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Speech on the other hand is the verbal form of language and is composed of a number of isolated sound or phonemes Language makes speech possible, even though we can have language without speech
Two important requisites for speech development - Intact hearing - Sufficient intelligence
Receptive language refers to the ability to understand, encompasses visual (reading, sign language comprehension) and auditory (listening comprehension) skills Expressive language refers to the ability to produce symbolic communication, this output may be either visual (writing, signing) or auditory (speech)
Lalling
Hearing plays an important role Begins during the 6 months of the childs life Defined as the repetition of heard sounds or sound combinations
Echolalia At 9 or 10 months of age, the child may be heard imitating sound which others have made, and which are prevalent in environment Sounds which the child recognizes, are likely to be imitated first True speech
Between 12 and 13 months of age, the average child really begins to talk The child intentionally uses conventionalized sound pattern (words) Before the child can truly speak, he must himself be able to understand speech
Berry MF, Eisenson J. Speech Disorders : Principles and practices of therapy. London : Peter Owen Limited, 1973.p.18-22
GRAMMAR
The study of meaning, includes the study of vocabulary and the number of words a child knows The ability of the child to use his or her language in interactions with others
SEMANTICS
PRAGMATICS
Santrock JW. Child Development. 7th Ed. Madison: Brown & Benchmark, 1996. p.321
To determine whether a child has speech delay, the physician must understand normal speech milestones
Table 1. Milestones of Language Development and Indications for Evaluation of Language Problems
Age of acquistion Birth Age at which skill is significantly delayed Shortly after birth Abnormal findings or red flags for full assessment at this age Lack of response to sound at any age
Skill
Response to sound
Birth
Reciprocal cooing, turn- 4 mos. taking Babbling (repetitive consonant vowel combinations) Response to name
Lack of interest in interaction with people at any age Lack of any drive to communicate after 4mos. of age Loss of the early ability to see or babble Poor sound localization or lack of responsiveness
9 mos.
9 mos.
15 mos.
10 to 16 mos.
18 mos.
10 to 16 mos.
18 mos.
Age of acquistion
Skill
18 to 24 mos.
Age at which Abnormal findings or skill is red flags for full significantly assessment at this age delayed 24 mos. Minimal comprehension and limited symbolic play, such as doll or truck play 30 mos. Less than 30 words at 24 months, 50 words at 30 months Lack of two-word utterances when vocabulary is > 50 words > utterances are unintelligible to family after age 2 years Frequent immediate or delayed repetition of what others say (echolalia)
18 to 24 mos. 18 to 24 mos.
Vocabulary spurt
Two-word utterances
30 mos.
24 to 36 mos.
30 to 36 mos.
36 mos.
36 mos.
Skill Short stories, asks why Good intelligibility to unfamiliar folks Full, well-formed sentences Correct production of basic consonants Correct production of all speech sounds
Age at which Abnormal findings or skill is red flags for full significantly assessment at this age delayed 48 mos. Rote memorization with failure to generate novel stories 48 mos. > utterances are unintelligible to strangers after age 4 years Consistent use of only short and simple sentences Errors in consonants such as b, p, d, t, p, k, m, n, l, r, w, s. Immature production blends such as st, sh,sp.
36 to 48 mos. 5 years
48 mos.
7 years
Feldman HM. Language disorders. Dalam : Berman S, penyunting. Pediatric Decision Making. Edisi ke-4. Philadelphia: Mosby, 2003.h.94-97