Edukasi orangtua

One of the most important aspects of a baby’s early development is the ability to communicate. In order to learn
to communicate, a baby needs to hear the speech of other people, have opportunities to repeat or imitate sounds
and words they hear, have different experiences within their environment, and have a need or desire to
communicate. There are speech and language skills we can help the baby develop before their cleft palate repair
surgery. Even before cleft palate repair surgery, your baby should be able to make a variety of sounds. There are
many things you as a parent can do to support speech development. Children learn best during positive
interactions, so make communicating with the baby a fun experience. As your child’s parent/caregiver, you are
their first and best teacher. By adding language into your everyday activities, you can help your child develop
their speech and language skills. You can turn simple routines and playtime into a language-learning experience
by doing things like labeling and describing objects and actions, taking turns in conversation and play and
providing your child with opportunities to communicate.

It is never too early to start talking with your baby! Back-and-forth interaction is the best way to help children
learn how to communicate. The first three years of life are very important for language and communication
development. As a newborn, babies cry to express that they need something. Within their first year, babies begin
to smile and laugh, babble, make actions/gestures, and eventually use single words and word combinations to
express what they want and need. Babies and children use different senses to learn language, such
as hearing and vision. For example, a child learning a spoken language needs to hear what their caregiver is
saying. A child learning a sign language needs to be able to see their caregiver’s hand positions, movements and
facial expressions. Language development involves what the baby can understand (receptive language) and what
the baby can express to us using eye contact, gestures, pointing, vocalizations and words (expressive language).

To help develop the baby's receptive language

Before they can use words, babies have to understand the meaning of words. This does not happen
automatically – they need caring adults to help them, by using lots of different words and phrases. When
adults use words that match what is happening around them, babies and children begin to understand the
meaning of those words. Repetition is very helpful – a child needs to hear/see a new word many times before
they learn what it means. As children get older, their receptive language skills help them identify objects and
pictures, follow simple and complex instructions, answer questions, understand stories and learn to read and
understand written text.
 Follow your child’s lead and interests. It is easier for children to learn new words when you talk
about things they enjoy. Watch for clues, such as what they are looking at or facing, what catches their
attention, what they reach for or point to, what they choose to play with and what they talk about. If
your baby or child turns or pushes away from something, this usually means they are not interested in
it, or they need a break from that toy/activity.

Why follow your child’s lead? When you talk about what your child is interested in, he/she has an
easier time learning language . By following your child’s lead, it shows your child that you are
interested in what he/she is doing.

How to follow your child’s lead ? Watch to see what your child is interested in. Wait to give your child
a chance to choose the toy or activity. Join in and talk about what you and your child are doing.

When not to follow your child’s lead? Your child is doing something you don’t want him/her to do
(e.g., throwing a toy, biting). Your child has a short attention span.

 Join In and Play. Once you know what your child is interested in – join in and play. This creates many
opportunities for your child to learn language and interact with you. Lets your child choose the toy or
activity, watch how your child is playing, and play along, get your own toy and copy what your child is
doing, and how your child new ways to play, using your own toys
*Note: if your child is not playing safely, do not copy or join in with their play. Instead, calmly state a
clear rule or boundary (example: “I won’t let you throw the blocks”) and help your child find a safe
way to play.
 dibuat kotak
Babies and children learn best through play and positive back-and-forth interactions. Play helps your
child practice new skills, learn about the world around them and develop communication skills. Play is
also important for your child’s mental health and well-being. When we think of play, we often think of
toys – but play comes in many forms! Some other ways to play include: people, games (example: Peek-
a-Boo), songs and rhymes, dancing. sharing books. Play is most helpful for learning when it is fun,
interactive and led by your child.

When you follow your child’s lead during play, your child will be able to explore things that interest
them. This can also help you build interaction and talk about things that match what they enjoy. As
your child gets older, they will find continue to find new ways to play. Pretend play uses your child’s
imagination, like taking care of a toy doll or acting out routines, such as going to school or cooking.
Pretend play helps build language, thinking and social skills. Games with rules (examples: hide and
seek, duck-duck-goose) can help your child develop new skills for turn taking and following directions.
By joining in and playing together, you create many opportunities for your child to learn more
language and to practice talking with you.

 Pair sounds and words with actions: A good time to do this is during play. For example, when
playing with toy farm animals, say "moo, moo" while making the cow move across the table. When
pretending to feed a baby doll, say "mmm...yum." Play turn-taking games: play games such as peek-a-
boo and pat-a-cake. Keep repeating the activity so your baby learns the routine. Teaching turn-taking is
a first step to having conversations with your baby.

 Be face-to-face and make eye contact. Physically get down to your baby's level. This may mean you
sit on a small chair, sit on the floor, or lift your baby up to your level. Being face to face helps the child
know that you are paying attention and are interested in what he/she has to “say”; establish and
maintain eye contact, an important part of communication; learn to focus on the same thing as you and
see how you say different sounds and words.

Being face to face helps the parents notice what your child is looking at, which is a clue to what they
are interested in and observe your child’s facial expressions – so that you know when to stop, when to
change activities, and when to keep playing.

How do I get face to face? Get down to your child’s physical level (e.g., sitting on small chairs, lying
on the floor, raising your child up, etc.), move as your child moves to maintain face to face contact and
hold motivating objects (i.e., favourite toys/food) beside your cheek to encourage your child to look at
your eyes and mouth. Hold a toy or object by your face to encourage your baby to look at you. Try to
keep their attention while talking to them.

 Use gestures. When talking to your baby use gestures to help them understand what you are saying.
For example, wave while saying "bye", lift your arms for "up", or shake your head for "no".
Follow your baby's lead: talk about the toy that your baby is looking at or showing interest in. Talk
about your baby’s actions using sounds and/or words that match what your baby is doing.
 Use simple language. Try to use language that is one step ahead of your baby's language level when
talking to them. For example, if your baby uses vocalizations, you can use single words (e.g., "milk").
Repetition: You will need to repeat important words many times in different situations so your baby
learns what they mean. You can use facial expression or tone of voice to emphasize what you are
saying. Use short sentences when talking to your child (i.e., one to three words at most). Always stay
one step above your child’s current level of communication. For example: you offer your child juice.
Instead of asking, “Do you want to have a glass of juice?” try the following:

This strategy can be used to help your child understand what you say. Using short phrases helps your
child to pick out the important words from the sentence. If your child already has a good understanding
of language, using short sentences will make it easier for your child to copy what you are saying

 Say what you think your child means. If your child does not use words, or you don’t understand
what was said, say it as your child would if he/she could. Give your child a good, clear model of
how the words should sound, without calling attention to the error. For example:

o Child: “ba”
o Parent: “Bird, yes there’s the bird!” (Give your child the words for sounds or gestures that
he/she uses.)
o Child: Reaches for juice and grunts “ah-ah”
o Parent: Interprets that child wants juice and says, “Juice. Daddy Juice.” (Parent then pours
child juice).
o Child: Screams and begins to cry when parent presents book at bed time.
o Parent: Interprets that child does not want to read book and say,
“No, no book!” (Parent offers child a different book to read or another night time activity).

 Use Different Types of Words. Children need to learn different kinds of words to help them combine
words and build longer sentences. For example:
o Objects: ball, cookie, puppy, juice, swing, school, park, mommy, daddy
o People: mommy, daddy, aunt, brother, baby, teacher
o Places: home, park, school, day care
o Actions: eat, give, open, push, walk, splash
o Describing words: hot, cold, happy, sad, big, small, wet, sticky
o Locations: in, on, out, up, down, under
o Time: first, then, before, after, today, tomorrow

 Add language to everyday activities. This is a good opportunity to label important actions and
objects, repeat key words and give your child a reason to communicate and take turns together. Set up:
label the routine (e.g., “getting dressed”). Mark each step, for example, “shirt on”, “pants on”, “socks
on” . Hold up pants and wait for your child to say or do something . Take turns choosing what to put on
next . Label the end of a routine (e.g., “all finished”) . Other examples of daily routines bath time, meal
time , bed time and play time .

Talk to your baby about what you are doing during routine activities. Some examples of daily routines
are bath-time, mealtime, bedtime and playtime. Talk about objects and actions during each step in the
routine, for example "all-done", "away", "more", "wash hair" and "night-night." Children need to
understand words before they can say them. You can help them learn new words by adding language to
play and daily activities.
o Tell your child names of people and objects that they are interested in
 o Describe what you/your child are doing, during daily routines (examples: when getting
dressed, having a snack)
o Make more comments and avoid asking questions
o Repeat important words many times in different sentences
o Add emphasis to important words to help them stand out
Tip: when your child is first learning language, use words that can help your child share their needs
(examples: help, hungry/eat, more, mine, stop).

 Labelling (or naming) is a way for you to help your child learn new words. Labelling is useful
because it shows your child that you are responding to his/her focus of interest. Teaches your child that
you can use a word instead of a gesture. Here are some suggestions for things to talk about: tell your
child names of people and objects that he/she is interested in. Talk about what your child is doing. Talk
about where the objects and people are. Use words that are useful (functional) for your child in
everyday situations.

 Repeat, repeat, repeat. Repeat important words several times in many different situations: For
example, see how many times you can repeat the word “bubbles” in an activity by combining it with
other words: “Bubbles” “Open bubbles” “Blow bubbles” “Pop bubbles” “Close bubbles” “Bubbles”
“More bubbles”. Wait to give your child a chance to react or respond. Some children need to hear a
word many times before they can understand it and try to say it.

To help your baby develop expressive language

Babies and children express their needs in different ways, at different ages and in different situations. Newborn
babies and infants communicate mostly by crying, grunting, laughing, smiling and making different facial
expressions. They need their caregivers to interpret their needs. Young babies use actions and gestures to make
things happen. For example, a baby may reach their arms up to be picked up. Gestures are a helpful building
block to developing language. It is important to interpret and respond to these actions so that your child keeps
communicating.
Babies need lots of practice when they are learning to communicate – one way they practice is by babbling.
Babies learning spoken language babble by making different sounds with their voice and mouth (examples:
“ma” “baba” “badada”). Babies learning sign language babble by making different hand shapes and movements
(example: open/close hand).
A baby’s first words are not always the same as adult words. Babies and young toddlers may shorten long words
(example: “nana” for “banana”) or use sounds that are easier to say (example: “ta” for “cup”). They may also
use their first words in different ways than an adult. For example, a baby may use the word “doggy” when
talking about different animals, until they learn the words for other animals.
Tip: You will know if a sound or early sign is a word if your child uses it often to express or request the same
things. First words also include gestures, like pointing, waving and reaching up.
By around 18-24 months old, toddlers begin to combine words into short phrases (examples: go car, more milk,
want banana). This helps them communicate bigger ideas. Before they can combine words, your child needs to
know lots of different words – including action words (examples: go, eat), location words (examples: up, in) and
describing words (examples: big, happy). As children get older, they use their expressive language to describe
objects and places, share ideas and feelings, ask questions (examples: who, what, where), talk about events
(examples: past, present, future) and tell stories
 Give the Child a Reason to Communicate. These strategies remove the ability to only answer “yes”
or “no” and encourages your child to use the specific name of the object. The strategies also provide a
chance for your child to comment or react.
o Say something and wait to see how your child responds
o Hold up two items and wait to see which one your child picks
o Do something silly and wait to see how your child reacts
o Give your baby/child a closed container with a favourite toy inside and wait to see how they
ask for help

Offer desired objects bit by bit. This strategy works well at snack time: pour only a little juice or milk
into your child’s cup, so that he/she has to ask you for more several times during snack time. Be the
“keeper” of all of the pieces. When playing with toys that have multiple pieces (e.g., puzzle, blocks,
etc.), keep all of the pieces in a bag or container, encouraging your child to request one piece during
each turn

Offer a choice ...

o Show and name each choice item while asking “Do you want car or block?”
o Wait for your child to “tell” you what he/she wants (e.g., by looking, reaching, pointing,
vocalizing, or using words)
o Give only the object that was asked for
o Label the item as you hand it to your child (e.g., “Block, you want block.”)

Create a silly or unusual situation ... Do something your child would not expect and wait for a reaction.
Examples of silly situations:

o put your child’s pajama pants on his/ her head

o put both of your child’s socks on the same foot
o start happily bathing your child in a bathtub that has no water in it
o start to pour your child’s juice but “forget” the cup

 Give choices: Give your baby choices so they can tell you what they want. For example, show and
name each item while asking "Do you want or ?". Then wait and watch as your baby looks, reaches,
vocalizes or attempts the word in response.

 Encourage the baby to be more vocal. Babies love to look at faces. To make your baby aware of lip
and tongue movements make funny faces, stick out your tongue, open and close your lips, and blow
kisses. This gets your baby to concentrate on your face, which will be important later when you try to
get your baby to imitate specific speech sounds. Use non-speech noises with your baby. Practice
making "raspberries" using your lips and when sticking out your tongue. This gets your baby to focus
on your face, and it allows your baby to see and hear an oral airflow activity. To keep your baby’s
interest, you can make these sounds with different pitches and loudness levels. Raspberry sounds may
be difficult for your baby to imitate before cleft palate repair but it is still important for your baby to
listen, focus on your face and learn about sounds.

 Comment…avoid asking question. We often ask too many questions and this stops conversation
instead of keeping it going. Try to ask fewer questions, turn a question into a comment, instead of
asking a question, talk about what you or your child is doing instead of asking: “Is this car going up?”
You could say: “Car goes up.” Label new words instead of testing whether your child knows the
word ... Instead of asking: “What’s that?” or “Say apple?” You could say: “Look, apple, yummy
apple.”
Ask questions when you really need to find out information (e.g., “Where are mommy’s keys?”)
Using too many questions provides fewer opportunities for your child to imitate words
 Avoid using grunting and growling sounds. Babies who are having trouble producing consonants
may overuse these sounds and this pattern can be difficult to get rid of. Parents should not reinforce
these types of sounds. If your baby babbles with grunting and growling sounds, smile and babble back
with more easy and relaxed vocalizations such as "ahh", "ohh" or "oww" and combinations such as
"nanana", "yayaya" or "wawawa". Eventually, your baby will respond with the sounds that you make.

 Wait for a response: Give your baby time to respond using eye contact, gestures and/or vocalizations.
Model the sounds and early words that your baby is trying to say. For example, say "On. Put block on"
while giving your baby a block to put on top of a block tower. Waiting gives your baby or child time to
think about what has just happened and then take a turn. Some children need more time to take a turn –
especially young babies and toddlers.

o Wait at least five seconds for your child to take their turn, before saying or doing something
new
o While you are waiting, stay engaged with your baby/child to let them know you are expecting
them to do something
o Watch your baby/child to notice how they take their turn – they may look somewhere, make a
facial expression, or use a gesture/sound/word
o When your baby/child takes a turn, give them enough time to finish what they are doing or
saying
o After they have taken a turn, keep the conversation going by responding to their message and
saying or doing something new
o If your child does not take a turn after five to ten seconds of waiting, you can say something
new or give them a new opportunity to communicate and wait again.

o Wait for your child to comment, react, or ask for more with a gesture or a word. If your child
does not say anything after you have waited five to ten seconds, model the words that he/she
should have said. For example: Parent: “We are going to put the block _____.” Parent waits
five to ten seconds for child to fill in the word “on”. Child: Does not respond. Parent: “On. Put
block on.” Parent gives child block to put on top of the block tower. Be available to help your
child in situations, but wait for your child to request for “help” by making eye contact,
bringing the object to you, vocalizing, or saying “help”

 Motivation: You may need to motivate your baby to communicate. For example, pour only a little
milk into your baby's cup so they have to "ask" for more during mealtime. Your baby may ask for more
by using a gesture, looking, vocalizing and/or trying to say a word.

 Help the child take turn. Children need opportunities to join in back-and-forth interactions when they
are learning how to communicate. For young babies, taking a turn may be a wiggle, facial expression
or a sound. Toddlers and children may take a turn using a gesture, facial expression or words/sentences.
Turn taking is an important skill for your child to learn. At first, children learn to take turns in play.
Later, children understand how to take turns “talking” in interactions. Turn taking helps increase a
child’s attention span, and promotes eye contact. Take turns by:
 o Setting a limited number of turns that you expect your child to take at first (e.g., place two
blocks on the tower before he/she leaves)
o Labelling turns from your child’s perspective, (e.g., “My turn” and “Mommy’s turn.”)
o Using phrases such as, “One more block” and “Blocks are all done.”
o Increasing the number of turns you expect your child to take, based on how he/she is
responding to the activity
o Taking your turn quickly to keep your child’s interest

 Respond to your child’s massage and expand. When babies and children are still learning, the ways
they communicate won’t match how an adult would communicate. They may share their ideas without
using words (example: looking, crying, pointing, grunting), and they make mistakes in the way they
make words or sentences.
o Notice how your child communicates in different ways, with or without words
o Respond to your child’s intended message, without expecting them to say it a certain way
o Say the words that match your baby/child’s gestures. For example, say “up” when they reach
up
o If your child is using words, expand on their message by adding one or two more words
o Use different words with the same meaning to build your child’s vocabulary (example: big,
huge, gigantic)
Tip: If your child is using words, but the words and sentences are hard to understand, repeat their
message back correctly to help them learn how to say the words. You do not need to point out the
mistakes – simply repeat the message how you would say it. For example:
o Child: “That a big tar!”  coba dibuat dalam kalimat sendiri
o Parent/Caregiver: “That’s a big star”  coba dibuat dalam kalimat sendiri

 Gestures: Teach your baby gestures to give them a way of expressing themselves before they are able
to "talk." Say the word and use the gesture at the same time. Examples of gestures to show your baby
include lifting arms for "pick me up"; waving for "hi, bye"; head shake for "no"; and clapping for
"good job, hooray."

 Imitate, interpret and expand: Imitating your baby’s sounds, gestures or words will motivate them to
interact and communicate with you. During everyday activities, repeat what your baby is saying and/or
doing, and add another piece of information. For example, if your baby says "more" and holds up an
object, repeat the word "more" and add the name of the object (e.g., "more banana"). When your baby
reaches for a toy cow and says " ", you can interpret that your baby wants the toy and say “cow moo”.

Imitation will motivate and encourage your child to interact with you. Imitation shows your child that
you are interested in what he/she is doing, and also encourages him/her to imitate you back.
Some suggestions for imitating your child are follow your child’s lead by imitating his/her body
movements and facial expressions and try imitating with another toy rather than expecting your child to
share his/her toy Imitate what your child says and make corrections. For example:

o Child: “Ded car.” Parent: “Yes, red car.”

Imitate and add one or two more words.
 o Child: “Put baby.” Parent: “Put baby on table.”
Add new ideas to what your child says.
o Child: “Doggie!”
Parent: “Doggie says woof, woof!

 Stimulate early speech sounds

Use different vowel sounds. Practice by vocalizing vowels and vowel combinations (e.g., "ahh",
"aawee", "oowaa", "oowee"). You can do this by either saying them or singing them. Using
exaggerated tones and varied loudness levels will capture your baby's attention. It is fun to use pictures
or toys when encouraging different vowel combinations.

Some speech sounds will be easier for your baby to produce before their cleft palate is repaired.
These include nose sounds (m, n) and speech sounds that do not need air pressure to build up in the
mouth (h, w, y). The ability to produce other early developing mouth sounds (e.g., p, b, t, d) is
limited before cleft palate repair surgery as having a cleft palate makes it difficult for pressure to
build up in the mouth. A baby with an unrepaired cleft palate can make the "m" sound so they can
say "mommy", but they cannot make the "d" sound. This is why fathers have to wait to hear
“daddy” until after the cleft palate is repaired.

Encourage consonant and vowel combinations during babbling using sounds your baby can make
correctly (e.g., "mama", "nana", "haha", "wawa", "yaya"). Also encourage your baby to copy or
imitate sounds while playing with you. This is an important early step in speech development as
children imitate sounds more easily than words. Some examples of sound imitation using m, n, h,
w, y are:

Model easy first words that have the sounds your baby can make (e.g., "mama", "more", "moon",
"nana", "no", "hi", "home", "yeah", "wow", "ow" for 'ouch', "one"). Remember your child may not
repeat what you have said. Just keep practicing.

Babies learning a spoken language begin practicing speech sounds (examples: “puh”, “duh”, “ah”,
“ee”) when they babble. They begin to put these sounds into words as they get older. Some sounds
are easier for babies and young children to say, such as vowel sounds (examples: “ee” “ah” “oo”)
and sounds made with the lips (examples: mmmm, puh, buh). In most languages, these sounds are
the first to develop.
Certain speech sound errors are common in early development. For example, in English, it is
common for young children to say “tat” for “cat” or “top” for “stop”. If your child is having
 trouble saying certain sounds in words, you can help them by repeating the word with the correct
sounds.
When your child is three years old, you should be able to understand most of what they say.
Research shows that children learn most of the speech sounds in their first language by the age of
five.

 Sing a song: Pause during or at the end of a song to allow your baby a chance to vocalize or imitate an
action. When you repeat a song many times, your baby may start to anticipate their turn in the song or
try to fill in the sound, word or action. Songs and finger plays you could use with your baby include
The Wheels on the Bus; Twinkle, Twinkle, Little Star; Itsy Bitsy Spider; Row, Row, Row Your Boat;
Head, Shoulders, Knees and Toes; Pat-a-Cake; Old MacDonald Had a Farm. Sing songs slowly so your
child can sing or move along. Leave out familiar words or parts of the song for your child to fill in with
a gesture, sound, or word (Example: Twinkle twinkle little _____. How I wonder what you _____).
Choose songs that use gestures and actions (Example: if you’re happy and you know it – clap your
hands)

 Read to your baby: Choose sturdy board-books, soft cloth or vinyl books with bright colors and
repetitive or rhyming text. While reading to your baby, imitate the sounds they make, label the pictures
and encourage turn-taking by waiting after you take your turn to give your baby a chance to make
another sound or to look at or touch a picture in the book. Books, songs and rhymes are great ways to
model language and build early literacy skills. When sharing a book with your child, let them lead the
activity and find ways to make it fun and interactive.

o Let your child choose the book

o Sit across from your child (face to face) with the book facing toward them
o Let your child hold the book and turn the pages
o Give them as much time as they need to explore each page
o Talk about the pictures that your child is interested in

Tip: You don’t need to read all of the words on each page – you can make up your own story or talk
about the pictures that your child is interested in.
When sharing a book allow your child to choose the book, give your child as much time as he/she
needs to look at the pictures. Join in with sounds, actions, or words. Some suggestions when reading a
book:

o Sit face to face with your child with the book facing toward him/her
o Use books with lots of pictures
o Label the pictures (e.g., “I see a ball.” Pause and wait for your child to take their turn)
o Keep the story simple, make up the words to the story, or change them
o Use an excited voice, make sounds and special voices that go with the story
o Leave out familiar words or parts of the story for your child to fill in (e.g., “Once there was a
bear who loved _____.”)
o Talk about the cause of events (Why? How come?)
o Enjoy and share that special joy of stories with your child

Tips for Parents

Any time is a good time to help your child learn language and literacy skills! Parents have the power to boost
their children’s language and literacy development when they:

 Make it easy for their child to start conversations

 Respond with interest to whatever their child tells them, with or without words
 Talk frequently with child about things of interest to the child
  Have conversations with child that go back and forth a number of times
 Talk at a level that their child can understand and learn from (not too complex or too simple)
 Expose their child to print in a variety of ways, especially with books

Create back-and-forth interactions and model language in everyday activities.

CONCLUSION

As a member of the cleft care team, the speech pathologist works closely with the surgeon and other team
members to ensure that timely assessments and appropriate management are provided. The first assessment of
communication skills should begin in infancy even before the child begins to speak, focusing on the language
skills and emerging sound production. In older children, accurate assessment is required to identify those
children who would benefit from speech therapy and / or secondary surgery for optimizing speech outcomes.
Speech language therapy focuses not only on direct one-on-one therapy, but also on early intervention
programmes that will reduce the manifestation of communication disorders in individuals with cleft lip and
palate. Cleft care is most successful when services are not only comprehensive, but also interdisciplinary in
nature. Thus, it is important for each member of the team to understand the fundamental principles of care in the
area of expertise of other members of the team.

 terapis wicara harus bertemu dengan orang tua secepat mungkin, namun tentunya paling lambat saat
anak berusia 3 bulan, untuk memberikan informasi mengenai perkembangan bicara dan bahasa dan
untuk mendiskusikan dampak dari sumbing pada perkembangan tersebut

 Tujuan kemampuan fonasi yang tepat selamat tahap awal perkembangan bicara dan bahasa mencakup
peningkatan vokalisasi bayi dan memperluas perbendaharran konsonannya

 Frekuensi dan variasi vokalisasi dapat menurun segera setelah operasi palatal, dan beberapa bayi
membutuhkan beberapa minggu untuk melanjutkan tingkat produksi pada saat sebelum operasi

 Perbaikan mekanisme velofaring secara langsung tepat setelah operasi tidak mungkin terjadi, tetapi
terjadi seiring berjalannya waktu dan perkembangan konsonan juga perbendaharaan kata

 Intervensi dini harus dipertimbangkan untuk anak yang tidak menambahkan konsonan baru ke
inventaris fonetik mereka setelah operasi palatal. Intervensi biasanya berfokus pada memfasilitasi
pertumbuhan kosakata ekspresif balita atau inventaris fonetik, atau keduanya.

 Perluasan inventaris konsonan anak harus difasilitasi dengan menggunakan artikulasi konvensional dan
strategi fonologis. Mainan tiup dengan resistensi rendah dapat digunakan untuk melatih aliran udara ke
mulut, tetapi aktivitas meniup biasanya tidak efektif bila ditujukan untuk memperkuat otot labial atau
langit-langit pada anak
Communication Checklist

Monitoring child’s communication development can help identify communication difficulties at a young age. If
the child is having difficulty, early intervention can help make sure they have a way to communicate their needs
and interests. The checklist below can be used from birth to age four to decide if the child needs help with their
speech and spoken language development.

By Two Months
Has the baby had their hearing screened?

By Six Months
Does the child:

 Startle in response to loud noises?

 Turn to where a sound is coming from?
 Make different cries for different needs (hungry, tired)?
 Watch your face as you talk?
 Smile/laugh in response to your smiles and laughs?
 Imitate coughs or other sounds such as ah, eh, buh?

By Nine Months
Does the child:

 Respond to their name?

 Respond to the telephone ringing or a knock at the door?
 Understand being told no?
 Get what they want through using gestures (reaching to be picked up)?
 Play social games with you (Peek-a-Boo)?
 Enjoy being around people?
 Babble and repeat sounds such as babababa or duhduhduh?

By 12 Months
Does the child:

 Follow simple one-step directions (sit down)?

 Look across the room to a toy when adult points at it?
 Consistently use three to five words?
 Use gestures to communicate (waves hi/bye, shakes head for no)?
 Get your attention using sounds, gestures and pointing while looking at your eyes?
 Bring you toys to show you?
 Perform for social attention and praise?
 Combine lots of sounds together as though talking (abada baduh abee)?
 Show an interest in simple picture books

By 18 Months
Does the child:

 Understand the meaning of in and out, off and on?

  Point to more than 2 body parts when asked?
 Use at least 20 words consistently?
 Respond with words or gestures to simple questions (Where’s teddy? What’s that?)?
 Demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)?
 Make at least four different consonant sounds (p ,b, m, n, d, g, w, h)?
 Enjoy being read to and sharing simple books with you?
 Point to pictures using one finger?

By Two Years
Does the child:

 Follow two-step directions (Go find your teddy bear and show it to Grandma.)?
 Use 100 to 150 words?
 Use at least two pronouns (you, me, mine)?
 Consistently combine two to four words in short phrases (Daddy hat. Truck go down.)?
 Enjoy being around other children?
 Begin to offer toys to other children and imitate other children’s actions and words?
 Use words that are understood by others 50 to 60 per cent of the time?
 Form words or sounds easily and without effort?
 Hold books the right way up and turn the pages?
 Read to stuffed animals or toys?
 Scribble with crayons?

By 30 Months
Does the child:

 Understand the concepts of size (big/little) and quantity (a little/a lot, more)?
 Use some adult grammar (two cookies, bird flying, I jumped)?
 Use over 350 words?
 Use action words such as run, spill, fall?
 Participate in some turn-taking activities with peers, using both words and toys?
 Demonstrate concern when another child is hurt or sad?
 Combine several actions in play (puts blocks in the train and drives the train, drops the blocks off)?
 Put sounds at the beginning of most words?
 Use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)?
 Recognize familiar logos and signs involving print (Stop sign)?
 Remember and understand familiar stories?

By Three Years
Does the child:

 Understand who, what, where and why questions?

 Create long sentences using five to eight words?
 Talk about past events (trip to grandparents house, day at child care)?
 Tell simple stories?
 Show affection for favourite playmates?
 Engage in multi-step pretend play (pretending to cook a meal, repair a car)?
 Talk in a way that most people outside of the family understand what she/he is saying most of the time?
 Have an understanding of the function of print (menus, lists, signs)?
 Show interest in, and awareness of, rhyming words?
Monitor the child's developmental milestones

These developmental milestones have been provided to show some of the skills that mark the progress of young
children as they learn to communicate. Parents may use these milestones to help monitor the child's
development.

By 6 months

Most children can:

 turn to source of sounds

 startle in response to sudden, loud noises
 make different cries for different needs (for example, I'm hungry, I'm tired)
 watch your face as you talk
 smile and laugh in response to your smiles and laughs
 imitate coughs or other sounds (for example, ah, eh, buh)

By 9 months

Most children can:

 respond to their name

 respond to the telephone ringing or a knock at the door
 understand being told "no"
 get what they want through sounds and gestures (for example, reaching to be picked up)
 play social games with you (for example, peek-a-boo)
 enjoys being around people
 babbles and repeats sounds (for example, babababa, duhduhduh)

By 12 months

Most children can:

 follow simple one-step directions (for example, "sit down")

 look across the room to something you point to
 use three or more words
 use gestures to communicate (for example, waves "bye bye", shakes head "no")
 get your attention using sounds, gestures and pointing while looking at your eyes
 bring you toys to show you
 "perform" for attention and praise
 combine lots of sounds as though talking (for example, abada baduh abee)
 show interest in simple picture books

By 18 months

Most children can:

 understand the concepts of "in and out", and "off and on"
 point to several body parts when asked
 use at least 20 words
 respond with words or gestures to simple questions (for example, "where's teddy?", "what's that?")
  demonstrate some pretend play with toys (for example, gives teddy a drink)
 make at least four different consonant sounds (for example, b, n, d, g, w, h)
 enjoy being read to and looking at simple books with you
 point to pictures using one finger

By 24 months

Most children can:

 follow two-step directions (for example, "go find your teddy bear and show it to Grandma")
 use 100 or more words
 use at least two pronouns (for example, "you", "me", "mine")
 consistently combine two or more words in short phrases (for example, "daddy hat", "truck go down")
 enjoy being with other children
 begin to offer toys to peers and imitate other children's actions and words
 be understood by people 50% to 60% of the time
 form words and sounds easily and effortlessly
 hold books the right way up and turn pages
 "read" to stuffed animals or toys
 scribble with crayons

By 30 months

Most children can:

 understand the concepts of size (big and little) and quantity (a little, a lot, more)
 use some adult grammar (for example, "two cookies", "bird flying", "I jumped")
 use more than 350 words
 use action words (for example, run, spill, fall)
 begin taking turns with other children, using both toys and words
 show concern when another child is hurt or sad
 combine several actions in play (for example, feed a doll then put it to sleep, put blocks in train then
drive train and drop blocks off)
 include sounds at the beginning of most words (for example, say "cat" rather than "at")
 produce words with two or more syllables or beats (for example, "ba-na-na", "com-pu-ter", "a-pple")
 recognize familiar logos and signs, for example stop sign
 remember and understand familiar stories

By age 3

Most children can:

 understand "who", "what", "where" and "why" questions

 create long sentences using 5 or more words and talk about past events (for example, trip to
grandparents' house, day at childcare)
 tell simple stories
 show affection for favourite playmates
 engage in multi-step pretend play (for example, cooking a meal, repairing a car)
 be understood by most people outside of the family, most of the time
 be aware of the function of print (for example, in menus, lists, signs)
 have a beginning interest in, and awareness of, rhyming