The Diagnostic Accuracy of Delayed Development in Adolescents Isadora Lorenna Alves Nogueira, Jéssica Dantas de Sá Tinôco , Maria Isabel da Conceição Dias Fernandes , Milena Freire Delgado, Isabel Neves Duarte Lisboa, Marcos Venícius de Oliveira Lopes , and Ana Luisa Brandão de Carvalho Lira Isadora Lorenna Alves Nogueira, PhD, is a nurse; Isabel Neves Duarte Lisboa, MD, is a nursing profressor; Isabel Neves Duarte Lisboa, PhD, is a nurse at Department of Nursing, Federal University of Rio Grande of Norte, Natal, Rio Grande do Norte, Brazil, Jéssica Dantas de Sá Tinôco and Maria Isabel da Conceição Dias Fernandes, PhD, are a nursing profressor, are from Nursing Department, State University of Rio Grande of Norte, Caicó, Rio Grande do Norte, Brazil, and Marcos Venícius de Oliveira Lopes, PhD, nursing profressor is from Nursing Department, Federal University of Ceará, Fortaleza, Ceará, Brazil INTRODUCTION: The early identification of developmental delay in adolescents by health professionals is relevant for a good prognosis. However, the clinical indi- cators of development delay are unclear in nursing science. PURPOSE: To analyze the clinical indicators of delayed development in school adolescents. METHODS: A diagnostic accuracy study that investigated delayed development among 385 adolescents in public schools between July and September of 2017. The accuracy measures were analyzed using a latent class analysis based on sensitivity and specificity values. FINDINGS: The delayed development is present in 18.26% of school adolescents. The best accuracy values were as follows: low self-esteem (0.9838), dissatisfaction with own image (0.8400), impaired daily activities (0.9815), internalization behav- ior (0.8304), outsourcing behavior (0.6367), eating disorders (1.0000), emotional insecurity (0.7093), dependent behavior (0.9836), and altered sexual maturation (0.6085). CONCLUSION: Thus, this set of nine clinical indicators can be used by nurse prac- titioners to confirm delayed development in school adolescents. IMPLICATIONS FOR NURSING PRACTICE: This research contributes by provid- ing accurate clinical indicators of delayed development in adolescents. Thus, nurses should recognize delayed development in adolescents through accurate clinical in- dicators and propose nursing interventions that have positive health results. Search terms: Accuracy, adolescent, clinical indicators, growth and development, nursing, school Author contact: bebel_6@hotmail.com, with a copy to the Editor: journal@nanda.org Introduction Adolescence is a transitional period between childhood and adulthood involving changes in physical, social, cogni- tive, and psychosocial dimensions (Jaureguizar, Bernaras, Bully, & Garaigordobil, 2018; Wilhsson, Svedberg, Hogdin, & Nygren, 2017). Adolescence is a period of intense brain de- velopment, which may be influenced by social support, diet, relationship with parents and friends, socioeconomic condi- tions, drugs, and diseases (Andersen, 2016). Adolescence is a vulnerable period during which develop- ment delay can occur, consequently leading to irreparable disorders in adulthood (Becker & Maughan, 2017; Gerard & Booth, 2015; Jaureguizar et al., 2018; Waite & Creswell, 2014). Development delay in adolescents is caused by changes in one or more of the biosocial, psychosocial, and cognitive do- mains in individuals aged between 10 and 19 years (Delgado et al., 2018). Studies conducted in the United States and China es- timate that the prevalence of developmental delays in adolescents is approximately 40% (Cunha, Berkovits, & Albuquerque, 2018; Zhang et al., 2017). This delay can have negative impacts on school performance, increase mortal- ity, reduce professional opportunities, and increase health spending (Quin, 2017; Rios, Santiago, Fernandes, & Alves, 2017; Waite & Creswell, 2014). Thus, the early identification of developmental delay by health professionals is relevant for a good prognosis (Mi- randa, Resegue, & Figueiras, 2003). In this context, nursing consultations with adolescents are important. Nurses should identify and evaluate the development of adolescents’ phys- ical, cognitive, and psychosocial domains (Quin, 2017) by means of accurate clinical indicators. Accurate clinical indicators may contribute to nurses’ di- agnostic inference and manifest in improvement in the qual- ity of health care (Lopes, Silva, & Araujo, 2013). However, © 2020 NANDA International, Inc. 1 International Journal of Nursing Knowledge Volume 0, No. 0, August 2020