Foreword xiii
Preface xv
Glossary of Abbreviations xvii
1 An Introduction to the History of Age Estimation in the Living 1
Andreas Schmeling and Sue Black
1.1 Introduction 1
1.2 Dental Development 3
1.3 Skeletal Maturation 5
1.4 Secondary Sexual Development 8
1.5 Conclusion 10
References 12
2 Immigration, Asylum Seekers and Undocumented Identity 19
Heather Law, Lorraine Mensah, Sue Bailey and Julia Nelki
2.1 Asylum Seeker to Refugee 26
References 28
3 Clinical and Legal Requirements for Age Determination in the Living 30
Philip Beh and Jason Payne-James
3.1 Introduction 30
3.2 Contrasts between Age Assessment in the Living and the Deceased 31
3.3 Reasons for Age Estimation of Bodies and Human Remains 32
3.4 Reasons for Age Estimation of Living Individuals 32
3.5 Assessment Techniques 37
3.6 How Age May Be Specifically Documented 37
3.7 Birth Certificates 38
3.8 Identity Cards 38
3.9 Driving Licence 38
3.10 Passports 39
3.11 Age Verification Cards 40
3.12 Other Documents 40
3.13 Medical Issues 40
3.13.1 Duties to Examinee 40
3.14 Communication 41
3.15 Summary and Conclusions 41
References 42
4 Legal Implications of Age Determination: Consent and Other Issues 43
George Fernie and Jason Payne-James
4.1 Introduction 43
4.2 Principles of Practice 44
4.3 Duties of the Examining Practitioner 47
4.4 Criminal Issues in Age Determination in the Living 48
4.5 Practical Implications 51
4.6 Summary 53
References 54
5 The Challenges of Psychological Assessments of Maturity 55
Julia Nelki, Pete Grady, Sue Bailey and Heather Law
5.1 Introduction 55
5.1.1 Current Status in the UK 57
5.2 Need for Determination of Maturity 58
5.3 Psychological Maturity as a Concept 59
5.3.1 Child Development 60
5.3.2 Middle Childhood 61
5.3.3 Adolescence 62
5.3.4 Ethical Framework 63
5.4 Current Practice 65
5.5 Suggestions for a Framework for Good Practice 67
5.5.1 Setting 68
5.6 Summary and Conclusion 69
Appendix 5.A Proposed Framework, Based on Common Assessment Framework (Department of Schools Families and Children, 2007) 69
References 74
6 Principles of Physical Age Estimation 77
Sue Black and George Maat
6.1 Intra-uterine Growth and Development 79
6.2 Birth and Infancy 82
6.3 Childhood 83
6.4 Juvenile 85
6.5 Adolescence 85
6.6 Adult 86
6.7 Senescence 87
6.8 Summary 88
6.9 Growth Studies 89
References 91
7 Growth, Maturation and Age 95
Noël Cameron and Laura L. Jones
7.1 Growth, Maturation and Age 95
7.1.1 The Concept of Time 95
7.1.2 Maturity Indicators 98
7.1.3 Maturational Variation 99
7.1.4 Uneven Maturation 99
7.1.5 Sexual Dimorphism 100
7.1.6 Maturity and Size 100
7.2 Assessment of Maturation 101
7.2.1 Skeletal Maturity 101
7.2.2 Dental Maturity 101
7.2.3 Secondary Sexual Development 102
7.2.4 Independence of Methods 102
7.3 Secular Trends 102
7.4 Worldwide Variation in the Timing of Maturation 104
7.4.1 Secondary Sexual Development 104
7.4.2 Dental Development 109
7.4.3 Skeletal Development 109
7.5 Factors Associated with the Timing of Maturation 112
7.5.1 Genetic Variability 112
7.5.2 Demographic Factors 113
7.5.3 Biological Factors 114
7.5.4 Environmental Factors 116
7.6 Summary 120
References 120
8 Practical Imaging Techniques for Age Evaluation 130
Andreas Schmeling, Sven Schmidt, Ronald Schulz, Andreas Olze, Walter Reisinger and Volker Vieth
8.1 Introduction 130
8.2 Radiation Exposure in X-ray Examinations for the Purpose of Age Estimation 131
8.3 Radiological Examination of the Hand 133
8.4 Radiological Examination of the Teeth 138
8.5 Radiological Examination of the Clavicles 142
8.6 Summary and Conclusions 144
References 145
9 External Soft Tissue Indicators of Age from Birth to Adulthood 150
Anil Aggrawal, Puneet Setia, Avneesh Gupta, and Anthony Busuttil
9.1 Growth Patterns 151
9.2 Anthropometric Parameters in Children 151
9.2.1 Growth Charts 152
9.2.2 Developmental Milestones 159
9.2.2.1 Head Control 159
9.2.2.2 Rolling 159
9.2.2.3 Sitting 160
9.2.2.4 Gross Motor 160
9.2.2.5 Fine Motor 161
9.2.2.6 Social and cognitive 161
9.2.2.7 Speech and language 162
9.3 Pubertal Changes 162
9.3.1 Stages of Pubic Hair Development Derived from Tanner (1962) 163
9.3.1.1 Pubic Hair Development in Males 164
9.3.1.2 Pubic Hair Development in Females 164
9.3.2 Stages of Axillary Hair Development Derived from Tanner (1962) 164
9.3.3 Stages of Development of Male Genitalia Derived from Tanner (1962) 166
9.3.3.1 Testicular Volume 166
9.3.3.2 Age of First Erection and Ejaculation 167
9.3.4 Stages of breast development as derived from Tanner (1962) 168
9.3.5 Age of Menarche 168
9.4 Areas of New Research 170
9.5 Conclusion 170
References 171
10 Age Evaluation and Odontology in the Living 176
Jane Taylor and Matthew Blenkin
10.1 Introduction 176
10.2 Overview of the Development of the Dentition 177
10.3 Techniques of Dental Age Estimation 179
10.4 The Sub-adult Dentition 180
10.4.1 Sub-adult: Physical/Anatomical 180
10.4.1.1 Tooth Counts 180
10.4.2 Sub-adult: Radiographic 182
10.4.2.1 Atlas Style Techniques 182
10.4.2.2 Techniques Employing Measurement 184
10.4.3 Sub-adult: Destructive 187
10.4.3.1 Histological Techniques 187
10.4.3.2 Aspartic Acid Racemization 187
10.5 The Adult Dentition 187
10.5.1 Adult: Physical 188
10.5.1.1 Tooth Wear 188
10.5.2 Adult: Radiographic 188
10.5.2.1 Third Molars 189
10.5.2.2 Secondary Dentine Apposition 190
10.5.3 Adult: Destructive 191
10.5.3.1 The Gustafson Method 191
10.5.3.2 Root Transparency 191
10.5.3.3 Amino Acid Racemization and Histological Techniques 191
10.6 Summary 191
References 193
11 Age Evaluation from the Skeleton 202
S. Lucina Hackman, Alanah Buck and S. Black
11.1 Background 202
11.2 Fetal Age 204
11.3 Birth 208
11.4 Juvenile/Child 210
11.5 Age Estimation from the Skeleton in Living Adults 221
11.6 Medial Clavicle 222
11.7 Sternal Ribs and Costal Cartilages 223
11.8 Pelvis 224
11.9 Skull Sutural Closure 224
11.10 Laryngeal Cartilages 225
11.11 Other General Ageing Features 226
11.12 Summary 226
References 226
12 Age Evaluation after Growth Cessation 236
Anil Aggrawal, Puneet Setia, Avneesh Gupta and Anthony Busuttil
12.1 Background 236
12.2 Consent 237
12.3 Radiology 237
12.3.1 Pubic Bones 239
12.3.2 Long Bones 242
12.3.3 Skull Sutures 243
12.3.4 Costal Cartilages 246
12.3.4.1 Sternum 246
12.3.5 Vertebrae 247
12.3.6 Laryngeal Cartilages 250
12.4 Odontology 250
12.5 Soft Tissues of Face 251
12.6 Genetics in Age Estimation 252
12.7 Physiological and Biochemical Parameters for Age Estimation 253
12.8 Areas of Future Research 254
12.8.1 Small Long Bones 254
12.8.2 Scapula 254
12.8.3 Others 254
12.8.4 Histology 256
12.9 Conclusion 257
References 257
13 The Presentation of Results and Statistics for Legal Purposes 267
David Lucy
13.1 Introduction 267
13.2 Evidence and Intelligence 269
13.3 Statistical Methods in Age Estimation 270
13.4 Classical, or Frequentist, Approaches 271
13.5 Bayesian Approaches 271
13.6 The Relevance to Age Estimation 272
13.7 Likelihood Ratio Approaches 274
13.8 Errors of Interpretation 279
13.9 Concluding Comments 280
Appendix 13.A Age-Related Data from Gustafson (1950) 281
References 282
14 Key Practical Elements for Age Estimation in the Living 284
Sue Black, Jason Payne-James and Anil Aggrawal
14.1 The Four Pillars of Age Estimation 286
14.1.1 Pillar 1: Social and Psychological Evaluation 286
14.1.2 Pillar 2: External Estimation of Age 286
14.1.3 Pillar 3: Skeletal Estimation of Age 288
14.1.4 Pillar 4: Dental Estimation of Age 289
14.2 Conclusion 290
Index 291
