Auditory Verbal Therapy: Part 10

Auditory Verbal Therapy: Part X

Principle X

Promote education in regular classrooms with typical hearing peers and with appropriate support services from early childhood onwards.

We're talking mainstreaming.  Children who are born deaf can definitely be placed in a regular classroom with hearing peers.  This is happening more and more often.  Parents and professionals should plan and prepare for this if they think it is a good fit for the child.  Many children who are born deaf are also born with other challenges such as Down syndrome or cerebral palsy and may require a specialized setting.  Work as a team to figure out what is reasonable.  Teamwork will be necessary.  The team should consist of: the parent, speech therapist, audiologist, classroom teacher, principle, resource teacher, and AV therapist.  Am I missing anybody?

Auditory Verbal Therapy: Part 9

Auditory Verbal Therapy: Part IX

Principle IX

Administer ongoing formal and informal diagnostic assessments to develop individualized Auditory-Verbal treatment plans, to monitor progress, and to evaluate the effectiveness of the plans for the child and family.

Every therapy session should be diagnostic in nature.  This means that the therapist should always be alert to the child's progress and performance in listening, language, and speech.  Standardized tests should always be administered every 6 months.  A great standardized test that looks at listening, language, and speech is the Cottage Acquisition Scale for Listening, Language, and Speech (CASLLS).  

Auditory Verbal Therapy: Part 8

Auditory Verbal Therapy: Part VIII

Principle VIII

Guide and coach parents to help their child self-monitor spoken language through listening.

Parents are encouraged to imitate any noises the child makes.  This can be a very fun game for mom and baby, and it helps develop the auditory feedback loop.  The child needs to have the skills of listening to what other people say, and repeat it.  This then transfers into the child being able to listen to their own speech and modify it.  This strength is crucial to developing proper speech and language skills.  All this from saying, "Goo goo" and "ba ba ba" and "mee mee mee"?  You betcha!

Auditory Verbal Therapy: Part 7

Auditory Verbal Therapy: Part VII

Principle VII

Guide and coach parents to use natural developmental patterns of audition, speech, language, cognition, and communication.

I think the key word here is expectations.  Parents need to understand that children follow a developmental sequence with regards to language, cognition, and speech.  The child needs to continue on that developmental path.  We can't skip steps.  We can certainly move through them more quickly, and we hope to catch them up to their peers, but there are no shortcuts.

 Another key concept is hearing age.  We have to take into account how long the child has been hearing.  AN important thing to understand is that listening and speech develop together - not separately.  This article is my favorite reference for further discussion on these important concepts.

Auditory Verbal Therapy: Part 6

Auditory Verbal Therapy: Part VI

Principle VI

Guide and coach parents to help their child integrate listening and spoken language into all aspects of the child's life.

Children born with hearing loss, especially if it is amplified late, are not natural listeners.  It needs to become a habit.  And habits can be taught!  Parents need to learn how to take advantage of everyday listening moments and capitalize on them.  For example, the mom and baby are playing with blocks and the doorbell rings. She could just get up and go answer the door, but she would be missing out on a great learning opportunity.  Mom should sit up straight and announce, "I heard something!" and point to her ear.  She is teaching the child to notice sounds as they occur around her.  She is also teaching her that sounds go through the ear/hearing aid/implant thus teaching the child the importance of the device that they wear and its connection with noises. 

Auditory Verbal Therapy: Part 5

Auditory Verbal Therapy: Part V

Principle V

Guide and coach parents to create environments that support listening for the acquisition of spoken language throughout the child's daily activities.

Dishwashers are loud.  So are air conditioners and fans and fish tanks and lights and washing machines.  A house can be a loud and distracting place, especially for a child with a hearing loss.  They need to hear conversations happening around them in order to learn language, and background noise makes that so much more difficult.  Therefore a big part of AV therapy is educating parents to be more aware of the noises that surround them and convince them how important it is to reduce it as much as possible.  Run the dishwasher at night.  Same with the dryer and washer.  If your lights hum (like the ones in my kitchen - so obnoxious) then just leave them off.  Classrooms are a totally different story but most teachers are open to trying whatever they can to help the classroom be a quieter place.  After all, it improves learning for all children, not just the ones with hearing loss (Nelson, Soli 2000).

Auditory Verbal Therapy: Part 4

Auditory Verbal Therapy: Part IV

Principle IV

Guide and coach parents to become the primary facilitators of their child's listening and spoken language development through active, consistent participation in individualized Auditory-Verbal therapy.

Auditory Verbal Therapy is a big commitment for the whole family.  Most therapists I know have a serious discussion with the parents before they start therapy in order to make sure that they know it will require lots of time and effort. Still, most parents I've met are happy to be involved and learn more.  They feel validated to know that lots of the things they are doing at home already (reading books, singing songs, telling stories) are providing necessary foundations for their child's learning.  They just need to be taught some strategies and skills to use along with those activities that can help strengthen specific skills such as: listening, articulation, auditory memory, sequencing, categorizing, and many more.

Auditory Verbal Therapy: Part 3

Auditory Verbal Therapy: Part III

Principle III

Guide and coach parents to help their child use hearing as the primary sensory modality in developing spoken language without the use of sign language or emphasis on lipreading.

This might be a therapist or a mom, but whoever it is they are doing it right!  She knows to talk next to but not in front of the child.  She is optimizing listening and inhibiting visual cues.

Guiding, coaching and teaching parents is a big deal.  In fact, my experience with AVT has really helped me realize the power of empowering parents in any type of therapy. Who knows the child the best?  Who spends the most time with them?  Who wants what is best for them?  Who has hopes and dreams for this child?  The PARENTS.  Therefore they are the center of AVT.  When the parents feel knowledgeable and confident, the child's is more successful and the parents no longer feel like helpless bystanders.  The importance of this is reflected in the fact that principles 4-8 also revolve around coaching the parents.

Auditory Verbal Therapy: Part 2

Principle II

Recommend immediate assessment and use of appropriate, state-of-the-art hearing technology to obtain maximum benefits of auditory stimulation.

A child born with a hearing loss should be fitted for hearing aids as soon as possible to receive auditory stimulation.  The early years are the most crucial.  The first 3 1/2 years of life are when neuroplasticity is at its greatest, meaning the brain is the most adaptable.  The younger the child, the more adaptable the brain and the easier it will be for them to learn to listen and talk.  Therefore, the older the child, the more difficult it is because the auditory centers of the brain have begun to reorganize themselves. (Sharma et al., 2002; 2004; Sharma, Dorman, and Kral, 2005).

Auditory Verbal Therapy: Part 1

Principle I

Promote early diagnosis of hearing loss in newborns, infants, toddlers, and children, followed by immediate audiologic management and Auditory-Verbal Therapy.

Most states have implemented a newborn hearing screening program in which many types of hearing loss can be detected.  We need to ensure that when a child is identified with a hearing loss, the family is educated regarding all of their options and that appropriate follow-up is established.  A child can be fitted with a hearing aid as early as one month: the time it takes for a complete audiological exam, molds to be made, and the hearing aid to be ready for the child.

Auditory Verbal Therapy Series: Introduction

Fact:  90-95% of children with hearing loss are born to hearing parents (Mitchell & Karchmer, 2004).  This fact means that most parents who have a child with hearing loss don't know any sign language and would like their child to learn to listen and use spoken language.  With today's technology that is possible!  Which means many parents are choosing Auditory Verbal Therapy because the possibilities that it provides most closely match their hopes and dreams for their child.  I've decided to do a series on the principles of Auditory Verbal Therapy because it is still a relatively unknown area.  I studied these principles very closely in college and someday would like to become one of the current 600 Listening and Spoken Language Specialists.  It's quite the process but I'll get there eventually!  

Join me tomorrow as I discuss Principle I of Auditory Verbal Therapy!