AUDITORY VERBAL THERAPY
DEFINITION OF AVT
Auditory verbal therapy provides systematic instructions to
hearing impaired children and their parents.
Auditory: Children who are deaf learn how to listen.
Verbal: Children who are deaf learn how to talk.
Therapy: Parent/caregiver attends one to one lessons with
their child and learns how to teach their children in everyday
situations.
Auditory verbal therapy (AVT) is an early intervention
approach for the children who are deaf or hard of hearing
and are fitted with hearing devices in an early age.
It is
individualized therapy on one to one basis in a listening
environment. The goals are set in four areas of development
such as; audition language, speech and cognition. Parents
are partners in this program focused to develop spoken
language communication.
AVT emphasises the development
of listening and language through natural play, singing, daily
routines as well as structured therapy activities. AVT focuses
on education, guidance, family support and rigorous
application of techniques, strategies conditions and
procedures that promote optimal acquisition of spoken
language through listening.
PREREQUISITES OF AVT
• Early detection
• Appropriate use of hearing device
• One on one intervention with full parent involvement
• Absence of signs and speech reading training
• Integration with hearing peers
• On going diagnostic therapy.
THE GOALS OF AVT
The goal of auditory verbal practice is that children with
hearing impairment can grow up in regular learning and
living environments that enable them to become independent,
participating and contributing citizens in mainstream
society.14 The goals of AVT are for children to learn to
listen and talk to engage in meaningful conversation, to be
assimilated into regular school programs and to haveeducational, social and vocational choices throughout life.15
The goal of Auditory Verbal Therapy is to develop
conversation and competency in children.
SIGNIFICANCE OF AVT
Developing spoken language through listening requires an
ongoing commitment and dedication by all involved. Parents/
caregivers are the key players in their child’s development.
It is the parents who provide the wealth of spoken language
interaction on a one to one basis throughout the child’s
waking hours. They need to develop an understanding of
the different stages of Listening, Language, Speech and
Cognition. They need to know, understand and learn how
to develop listening skills through meaningful everyday
interaction with their child. This is the role of an AVT
therapist to help, guide and coach them in this area. When a
child is diagnosed with hearing impairment, parents will
seek a program to suit their goals and needs. When their
child is fitted with advance hearing devices, Auditory
Habilitation program is more logical to be followed. A family
centered auditory habilitation program has focus primarily
on providing parents and family members with skills,
knowledge and confidence to provide the best possible
auditory language learning environment for their child
through participation and practice. Therapist provides this
participation and practice to parents in customized one to
one auditory verbal sessions with their child. Such a program
is based on ongoing assessment of the child’s individual
needs.Parents learn about the different stages of Listening,
Language, Speech and Cognition. They also gain the skills
to use appropriate spoken language in play and other daily
activities.
They learn to capitalize on the many opportunities
for stimulating listening and language learning that arise in
natural interaction in the home (Listen, Learn and Talk,
Cochlear Hear now and Always).18
AVT can provide opportunities to many children who
are deaf or hard of hearing to learn to listen to process
spoken language and to talk. AVT promotes early detection
and diagnoses of hearing impairment, consistent use of
hearing device, individualized therapy and learning
environment where listening and spoken language are the
expected mode of communication.13
AVT helps parents to develop skills to become the
primary models for speech and language development. AVT
encourages the child to realize his auditory potential to learn
spoken language communication. AVT is individualized andtailored to the specific needs of the child and the family. It
is not a combination of formal exercises and is not conducted
in a group. The child’s auditory abilities develop because
emphasis is placed on listening throughout all the child’s
waking hours, “so that listening becomes an integral part of
his/her personality
(Cole et al, 2005).
The role of the family
in early intervention is essential to establish the child’s
preverbal skills, and for the parents and family to accept
the hearing impairment. The parents become confident in
their role as the primary language model and facilitator. All
these necessary elements of effective early intervention are
found in AVT.
STRUCTURE OF AVT
Whenever, the child learns to perform any task in a
structured activity or game, the task must then be integrated
into real life situations in order to be functional for him or
her. Parents/ caregivers and family members are the best
people to develop spoken language through listening in the
home, in the natural environment.
AVT encourages and
follows natural language and speech development through
play and active involvement in every day situations. Listening
becomes a way of life9
(Estabrooks and Samson, 1992).
AVT can be taken in a hospital, clinic, as private practice
and in a school. Auditory verbal therapist takes sessions
once or twice a week, for an hour with goals based on the
natural patterns of development of children with typical
hearing. In each AVT session, the therapist provides
coaching and guidance for the parents and diagnostic
assessment of the progress of the child. The therapist uses
strategies and techniques to maximise the auditory potential
of the child. Auditory verbal therapy is considered diagnostic
because it is the process of ongoing examination of the
individual child’s overall progress.
AVT is diagnostic as it
attempts to explain or establish the functional level of the
development of the child who is deaf or hard of hearing in
line with their hearing peers.
PREOPERATIVE HABILITATION
Preoperative habilitation is vital preparation for the continuing
auditory verbal habilitation after the surgery and switch on.
After switch on, the postoperative habilitation begins. The
electronic sound the child hears through the cochlear implant
is different from any acoustic sound the child may have
heard through their hearing aids.
VARIABLES AFFECTING OUTCOMES OF AVT
1. Age at diagnosis and implantation
2. Audiological management
3. Emotional state of the family
4. Child’s intelligence and development
5. Skills of the therapist
6 Family participation.
CONCLUSION
Scientific advances in hearing technology and recent trends
in family oriented therapy and education has provided great
opportunities for children who are deaf or hard of hearing
to acquire intelligible spoken language. Auditory verbal
therapy, as an applied science with objectively measured
goals, guides and supports parents in helping their child
learn to talk by listening to learn. Consequently, their child
can grow up with abundant choices in life.
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