for use in filed research, school screening and clinical
practice.
Key word : Pubertal Staging, Tanner Photograph
because the possibility of concealed disease during the earlier period of child development needs
to be detected. However, to undress children sometimes is problematic and unethical in several
countries. Therefore, in this study the authors evaluated the concordance between children's self-
assessment by Tanner photograph with a written description, and examination by pediatricians. One
hundred and ninety four children (100 girls, 94 boys), aged 7-15 years, were recruited in this study.
The outcome demonstrated that the two processes of investigation were in good concord: the weight
kappa of 0.76 and 0.79 for the breast stage (B) and pubic hair stage (PH), respectively, in girls. In
boys, the weight kappa were 0.59 and 0.73 for genital stage (G) and pubic hair (PH) stage, respec-
tively. However, the weight kappa for genital stage was improved after the subjects were provided
more time to examine themselves before choosing the photograph. ln girls, the mean chronological
age (CA) for B stage II, III, IV was 10.4เธ‘ 1.3, 12.5เธ‘ 1.3, 13.6เธ‘0. 7 years and for PH stage II, III, IV
was 11.9เธ‘1.4, 12.9เธ‘1.2, 13.5เธ‘0.9 years. The normal CA for the onset of puberty in girls was be-
tween 7.8-13.0 years. In boys, the mean CA for G stage II, III, IV
wa~
11.3เธ‘1.7, 12.4เธ‘1.2, 13.2เธ‘1.2
years, and for PH II, III, IV was 12.2เธ‘1.3, 13.1เธ‘1.0, 13.9เธ‘1.7 years. The normal CA for the onset
of puberty in boys was 7.9-14.7 years. In addition, the authors constructed the normal value for
penile length in Thai boys, aged between 9-15 years, to be used as a reference. Therefore, this study
demonstrated a good concordance between the self-assessment by Tanner photograph and examina-
tion by pediatricians. This can be applied for use in filed research, school screening and clinical
practice.
Key word : Pubertal Staging, Tanner Photograph
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