Presentation on theme: "Early Identification and Effective Intervention: The Auditory-Verbal Approach Kathryn Wilson, M.A., CCC-SLP, Cert.AVT Sara Lake, B.A., J.D. February 20,"— Presentation transcript:
Early Identification and Effective Intervention: The Auditory-Verbal Approach Kathryn Wilson, M.A., CCC-SLP, Cert.AVT Sara Lake, B.A., J.D. February 20, 2004 Washington, D.C
Presentation Topics Auditory-Verbal Philosophy Principles of the Auditory-Verbal Approach How A-VT Differs From Other Approaches, Interventions, and Therapies Outcomes How to Access A-VT Services, Professional Training & Certification Case Presentation
Auditory-Verbal Philosophy Auditory-Verbal International, Inc. Position Statement The Auditory-Verbal philosophy is a logical and critical set of guiding principles. These principles outline the essential requirements needed to realize the expectation that young children who are deaf or hard of hearing can be educated to use even minimal amounts of amplified residual hearing.
Use of amplified residual hearing in turn permits children who are deaf or hard of hearing to learn to listen, process verbal language, and to speak.
The goal of Auditory-Verbal practice is that children who are deaf or hard of hearing can grow up in regular learning and living environments enabling them to become independent, participating, and contributing citizens in mainstream society.
The Auditory-Verbal philosophy supports the basic human right that children with all degrees of hearing impairment deserve an opportunity to develop the ability to listen and to use verbal communication within their family and community constellations.
Tori Fraternal twin Familial history of hearing loss Passed NHS Age at identification:15 months First hearing aid fitting: 16 months Began AVT at 18 months Cochlear Implant at 4 years of age Video:C.A. 8 yrs, 3 mo, 4 yrs post CI
Expected Results of NHS and Technological Advances: Average age of identification will decrease Greater access to information about all communication approaches Number of families seeking A-VT will increase Need for Certified Auditory-Verbal Therapists will increase More children will develop spoken language through the Auditory-Verbal approach
Principles of Auditory-Verbal Practice Adapted from Pollack, D. (1985) & Ling, D. et.al (2003)
Aggressive Audiological Management In an A-V approach : Pursuit of best amplification AVI Protocol for Audiological and Hearing Aid Evaluation
Suggested Protocol for Audiological and Hearing Aid Evaluation Adapted from AVI, 2003 Audiological Test Procedures Amplification Assessment Sound Field Aided Response Probe Microphone Measures FM Systems Frequency of Assessment Reports
Appropriate Amplification Technology Hearing Aids Cochlear Implants FM Systems In an A-V approach Therapist must possess and apply in-depth knowledge of speech acoustics
Favorable Auditory Learning Environments In an A-V approach All therapy is one-to-one Sessions are usually one time weekly for 1 hr. to 1 hr. 30 minutes. Best conditions for verbal learning are provided
At no time in a childs life are the physical and acoustic conditions as favorable for listening as in early infancy. Daniel Ling, Ph.D
Integrating Talking and Listening into ALL Aspects of Daily Life In an A-V approach Audition is the primary sensory modality Use of hearing for language acquisition is unique to AVT Emphasis on auditory learning vs. auditory training
Ongoing Assessment, Evaluation & Prognosis In an A-V approach All therapy is DIAGNOSTIC An average or better than average rate of progress is expected
Inclusion In Regular Schools In an A-V approach Mainstream education is a critical component Parents and AVT work in partnership to secure appropriate services and placement Similar expectations are established for children who are deaf/hh and those with normal hearing
Parents and/or Principal Caregivers as Primary Teachers In an A-V approach Parents actively participate in ALL sessions The parent is the primary student during therapy sessions The parent is the primary teacher in day- to-day life
Integration of Speech, Language, Audition and Cognition In an A-V approach The normal developmental sequence is followed Childs hearing age serves as the baseline vs. chronological age
An Auditory-Verbal approach embraces ALL the Principles
Outcomes in Auditory-Verbal Therapy Wray, Flexer & Saunders (1996) Followed 19 children, ranging in age from kindergarten through 10th grade. 84% reading on grade level At an early age, all were mainstreamed with hearing children.
Outcomes in Auditory-Verbal Therapy Robertson & Flexer (1998) Followed 54 school age children 81% Mainstreamed totally in the regular school 19% Mainstreamed partially 43% Read better than average hearing child 43% Read on the same level as the average hearing child 9% Read below average 5% Did not provide reading skill information
Outcomes in Auditory-Verbal Therapy Goldberg & Flexer (2001) Surveyed 114 graduates of A-V programs in the U.S. & Canada 94% had severe-to-profound or profound hearing loss 95% had hearing loss at birth or before 3 yrs. of age
Outcomes in Auditory-Verbal Therapy Goldberg & Flexer (2001) (n=114) Education 86% mainstreamed in elementary school 86% mainstreamed in middle or high school 91% mainstreamed in their senior high school year 78% attended a typical college or university program
How to Access A-V Services Auditory-Verbal International,Inc. (AVI) A-V Therapy has been practiced by pioneers since the 1940s and 1950s With more widespread early identification and improved technology, A-V Therapy is an option increasingly chosen by parents Luetke-Stahlman & Moeller (1987) 90% of parents of children with hearing impairment are typically hearing individuals
How to Access A-V Services AVI is a worldwide membership association and information clearinghouse regarding the Auditory- Verbal approach located in the Greater Washington, D.C. area
How to Access A-V Services AVI founded in 1987 by three visionaries: Daniel Ling, Doreen Pollack & Helen Beebe who believed audition should be the primary sensory modality for the acquisition of language for most children with hearing impairment
How to Access A-V Services AVI offers a complete listing of all Certified Auditory-Verbal Therapists as well as other practitioners in the approach; and Information regarding the approach, membership & free literature as well as A-V publications
How to Access A-V Services Through the AVI website, Or by contacting AVI at or (703)
Certification in A-V Therapy AVI administers an international certification program in the A-V approach with certified professionals on 5 continents Currently, Certified Auditory-Verbal Therapists in 33 of the United States
Certification in A-V Therapy International Certified Auditory-Verbal Therapists are in Europe, China, the Middle East, the Far East and Latin America Current certification standards and applications can be downloaded from the AVI website at:
Professional Training in A-VT Discipline of Auditory-Verbal Therapy is a hybrid one; combines elements of audiology, speech-language pathology & education of the deaf Also includes elements of other disciplines such as parent guidance, child development and technology Approach also a highly practical one
Professional Training in A-VT Proficiency in the approach involves both academic rigor and practical training
Professional Training in A-VT Training Opportunities AVI Standardized Curriculum (2001) & AVI Mentor Referral Service Refers professionals seeking A-V training to certified professionals providing such training; Part of mentorship can be accomplished through video observation and critique
Professional Training in A-VT Auditory-Verbal Learning Institute (AVLI) Offering quality A-V Distance Education products through an independent, yet AVI-affiliated institute Products include CD-ROMs with lecture and A-V demonstrations, videos, parent kits and other A-V publications
Professional Training in A-VT Auditory-Verbal Learning Institute (AVLI) 7205 N. Habana Ave. Tampa, FL Phone: (813) Web:
Professional Training in A-VT AVI International Conferences Auditory-Verbal Techniques & Strategies: A Professional Training May 26, 2004 Como, Italy Cert.AVTs Judith Simser & Tina Olmstead Immediately prior to NHS2004 AVI Biennial International Conference Summer 2005 Toronto, Canada
Professional Training in A-VT Professional Training Weeks at Auditory-Verbal Centers Auditory-Verbal Center of Atlanta (AVCA) Bolesta Center, Tampa, Florida Hear & Say Centre, Brisbane, Australia Learning to Listen Foundation, Toronto, Canada
Professional Training in A-VT Auditory-Verbal specialization at the Masters level (degree in audiology, SLP, education of the deaf) as part of the Ling Institute at the University of Ottawa in Canada
How to Access A-VT Services, Training & Certification Auditory-Verbal International, Inc Eisenhower Avenue, Suite 402 Alexandria, VA USA (703)
Case Presentation C.A. 17 months CI Age 6 months A-V Age: 11 months Age at Identification: 3 months Degree of H.L. Profound Etiology: Genetic Age at Implantation 12 months Hearing Aid Use Consistent use from 4 months of age Device: Clarion Co-existing Conditions None Educational Placement At home with mother until age 5/mainstream kindergarten
Discussion The Principles of A-VT outline the essential components for young children to develop intelligible spoken language through listening. The role of audition in processing spoken language and parents as primary models are two major differences in A-VT from other approaches.
Discussion Research supports the efficacy of the Auditory-Verbal approach. Information regarding the Auditory-Verbal approach, certification, and professional training is available through Auditory-Verbal International, Inc.
Conclusions Children identified early and enrolled in Auditory-Verbal Therapy can acquire developmentally appropriate communication skills. Auditory-Verbal Therapy is an effective intervention for newly identified infants, toddlers, and children whose parents have chosen spoken language as the desired communication outcome.