AUDITORY VERBAL THERAPY

The rehabilitative goal for young children is to maximize the auditory system’s
access to sound to ensure the best possible hearing for the development of oral
language and speech. The specific aims are to provide the best amplification
possible, supplemented with hearing assistive technology when indicated, and to
provide maximum exposure to language stimulation opportunities.
Children should always be fitted with binaural hearing aids unless contraindicated
by medical factors or extreme hearing asymmetries. The goal is to maximize
residual hearing, and two ears will accomplish that better than one.
Once the hearing aid has been fitted, treatment begins. Depending on the degree of
hearing loss, intensive auditory training, language stimulation, and speech therapy
are introduced in an effort to maximize language development.
Formerly referred to as unisensory or Acoupedics, the auditory-verbal philosophy
is based entirely on the use of audition and early amplification with hearing aids.
This method stresses the auditory channel as the means for the development of
spoken receptive and expressive communication skills.
The first 3 years of life are critical to a child’s general development, especially
with respect to communication, and the parents of young handicapped children
often lack the skills necessary to optimize family-infant interactions, which could
facilitate the child’s communication development.. In addition to espousing early
identification and intervention, AVT includes family support for parents and
members of the child’s extended family. Information exchange, demonstration
teaching (in which the family explores a variety of strategies to assist the child in
achieving communication), and educational advocacy for the parents are also
frequently included. The latter entails helping the parents to become effective
consumers of services and knowledgeable child advocates. An important
component of a parent-infant curriculum is audiologic management and
amplification. Here the emphasis is on helping the child to develop his or her
auditory potential. Emphasis is placed on further clarification of the nature of the
hearing loss, selection of amplification, and the development of full-time hearing
aid use.
It involves an organized sequential approach to the development of listening skills.
Here, the emphasis is on developing a program of auditory training experiences
that will guide the parents through a developmental sequence for their child that
parallels the development of auditory perceptual skills in the normal-hearing
infant.
The hierarchy of skills can be divided into the following levels:
1. Auditory perception of both environmental sounds and the human voice
2. Awareness of environmental sounds and the human voice as conveyors of
information and association of sounds with their physical sources
3. Development of an auditory-vocal feedback mechanism in which the child
monitors his or her own speech 4. Comprehension of meaning in syllables, words,
phrases, and sentences
5. Increasing verbal comprehension and the emergence of auditory memory and
sequencing skills
Another important component of AVT is vocal play strategies for speech
habilitation. The initiation and maintenance of vocal behavior is a major area of the
early-intervention program that is critical to young children. Full time use of
amplification is important so that the child with hearing loss can hear his or her
own speech as well as the speech of others. The use of an auditory program to
enhance the use of the auditory feedback mechanism is also important. Further,
parents are taught to use vocal play interaction techniques that are necessary for the
development of prelinguistic speech skills. Parents must also learn to develop
strategies that facilitate social and communicative turn taking. Finally, there are the
verbal interaction techniques of language programming. At this point, the focus is
on teaching the parent communicative interaction styles, particularly verbal
interaction patterns, which enhance the child’s acquisition of language. Linguistic
development is maximized by training parents to incorporate the principles of
adult-child interaction patterns that are reported to occur during the language
acquisition of normal children.
Through play-based therapy sessions, parents are given the tools – Auditory Verbal
techniques and strategies – to develop their child’s listening and spoken language.
Auditory Verbal therapy enables parents to help their child to make the best
possible use of his or her hearing technology and equips parents to check and
troubleshoot it in collaboration with their audiology team. This will maximise a
child’s access to sound so that listening and spoken language skills can be
developed to the fullest extent possible.
Through play-based sessions using the Auditory Verbal approach, the child
develops a listening attitude so that paying attention to the sound around him or her
becomes automatic. Hearing and listening become an integral part of
communication, play, education and eventually work. All learning from the
sessions carries over into daily life. This means that at home, parents can make
everyday activities such as setting the table or reading a story into a fun listening
and learning opportunity.
 AVT concentrates on developing the listening part of the brain (the auditory
cortex) rather than relying solely or partly on visual cues. There is a narrow
window within which to develop the brain as a listening brain (rather than
predominantly a visual brain, for example), and AVT seeks to make the
most of this window of neural plasticity in the first three and a half years of
life.
 AVT focuses on coaching the parents or carers of the child in the use of
Auditory Verbal strategies and techniques in everyday activities and play so
that every opportunity is used to develop their child’s listening brain and
spoken language skills.  
 AVT is an early intervention programme. By working intensively with the
child in their first few years they should require much less additional support
for the rest of their life. 
 AVT aims to develop the child’s social skills and theory of mind; the ability
to understand that their mind differs from another’s.  This prepares them to
make and keep friends at school
References:
 Audiology- Fundamentals(  Fred H. Bess and Larry Humes)
 Clinical Audiology An Introduction(Brad A Stach)
 Introduction to Audiologic Rehabilitation(Ronald L. Schow, Michael A.
Nerbonne)
 https://www.avuk.org/what-is-auditory-verbal-therapy