Acuan Bicara & Mendengar Anak 0-4 TH

Integrated Scales of Development
Language enables us to comprehend and express ideas, thoughts, opinions and emotions.
In the language learning process, understanding the language heard, that is, receptive language, always precedes the de-
velopment of expressive language. A young baby will turn when her mother calls her, or wave goodbye when asked, long
before she can say her own name or say bye bye. As well as learning to understand and express language, the development
of pragmatic skills is necessary in order to use language appropriately in different social contexts and for different purposes.
From birth to school age is a time of enormous development in a child’s life. A baby grows from a totally dependent being
into a competent communicator and an independent thinker and learner by the time she begins school.
The following tables are an integrated scale that outline typical stages of development in the areas of listening, receptive
and expressive language, speech, cognition and social communication. They have been adapted from a number of sources:
• Cottage Acquisition Scales for Listening, Language and Speech
• Preschool Language Scale - 4 (PLS 4)
• The Bzoch-League Receptive-Expressive Emergent Language Scale Second Edition
• (REEL - 2)
• The Early Learning Accomplishment Profile Kit (E-LAP)
• The Learning Accomplishment Profile Revised Edition Kit (LAP-R)
• The Rosetti Infant-Toddler Language Scale
• St. Gabriel’s Curriculum
A child with hearing impairment follows these stages of development. However, she will need greater exposure to spoken
language from the earliest possible time. Language, speech, cognition and pragmatic skills should be developed concurrently
through listening in a systematic program that follows the typical stages of development.
It is important to remember that the skills listed on the following pages are based on an average.
There is a considerable range between the earliest and latest times children achieve the various milestones. Your child may
not reach a milestone within the given timeframe, but this does not mean that they will not achieve it. These developmental
scales are meant as a guide only. They have been included to assist in the provision of a program to suit the individual
needs of a particular child.
For full reference and description see Listen Learn and Talk (Ref. Z60407). This is an auditory habilitation resource from
Cochlear.
Auditory Habilitation Theory 3

0 to 3 Months
Social
Listening Receptive Expressive
Speech Cognition Communication
(Audition) Language Language
(Pragmatics)
• Auditory awareness • Startles to sudden • Cries to express • Cries • Awareness of fami- • Appears to listen to
• Responds to sound noises hunger and anger • Begins vocalizing liar people/situations speaker
by smiling, head • Responds to spea- • Begins to vocalize to other than crying, • Looks at objects/fa- • Has brief eye con-
turning, stilling, ker’s face express pleasure e.g. coos, gurgles ces briefly tact but by 3 mon-
startling • Responds to talking • Occasionally voca- • Anticipates certain ths regularly looks
• Responds to loud by quietening or lizes in response to events, e.g. being directly at spea-
sounds smiling voicelike sounds fed ker’s face, localizes
• Recognizes mo- • Quietens with fami- speaker with eyes
ther’s/ caregiver’s liar voice and starts to watch
voice mouth rather than
whole face
• Smiles/coos in re-
sponse, in particular
to mother/caregiver
4 to 6 Months
Social
(Pragmatics)
• Sound begins to • Frequently localizes • Vocalizes for needs • Laughs • Looks at objects and • Maintains eye con-
have meaning sound source with and wants • Blows raspberries reaches for them tact
• Listens more acutely head or eye turn • Vocalizes in respon- • Coos • Starts to learn about • Loves games such
• Starts to associate • Occasionally response to singing • Yells cause and effect, as round and round
meaning to sound, ds to own name • Blows raspberries, • Starts to change e.g. plays with rattle the garden
e.g. responds to • Discriminates coos, yells duration, pitch and • Recognizes familiar • Produces different
own name occasio- between angry and • Vocalizes in respon- intensity (prosodic people vocalizations for
nally friendly vocal tones, se to speech features) • Brings objects to different reasons
• Responds to chan- e.g. cries in respon- • Starts to use a va- • Uses vowel [a] as in mouth • Imitates facial ex-
ges in vocal inflec- se to an angry voice riety of vocalizations car pressions
tions • Usually stops crying to express pleasure • Produces soun- • Takes the initiative
• Starts to localize in response to voice and displeasure ds with consonant in vocalizing and
source of voice with • Vocalizes when alo- features - friction engages adult in
accuracy ne or with others noises, nasal [m] interaction
• Listens to own voice • Plays at making • Starts to understand
sounds vocal turn taking,
e.g. vocalizes in
response to adult
vocal input

7 to 9 Months
Social
(Pragmatics)
• Localizes sound • Appears to recogni- • Repeats CV syllables • Babbles CV CV [pa • Imitates physical • Begins to under-
source with accuracy ze names of family in babble [pa pa] pa] [ba ba] action stand that communi-
• Discriminates supra- members in connec- • Starts to respond • Clicks tongue • Recognizes familiar cation is a two-way
segmental aspects ted speech, even with vocalizations • Uses a “singsong” objects process
of duration, pitch when person named when called by voice • Places object in one • Shows a desire to
and intensity is not in sight name • Imitates patterns of hand and then the interact with people
• Has longer attention • Responds with appro- • Plays more games, intonation other • Becomes more lively
span priate arm gestures e.g. pat a cake, • Uses low central vo- • Holds one cube and to familiar people
• Associates meaning to such words as up, peek a boo, hand wels most frequently takes another • Demonstrates antici-
to words high, bye bye, etc. clapping, etc. and [o] (hot) [ae] (bat) • Smiles at self in pation of activities
• Discriminates vowel • Enjoys music or sin- vocalizes during [a] (car) mirror • Nods, waves and
and syllable content ging games • Uses some conso- • Loves hiding and fin- claps
• Appears to listen to • Appears to “sing” nants [p, b, m, d] ding games • Calls to get attention
whole conversation • Vocalizes to greet a • Gives, points, shows • Requests by rea-
between others familiar adult • Pulls rings off peg ching and pointing
• Regularly stops ac- • Calls to get attention • Enjoys frolic play
tivity when name is • Uses some gestures • Continues to deve-
called and language appro- lop turn taking skills
• Appears to recognize priately, e.g. shakes • Begins book sharing
the names of a few head for “ho” by
common objects by • Vocalizes loudly • looking at pictures in
localizing them when a book with adult
they are named
• More regularly stops
activity in response
to “no”
• Will sustain interest
up to a minute while
looking at pictures or
books with adult
10 to 12 Months
Social
(Pragmatics)
• Associates meaning • Appears to enjoy • Uses jargon of 4 • Imitates sounds and • Resists when toy is • Starts to under-
to more words listening to new or more syllables - • number of syllables taken away stand question and
• Monitors own voice words short sentence-like • used by others • Relates an action to answer, e.g. shakes
and voices of others • Generally able to structures without • o Uses supraseg- an object, e.g. spo- head appropriately
• Localizes sound from listen to speech wi- true words mental on with stirring, car for “no”
a distance thout being distrac- • Starts to use varied • features with pushing • Understanding of
• Discriminates spe- ted by other compe- jargon patterns with • o Uses longer • Responds to lau- interaction continues
aker’s voice from ting sounds adult intonation pat- strings of ghter by repeating to develop
competing stimuli • Occasionally gives terns when playing • repeated syllables action • Understands gree-
toys and objects alone • o Vowels and conso- • Takes peg from peg tings
to adult on verbal • Initiates speech ge- nants board • Turn taking skills
request sture games such as • are systematically • Matches two identi- continue to develop
• Occasionally follows round and round the varied cal objects • Vocalizes in respon-
simple commands, garden • [ba di ba di] • Attempts to build a se to mother’s call
e.g. Put that down. • Talks to toys/objects • o Mostly uses plosi- two block tower • Indicates desire to
• Responds to music using longer verbal ves change activities
with body or hand patterns • and nasals [p, b, d, • Responds to lau-
movement in appro- • Frequently responds m] ghter by repeating
ximate time to songs or rhymes action
• Demonstrates by vocalizing • Begins directing
understanding of • Imitates action pai- others by tugging,
verbal requests with red with sound pushing
appropriate head • May use first words, • Vocalizes with ge-
and body gestures e.g. bye bye, mama sture to protest
• Shows increased • Enjoys games and
attention to speech initiates them
over prolonged pe-
riods of time

13 to 15 Months
Social
(Pragmatics)
• Identifies more • Understands more • Uses 7 or more • Imitates alternated • Sustains interest in • Continues to deve-
words new words each words consistently vowels desired object for lop eye contact with
• Processes simple week • Uses voice and • Approximates single two minutes and speaker for longer
language • Follows one step di- gesture to obtain words more periods
• Auditory memory of rections during play desired object • Uses most vowels in • Places circle in sha- • Takes turns as ex-
one item at the end • Understands simple • Continues to use vocal play pe board pressive language
of a phrase/senten- where questions, jargon with more • Uses more front • Builds a tower with develops
ce e.g. Where’s daddy? true words develo- consonants plosives two cubes • Plays fetching game
• Discriminates • Recognizes and ping [p, b, d], nasals [m, • Begins to make • Involves others by
between familiar demonstrates un- • Incorporates pau- n] marks on paper with showing things, e.g.
phrases derstanding of many sing and intonation • Uses fricative [h] thick crayon shoes/clothing du-
• Follows one step objects by pointing into jargon • Uses semivowel [w] • Imitates more ac- ring play
directions that are • Understands more • Imitates new words tions, e.g. patting • Begins to under-
familiar familiar phrases spontaneously doll stand “wh” que-
• Begins to recognize • Sings • Demonstrates stions
names of various functional use of
body parts, e.g. objects
eyes, hands • Removes lid of box
• Enjoys rhymes to find hidden toy
16 to 18 Months
Social
(Pragmatics)
• Discriminates • Understands more • Jargon disappears • Increases single • Imitates circular • Requests object or
between more phra- simple questions • Increases vocabu- word approximations scribble help from adult by
ses • Begins to under- lary, 10 or more • Most vowels present • Places 3 to 6 pegs in gesturing and voca-
• Identifies and asso- stand longer phrases meaningful words • Still mainly produ- pegboard lizing
ciates more words to with key word in • Decreases use of cing front conso- • Retrieves desired • Initiates vocal inte-
related objects, e.g. middle of sentence gesture - relies on nants [p, b, d, m, n, toy from behind an raction
toys, body parts, • Develops category talking to communi- h, w] obstacle • Prefers to be with
food, clothing vocabulary cate • Picks up small familiar people
• Imitates words he- • Identifies more body • Imitates words he- objects • Shows caution with
ard parts ard • Turns bottle upside strangers
• Finds familiar object • Asks for more down to obtain toy • Imitates other chil-
not in sight • Points to pictures in dren
• Understands 50 or a book and begins
more words to turn pages
• Identifies some • Demonstrates object
clothing items, toys permanence
and food

19 to 24 Months
Social
(Pragmatics)
• Auditory memory of • Completes two • Occasionally imi- • Approximates words • Imitates symbolic • Begins to develop
2 items requests with one tates 2 - 3 word • Substitutes /w/ for play, e.g. household more self confidence
• Discriminates songs object phrases /r/ activities and is happy to be
• Comprehends a va- • Chooses two familiar • Uses new words • Uses suprasegmen- • Uses one object as with other people
riety of phrases objects regularly tal features symbol for another • Initiates pretend
• Discriminates de- • Comprehends action • Increases expressi- • Most vowels and • Places triangle, cir- play
scriptive phrases phrases ve vocabulary to 30 diphthongs present cle, square in shape • Responds to re-
• Follows a two step • Points to a range words or more • Consonants [k, g, t, board quests from adults
direction, e.g. Get of body parts, e.g. • Attempts “stories” - ng] emerging • Imitates vertical • Practices adult-like
your ball and throw elbow, cheek longer utterances in • Consonants [p, b, strokes conversation about
it. • Begins to under- jargon to get mes- m, h, n, d] establi- • Threads three beads familiar themes
• Identifies by cate- stand personal pro- sage across shed - used in initial • Begins to tear paper • Uses words to inte-
gory nouns - my, mine, • Begins to use own position in words • Imitates ordering of ract
you name when talking • Consonants often nesting cups • Requests informa-
• Recognizes new about self omitted in medial • Begins to categorize tion, e.g. What is
words daily • Uses possessive pro- and final position objects in play this?
• Increases compre- nouns - mine • Uses two toys toge- • Develops turn taking
hension - decodes • May ask where que- ther in conversation
simple syntax stions Where car? • Stacks blocks/builds
• By 24 months un- • By 24 months may tower
derstands 250 - 300 use 2 - 3 word • Completes simple
words phrases with nouns, pull out puzzle
some verbs and • Activates mechanical
some adjectives toy
25 to 30 Months
Social
(Pragmatics)
• Auditory memory of • Begins to under- • Uses 2 - 3 word • Loves experimenting • Continues symbolic • Enjoys talking, e.g.
2 items in different stand complex lan- phrases more consi- with prosodic featu- play, e.g. talking on pretends to have a
linguistic contexts guage stently res the phone conversation on the
• Listens to familiar • Comprehends more • Uses some personal • Begins to use stress • Completes actions, phone
songs on tape complex action pronouns, e.g. me, correctly e.g. clap hands and • Completes actions,
• Comprehends longer phrases you • Repeats words and high 5s e.g. Give me five
utterances • Understands fun- • Asks for help using phrases • Uses toys appropria- • Begins to develop
• Listens from a di- ctions, e.g. What do two or more words, • Consonants [f, y] tely parallel play with
stance we use for drinking? e.g. wash hands emerging • Performs related other children
- points to up • Begins to name pri- • Consonants, e.g. activities at play • Talks more in play
• Begins to under- mary colors [m, p, b] used in • Turns one page at a • Shares toys
stand size differen- • Refers to self by final position time • Asks for help using
ces, e.g. big/little pronoun me • Word/phrases • Imitates vertical, two or more words
• Begins to under- • Repeats 2 numbers shortened- medial horizontal lines and • Uses longer utteran-
stand prepositions, counting consonants often circle ces
e.g. in, on, under • Answers “wh” que- omitted • Matches identical
• Receptive vocabula- stions, e.g.. What’s • Tends to over pro- picture to picture
ry increases that?, What’s … nounce words and shape to shape
• Begins to under- doing?, Who? • Different pronun- • Puts two parts of a
stand concept of • Recites nursery ciation of the same whole together
quantity, e.g. one, rhymes and favorite word occurs fre- • Understands number
all songs quently concept of one and
• Understands pro- • Understands and • Whispers two
nouns, e.g. he, she, answers “can you”.
they, we Uses negation, e.g.
don’t, no

31 to 36 Months
Social
(Pragmatics)
• Continues to expand • Understands most • Knows gender voca- • Makes some substi- • Shares toys and • Takes turns and
auditory memory - 3 common verbs bulary tutions [f] for [th], takes turns more shares
item auditory me- • Understands and • Talks about what [w] for [r] appropriately • Recites rhymes
mory with different responds to more has drawn • Medial consonants • Develops parallel • Acts out songs -
linguistic features complex language • Gives both first and still inconsistent play sometimes changes
• Sequences 2 pieces and commands last name when • Final consonants • Begins to develop endings
of information in • Carries out 2 - 3 asked inserted more regu- interest in writing • Engages in make-
order verbal commands in • Relates recent expe- larly and drawing believe activities
• Listens to stories on one sentence riences • Consonants [l, r, sh, • Begins fantasy play • Begins to ask per-
tape • Understands several • Converses in 3 - 4 s, z, ch] emerging • Matches six color mission of others
• Follows 2 - 3 direc- prepositions, e.g. in, word simple senten- • Vowels and diph- cards • Expresses feeling
tions on under ces thongs established • Sorts and categori- • Initiates conversa-
• Expands concept • Begins using more • Omits some unstres- zes, e.g. blocks and tion
development complex language sed parts of speech pegs • Uses questions for a
• Identifies parts of an • Uses questions, e.g. • Pronunciation beco- • Names object when variety of reasons,
object who, what, where, mes more correct part of it is shown in e.g. to obtain infor-
• Understands time why • Whispers frequently a picture mation, to request
concept, e.g. today, • Uses pronouns, e.g. • Adds two missing
yesterday, tomorrow he, she, they, we, body parts to a dra-
• Understands What is you, me wing
missing?/Which one • Uses some plurals • Shows interest in
does not belong? • Uses possessives how and why things
• Uses more negati- work
ves, e.g. not, none, • Completes 2 - 3
nobody interlocking puzzle
• Begins to use and/ pieces
because • Imitates drawing a
• Names three or cross
more colors
37 to 42 Months
Social
(Pragmatics)
• Auditory memory • Can listen to a 10 - • Holds conversations • Uses some blends, • Begins one-to-one • Takes turns
increases to 5 items 15 minute story using many correct e.g. [mp, pt, br, dr, correspondence • Plays with other
• Sequences 3 or • Comprehends an grammatical struc- gr, sm] • Follows directions children more ap-
more pieces of infor- increasing level of tures (plurals, pos- • Consonants [j, v, th] using concepts, e.g propriately
mation in order complex language session, pronouns, emerging empty, full, same, • Shows understan-
• Retells a short story • Understands more prep, adj.) • Some substitutions different ding of others’ fee-
• Follows 3 directions difficult concepts, • Uses “when” and still made, e.g. [gw] • Develops more dif- lings/needs
• Processes complex e.g. quality, texture, “how many” que- for [gr] in blends ficult concepts, e.g. • Interacts through
sentence structures quantity stions • Pronunciations of quality, quantity, simple conversation
• Tracks a 6 word • Understands concept • Uses so/because words more stable texture • Initiates conversa-
sentence of day/night, e.g. di- • Relays a message from one production • Compares objects tion
stinguishes day from • Describes what to the next • Begins simple pro- • Enjoys role-plays
night activities objects can be used blem solving
• Follows directions for • Develops imagina-
using concepts of • Starts to answer tion
empty/full, same/ “what if?” questions
different • Answers What is
• Understands loca- missing?
tional prepositions, • Identifies which one
e.g. next to does not belong and
• Begins to under- answers Why?
stand comparatives, • Attempts to answer
e.g. I am taller than problem-solving
you. questions, e.g. What
• Understands about if?
900 words • Uses about 500 in-
telligible words

43 to 48 Months
Social
(Pragmatics)
• Processes longer • Continues to expand • Uses his/her/their • Reduces omissions • Draws simple • Increases confidence
and more complex vocabulary compre- • More consistent use and substitutions objects and self esteem
language structures, hension of plurals - irregular • Most consonants • Understands time • Requests made from
e.g. Can you find • Understands singu- and regular established concepts, e.g. others, e.g. shop/
something that lives lar/plural • Talks about pictures • More blends emer- .today/ tomorrow/ retail assistant
in a tree, has fea- • Understands diffe- and story books ging in initial and yesterday/ morning/ • Uses intonation ap-
thers and a yellow rence between past/ • Uses more sophisti- final position afternoon/ night propriately
crest? present/ future cated imaginative • Rate and rhythm • Tells how many fin- • Initiates conversa-
• Follows directions • Answers final word play normal gers and toes tion
with more difficult analogies • Uses negatives and • Uses appropriate • Associates an object • Adapts to changes
concepts, e.g. Put • Identifies objects some modals, e.g. loudness level with an occupation, of topic
the thick blue squa- missing from scene shouldn’t/ won’t/ • Uses appropriate e.g. thermometer/ • Uses language for
re behind the mpty • Understands day/ can’t intonation doctor different communi-
jug. morning/ afternoon/ • Uses comparisons • For accompanying • Continues to deve- cative intent, e.g.
• Re-tells longer sto- night • Makes inferences chart, see Sounds of lop imagination obtaining informa-
ries in detail - 5 or • Makes comparisons • Develops colloquial Speech pg 43. • Concentration incre- tion, giving infor-
more sentences of speed/weight expressions ases mation, expressing
• Tracks an 8 word • Understands 1500 - • Uses How much? • Copies simple pictu- needs/feelings,
sentence 2000 words How? questions re line drawings bargaining
• Uses 800 - 1500 • Matches patterns
words • Makes inferences
• Uses more complex
language structures
• Spontaneous ut-
terances are mo-
stly grammatically
correct
Sounds of Speech*
Sound Age Acquired
s 1 2 3 (Years)
4 5 6 7 8
vowel vowels
s
p p
m m
popcorn
h h
mommy
n no n
happy
w w
b b
water
k k
baby
g go g
cake
d d
t t
daddy
ng ring ng
tomato
f f
y y
funny
r r
yellow
l lion l
rabbit
s sun s
ch ch
sh sh * Typical average upper age limits of conso-
cheese
z z nant production
shopping
j j
zebra Acknowledgement
v v Source: Estabrooks, W. (1998) Cochlear Im-
jack
th th plant for Kids, © 1998 Warren Estabrooks and
velvet The
TH TH
think Alexander Graham Bell Association of the Deaf.
zh zh Inc. Reprinted by Permission.
those
pleasure
Personal Notes
Personal Notes
As the global leader in hearing solutions, Cochlear is dedicated to bringing the gift
of sound to people all over the world. With our hearing solutions, Cochlear has
reconnected over 180,000 people to their families, friends and communities in more
than 100 countries.
Along with the industry’s largest investment in research and development, we
continue to partner with leading international researchers and hearing professionals,
ensuring that we are at the forefront in the science of hearing.
For the hearing impaired receiving any one of Cochlear’s hearing solutions, our
commitment is that for the rest of your life you will Hear now. And always
Cochlear AG, European Headquarters

Peter Merian-Weg 4
CH - 4052 Basel, Switzerland Integrated Scales of Development from Listen Learn and Talk
Tel: +41 61 205 0404
Fax: +41 61 205 0405
English - December 2009
www.cochlear.com

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Integrated Scales of Development

Auditory Habilitation Theory 3

Auditory Habilitation Theory 5

Auditory Habilitation Theory 7

Auditory Habilitation Theory 9

Auditory Habilitation Theory 11

Auditory Habilitation Theory 13

Cochlear AG, European Headquarters

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