Path Analysis on The Biological and Social Life Course Factors Affecting Childs Speech and Language Development Delay

Merlita Indriasih, Harsono Salimo, Eti Poncorini Pamungkasari


Background: The development in children occurs once during the period of their life. The la­ngu­age ability is an indicator of all the development. The lack of stimulation can cause speech and la­ngu­­age disorders and this disorder can persist. This study aimed to determine the effects of bio­lo­gi­cal and social life course factors on delayed speech and language development.

Subjects and Method: This study was an observational analytic with cross-sectional approach, conducted in 25 integrated health posts (posyandu) located in Sleman Regency, Yogyakarta in March to April 2019. The total sample of 225 toddlers was chosen using fixed exposure sampling. The dependent variable was delayed speech and language development. The independent variables we­re income, employment, nutritional status, birth weight, history of toxoplasma, rubella, CMV and TORCH, history of infection, duration of gadget use, language, frequency of posyandu visit, and early childhood education (PAUD). Data collection on delayed speech and language de­ve­lop­ment were measured by Denver II. The data were analyzed by path analysis.

Results: Speech and language delayed development was directly decreased with normal birth weight (b= -2.19; 95% CI= -3.58 to -0.79; p= 0.002), employed mother (b = -1.32; 95% CI = -2.38 to -0.27; p = 0.013), good nutritional status (b = -2.14; 95% CI = -3.37 to -0.91; p = 0.001), re­gu­lar­ly attend integrated health post (b = -1.29; 95% CI = -2.31 to -0.26; p = 0.013 ), mono language (b = -1.02; 95% CI = -1.99 to -0.04; p = 0.041), low duration of gadget use (b = -1.59; 95% CI = 0.23 to 2.33; p = 0.017). Speech and language delayed development was directly increased with history of di­sease (b = 1.37; 95% CI = 0.34 to 2.40; p= 0.009), and did not attend Pre-school (b = 1.28; 95% CI = -2.65 to -0.53; p = 0.003). It was indirectly affected by number of children, income, and history of TORCH.

Conclusion: Delays in speech and language development are directly influenced by birth weight, infection history, employment, nutritional status, frequency to posyandu (integrated health posts), long usage of gadgets, PAUD (pre-school) and indirectly influenced by income and the number of children.

Keywords: the development of speech and language, the use of gadgets

Correspondence: Merlita Indriasih. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir.Sutami 36A Surakarta 57126, Central Java, Indonesia. Email: Mobile: 085­641097941.

Journal of Maternal and Child Health (2019), 4(6): 11-22

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Altman C, Goldstein T, Armon LS (2017). Quantitative and qualitative differences in the lexical knowledge of monolingual and bilingual children on the litmusclt task.Clinical linguistics and phonetics. 31(1112):931954.

Asthiningsih NWW, Muflihatin SK (2018). Deteksi dini perkembangan balita dengan metode DDST II di posyandu wilayah kerja Puskesmas Juanda Samarinda (Early Detection of Development of Toddlers with DDST II Method in Posyandu in Juanda Health Center Samarinda Working Area). Jurnal Endurance. 3(2): 367.

Barron I, Hayden, TA (2016). Essentials of infection prevention in the pediatric population. International Journal of Pediatrics and Adolescent Medicine. 3(4): 143–152. doi: 10.1016/j.ijpam.2016.10.002.

Brebner C, Stacie A, Clarie M(2017). Facilitating children’s speech, language and communication development: An exploration of an embedded, servicebased professional development program. Child Language Teaching and Therapy. 33(3): 223–240. doi: 10.1177/0265659017702205.

Brodin J, Renblad K (2019). Improvement of preschool children’s speech and language skills. Early Child Development and Care.

Datar A, Jacknowitz A (2009). Birth weight effects on children’s mental, motor, and physical development: Evidence from twins data. Maternal and Child Health Journal. 13(6): 780–794. doi: 10.1007/s1099500904616.

Eadie P, Angela M, Obioha CU, Kyriaki TE, Melissa W, Sheena R (2015). Speech sound disorder at 4 years: Prevalence, comorbidities, and predictors in a community cohort of children. Developmental Medicine and Child Neurology, 57(6): 578–584.

Festman J (2018). Vocabulary Gains of Mono and Multilingual Learners in a Linguistically Diverse Setting: Results From a GermanEnglish Intervention With Inclusion of Home Languages.Frontiers in Communication. 3(0): 1–15.

Hurley KM, Yousafzai AK, Lopez F (2016). Early Child Development and Nutrition: A Review of the Bene fi ts and Challenges of. American Society for Nutrition.7(0): 357–363. https://doi: 10.3945/

Jafari Z, Esmaili M, Toufan (2015). Bilingual proficiency and cognitive reserve in Persian–English bilingual older adults.Aging Clinical and Experimental Research. 27(3): 351–357. doi: 10.1007/s405200140288x.

Ministry of Health RI (2016). Pedoman Pelaksanaan Stimulasi, Deteksi dan Intervensi Dini Tumbuh Kembang Anak (Guidelines for the Implementation of Stimulation, Detection and Early Intervention of Child Growth). Summary for Policymakers. 0(0):1–30. doi: 10.1017/CBO9781107415324.004.

Kuta C (2017). The Negative Impact of Excessive Screen Time on Language Development in Children Under 6 YearsOld. Pediatric and Family Health Providers. Available at:

Lolita, Dewi YLR, Murti B (2019). Multilevel Analysis on the Contextual Effect of the Integrated Health Post Activity on Development of Children Under Five in Kubu Raya, West Kalimantan. 4(4): 222–229.

Lonigan CJ, Milburn T.F (2017). Identifying the Dimensionality of Oral Language Skills of Children With Typical Development in Preschool Through Fifth Grade.Journal of Speech, Language, and Hearing Research. 60(8): 2185–2198. doi: 10.1044/2017_jslhrl150402.

Madigan S, Mark W, Anre P, Dillon B (2014). Birth weight variability and language development: Risk, resilience, and responsive parenting. Journal of Pediatric Psychology.40(9): 869–877.

Malmberg LE, Lewis S, West E, Murray E, Syla K, Stein A (2015).The influence of mother and father sensitivity in the first year of life on children’s cognitive outcomes at 1836 months. Child:care, health and development. 42(1): 1–7.

Moonik, Hesti, Roky (2015). Faktorfaktor yang mempengaruhi keterlambatan perkembangan anak taman kanakkanak 2 (Factors that affect the delay in the development of kindergarten children 2). Jurnal eClinic. 3(0). Available at:

Mwesige AK, Abdul HM, Krister K, Sharon L, Julius JL (2018). Emerging viral infections in SubSaharan Africa and the developing nervous system: A mini review. Frontiers in Neurology. 9(0): 1–8. doi: 10.3389/fneur.2018.00082.

Niccols A, Milligan K, Sword W, Thabane L, Henderson J, Smith A, Sword W, Thabane LJ (2012). Integrated programs for mothers with substance abuse issues and their children: A systematic. Harm Reduction Journal. 9(14): 1–11.

Paz OO, Hanna M, Marian JJ, ineke Jm, Stefan VDS (2017). The link between motor and cognitive development in children born preterm and/or with low birth weight: A review of current evidence. Neuroscience and Biobehavioral Reviews.80(0): 382–393.

Permana A (2015). Hubungan antara prematuritas dengan perkembangan anak 23 tahun di RSUP DR. Sardjito (The relationship between prematurity and the development of children 23 years in the hospital Dr. Sardjito). Universitas Gadjah Mada. Available at:

Poduval J, Poduval M (2009).Working Mothers: how much working, how much mothers, and where is the womanhood? Mens Sana Monographs. 7(1): 63. doi: 10.4103/09731229.41799.

Prado EL, Dewey KG (2014). Nutrition and brain development in early life. Nutrition Reviews. 72(4): 67–284.

Profile of Indonesian Children (2015). Profil anak indonesia (profile of indonesian children). Jakarta: Kementerian Pemberdayaan Perempuan dan Perlindungan Anak.

Rahmawati NA, Yudianto S, Munif S (2016) Status pekerjaan ibu sebagai prediktor kemampuan bahasa lisan anak usia 45 tahun (The Profile of Indonesian Children Job Status of Mothers As Predictors of Oral Language Ability for Children 45 Years Old). Universitas Sebelas Maret. Available at:

Basic Health Research (2018). Hasil utama riset kesehatan dasar, Kementrian Kesehatan Republik Indonesia (Main results of basic health research, Ministry of Health of the Republic of Indonesia). Jakarta: Ministry of Health RI.

Safriana L, Salimo H, Dewi YLR (2017). Biopsychosocial factors, life course perspective, and their influences on language development in children. Journal of Maternal and Child Health. 02(03): 245–256. doi: 10.26911/thejmch.2017.02.03.06.

Sajalia H, Dewi YLR, Murti B (2018). Life Course epidemiology on the determinants of stunting in children under five in East Lombok, West Nusa Tenggara. Journal of Maternal and Child Health. 03(04):242–251. doi: 10.26911/thejmch.2018.03.04.01.

Scharf R J, Deboer MD, Guerrant RL (2014). Recent advances in understanding the longterm sequelae of childhood infectious diarrhea. Current Infectious Disease Reports.16(6): 1–11. doi: 10.1007/s119080140408y.

Schwab JF, Lew WC (2018). Speech.Wiley Interdiscip revolution cognitive science. 7(4): 264–275. doi: 10.1002/wcs.1393.

Soetjiningsih (2013). Konsep dasar tumbuh kembangan anak (The basic concept of children development). Jakarta: EGC.

Stolt S, Korja J, Matomaki H, Lapinleimu L, Haataja L(2014). Early relations between language development and the quality of motherchild interaction in verylowbirthweight children. Early Human Development. 90(5): 219–225. doi:10.1016/j.earlhumdev.2014.02.007.

Stoop C (2017).Children’s rights to mothertongue education in a multilingual world: A Comparative Analysis between South Africa and Germany. Journal Elektroniese Regsblad. doi: 10.17159/17273781/2017/v20i0a820.

Suparmiati A, Ismail DM (2013). Hubungan ibu bekerja dengan keterlambatan bicara pada anak (The relationship between working mothers and the delays in speech to children).Sari Pediatri. 14(5): 288–291. Available at:

Tan S, Irawan M, Wisnumurti DA (2019). Paediatrica Indonesiana. Pediatrica Indonesia. 52(5): 284–288.

Urke HB, Contreras M, Matanda, DJ (2018). The influence of maternal and household resources, and parental psychosocial child stimulation on early childhood development: A crosssectional study of children 36–59 months in Honduras. International Journal of Environmental Research and Public Health. 15(5).

Vaivada T, Gaffey MF, Bhutta ZA (2017). Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review. Pediatrics. 140 (2). doi: 10.1542/peds.20164308.

Verma S, Suman N, Verma P (2018). Effect of electronic gadgets on cognitive milestones of children below 2 years of age. Iaim. 5(6): 52–54.

Wijayanti A, Wekadigunawan C, Murti B. (2018). The Effect of Parenting Style, Bilingual School, Social Environment, on Speech and Language Development in Preschool Children in Surakarta, Central Java. Journal of Maternal and Child Health. 03(03):

–196. doi: 10.26911/thejmch.2018.03.03.03.


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