Recent studies suggest U.S. children today are developing some signs of sexual maturation earlier than in the past.Recent studies suggest U.S. children today are developing some signs of sexual maturation earlier than in the past. While this remains a common cause of parental anxiety and medical referrals, a new clinical report from the American Academy of Pediatrics says these early signs of development don't necessarily mean a child has started puberty. According to the authors of "Evaluation and Referral of Children with Signs of Early Puberty," to be published in the January 2016 issue of Pediatrics, in many cases, signs such as early development of pubic hair or body odor are often normal variations of puberty that do not require extensive testing or treatment. The report cites data highlighting puberty's age differences that can vary with patients' ethnicity, race, or obesity status. One recent study found that among seven- to eight-year-old patients, 23 percent of black, 15 percent of Hispanic and 10 percent of white girls had some degree of breast development. Authors of the AAP report said it serves as a guide to knowing which signs simply require observation by a primary care provider and which merit referral to a pediatric endocrinology sub-specialist. How do you know if you need to see a specialist? Key warning signs of medical disorders possibly requiring treatment include progressive breast enlargement and rapid growth in girls younger than age eight or genital enlargement in boys younger than age nine. Listen in as Paul Kaplowitz, MD, PhD, discusses the distinct differences between sexual maturation and puberty.