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J Adolesc Health. 2011 Apr;48(4):325-30. doi: 10.1016/j.jadohealth.2010.09.020. Epub 2010 Dec 30.

Feasibility of an Audio Computer-Assisted Self-Interview method to self-assess sexual maturation.

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  • 1Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.



Sexual maturation assessment using physical examination may no longer be feasible in some large epidemiologic surveys, such as National Health and Nutrition Examination Survey, because of the sensitivity of the examination and privacy concerns. This study tested the feasibility of a new automated audio computer-assisted self-interview (ACASI) module for children and adolescents for self-assessment of sexual maturation.


A cross-sectional feasibility study was conducted at a large urban children/adolescent clinic in Washington D.C. Self-assessed sexual maturation (Tanner stages) was reported by 234 youths (119 boys and 115 girls) aged 8-18 years by using the ACASI module. Girls assessed their breast and pubic hair development, and boys assessed their genital and pubic hair development. Self-assessments were compared with Tanner stages recorded by clinical examiners during routine well-child physical examinations conducted on the same day.


There was good/excellent agreement between boy's self-assessment and the examiner's assessment of their genital stage (weighted κ: .65, 95% confidence interval [CI]: .55-.75) and pubic hair stage (weighted κ: .78, CI: .70-.86). There was excellent agreement between girl's self-assessment and the examiner's assessment of their breast stage (weighted κ: .81, CI: .74-.87) and pubic hair stage (weighted κ: .78, CI: .71-.86).


The ACASI method is a feasible method of pubertal self-assessment for participants as young as 8 years in large epidemiologic surveys. However, additional testing is needed to determine the validity of this ACASI module.

Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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