Presentation on theme: "Kathryn Wilson, M.A., CCC-SLP, Cert.AVT"— Presentation transcript:
1 Kathryn Wilson, M.A., CCC-SLP, Cert.AVT Early Identification and Effective Intervention: The Auditory-Verbal ApproachKathryn Wilson, M.A., CCC-SLP, Cert.AVTSara Lake, B.A., J.D.February 20, 2004Washington, D.C
2 Presentation Topics Auditory-Verbal Philosophy Principles of the Auditory-Verbal ApproachHow A-VT Differs From Other Approaches, Interventions, and TherapiesOutcomesHow to Access A-VT Services, Professional Training & CertificationCase Presentation
3 Auditory-Verbal Philosophy Auditory-Verbal International, Inc Auditory-Verbal Philosophy Auditory-Verbal International, Inc. Position StatementThe 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.
4 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.
5 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.
6 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.
7 Tori Fraternal twin Familial history of hearing loss Passed NHS Age at identification: 15 monthsFirst hearing aid fitting: 16 monthsBegan AVT at 18 monthsCochlear Implant at 4 years of ageVideo: C.A. 8 yrs, 3 mo, 4 yrs post CI
8 Expected Results of NHS and Technological Advances: Average age of identification will decreaseGreater access to information about all communication approachesNumber of families seeking A-VT will increaseNeed for Certified Auditory-Verbal Therapists will increaseMore children will develop spoken language through the Auditory-Verbal approach
9 Principles of Auditory-Verbal Practice Adapted from Pollack, D. (1985) & Ling, D. et.al (2003)
10 Aggressive Audiological Management In an A-V approach:Pursuit of best amplificationAVI Protocol for Audiological and Hearing Aid Evaluation
11 Suggested Protocol for Audiological and Hearing Aid Evaluation Adapted from AVI, 2003 Audiological Test ProceduresAmplification AssessmentSound Field Aided ResponseProbe Microphone MeasuresFM SystemsFrequency of AssessmentReports
12 Appropriate Amplification Technology Hearing AidsCochlear ImplantsFM SystemsIn an A-V approachTherapist must possess and apply in-depth knowledge of speech acoustics
13 Favorable Auditory Learning Environments In an A-V approachAll therapy is one-to-oneSessions are usually one time weekly for 1 hr. to 1 hr. 30 minutes.Best conditions for verbal learning are provided
14 “At no time in a child’s life are the physical and acoustic conditions as favorable for listening as in early infancy.”Daniel Ling, Ph.D
15 Integrating Talking and Listening into ALL Aspects of Daily Life In an A-V approachAudition is the primary sensory modalityUse of hearing for language acquisition is unique to AVTEmphasis on auditory learning vs. auditory trainingAudition is the primary sensory modality for learning spoken languageIn an A-V approach, the child is in touch with his world through all his senses. He is a 5-sensed person.Attention is not directed to lipreading or use of tactile cues in order to develop or enhance the child’s listening skills. Visual or tactile information is provided only after the child is given opportunities to process thru hearing.Emphasis on auditory learning….Many of us have done Auditory training—specific exercises and activities designed to improve auditory skills—often taught in conjunction with other approachesIn A-V listening is used all day everyday—not just during a training sessionLing stated that the difference in auditory training and A-V is “teaching children to hear” vs “giving children reasons to learn to listen”—accomplished thru meaningful purposeful activities and life experiences.
16 Ongoing Assessment, Evaluation & Prognosis In an A-V approachAll therapy is DIAGNOSTICAn average or better than average rate of progress is expected
17 Inclusion In Regular Schools In an A-V approachMainstream education is a critical componentParents and AVT work in partnership to secure appropriate services and placementSimilar expectations are established for children who are deaf/hh and those with normal hearing
18 Parents and/or Principal Caregivers as Primary Teachers In an A-V approachParents actively participate in ALL sessionsThe parent is the primary student during therapy sessionsThe parent is the primary teacher in day-to-day life
19 Integration of Speech, Language, Audition and Cognition In an A-V approachThe normal developmental sequence is followedChild’s hearing age serves as the baseline vs. chronological age
20 An Auditory-Verbal approach embraces ALL the Principles
21 Outcomes in Auditory-Verbal Therapy Wray, Flexer & Saunders (1996)Followed 19 children, ranging in age from kindergarten through 10th grade.84% reading on grade levelAt an early age, all were mainstreamed with hearing children.
22 Outcomes in Auditory-Verbal Therapy Robertson & Flexer (1998)Followed 54 school age children81% Mainstreamed totally in the regular school19% Mainstreamed partially43% Read better than average hearing child43% Read on the same level as the average hearing child9% Read below average5% Did not provide reading skill information
23 Outcomes in Auditory-Verbal Therapy Goldberg & Flexer (2001)Surveyed 114 graduates of A-V programs in the U.S. & Canada94% had severe-to-profound or profound hearing loss95% had hearing loss at birth or before 3 yrs. of age
24 Outcomes in Auditory-Verbal Therapy Goldberg & Flexer (2001) (n=114)Education86% mainstreamed in elementary school86% mainstreamed in middle or high school91% mainstreamed in their senior high school year78% attended a typical college or university program
25 How to Access A-V Services Auditory-Verbal International,Inc. (AVI)A-V Therapy has been practiced by pioneers since the 1940s and 1950sWith more widespread early identification and improved technology, A-V Therapy is an option increasingly chosen by parentsLuetke-Stahlman & Moeller (1987) % of parents of children with hearing impairment are typically hearing individuals
26 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
27 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
28 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; andInformation regarding the approach, membership & free literature as well as A-V publications
29 How to Access A-V Services Through the AVI website,Or by contacting AVI at or (703)
30 Certification in A-V Therapy AVI administers an international certification program in the A-V approach with certified professionals on 5 continentsCurrently, Certified Auditory-Verbal Therapists in 33 of the United States
31 Certification in A-V Therapy International Certified Auditory-Verbal Therapists are in Europe, China, the Middle East, the Far East and Latin AmericaCurrent certification standards and applications can be downloaded from the AVI website at:
32 Professional Training in A-VT Discipline of Auditory-Verbal Therapy is a hybrid one; combines elements of audiology, speech-language pathology & education of the deafAlso includes elements of other disciplines such as parent guidance, child development and technologyApproach also a highly practical one
33 Professional Training in A-VT Proficiency in the approach involves both academic rigor and practical training
34 Professional Training in A-VT Training OpportunitiesAVI Standardized Curriculum (2001) & AVI Mentor Referral ServiceRefers professionals seeking A-V training to certified professionals providing such training;Part of mentorship can be accomplished through video observation and critique
35 Professional Training in A-VT Auditory-Verbal Learning Institute (AVLI)Offering quality A-V Distance Education products through an independent, yet AVI-affiliated instituteProducts include CD-ROMs with lecture and A-V demonstrations, videos, parent kits and other A-V publications
36 Professional Training in A-VT Auditory-Verbal Learning Institute (AVLI)7205 N. Habana Ave. Tampa, FL Phone: (813) Web:
37 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 NHS2004AVI Biennial International Conference Summer Toronto, Canada
38 Professional Training in A-VT Professional Training Weeks at Auditory-Verbal CentersAuditory-Verbal Center of Atlanta (AVCA)Bolesta Center, Tampa, FloridaHear & Say Centre, Brisbane, AustraliaLearning to Listen Foundation, Toronto, Canada
39 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
40 How to Access A-VT Services, Training & Certification Auditory-Verbal International, Inc. Eisenhower Avenue, Suite Alexandria, VA USA (703)
41 Case Presentation C.A. 17 months CI Age 6 months A-V Age: 11 months Age at Identification:3 monthsDegree of H.L.ProfoundEtiology: GeneticAge at Implantation12 monthsHearing Aid UseConsistent use from 4 months of ageDevice: ClarionCo-existing ConditionsNoneEducational PlacementAt home with mother until age 5/mainstream kindergarten
42 DiscussionThe 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.
43 DiscussionResearch 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.
44 ConclusionsChildren 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.