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
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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
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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.

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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.

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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.

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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
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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
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Video: C.A. 8 yrs, 3 mo, 4 yrs post CI

Expected Results of NHS and
Technological Advances:
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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
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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
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Audiological Test Procedures
Amplification Assessment
Sound Field Aided Response
Probe Microphone Measures
FM Systems
Frequency of Assessment
Reports

Appropriate Amplification
Technology
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Hearing Aids
Cochlear Implants
FM Systems
In an A-V approach
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Therapist must possess and apply in-depth knowledge of speech acoustics

Favorable Auditory Learning
Environments
In an A-V approach
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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

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“At no time in a child’s life are the physical and acoustic conditions as favorable for listening as in early infancy.”
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Daniel Ling, Ph.D

Integrating Talking and Listening into ALL Aspects of Daily Life
In an A-V approach
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Audition is the primary sensory modality
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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
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All therapy is DIAGNOSTIC
An average or better than average rate of progress is expected

Inclusion In Regular Schools
In an A-V approach
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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
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Parents actively participate in ALL sessions
The parent is the primary student during therapy sessions
The parent is the primary teacher in dayto-day life

Integration of Speech, Language,
Audition and Cognition
In an A-V approach
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The normal developmental sequence is followed
Child’s hearing age serves as the baseline vs. chronological age

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An Auditory-Verbal approach embraces ALL the Principles

Outcomes in Auditory-Verbal
Therapy
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Wray, Flexer & Saunders (1996)
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Followed 19 children, ranging in age from kindergarten through 10th grade.
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84% reading on grade level
At an early age, all were mainstreamed with hearing children.

Outcomes in Auditory-Verbal
Therapy
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Robertson & Flexer (1998)
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Followed 54 school age children
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81% Mainstreamed totally in the regular school
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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
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Goldberg & Flexer (2001)
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Surveyed 114 graduates of A-V programs in the U.S. & Canada
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94% had severe-to-profound or profound hearing loss
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95% had hearing loss at birth or before 3 yrs. of age

Outcomes in Auditory-Verbal
Therapy
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Goldberg & Flexer (2001) (n=114)
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Education
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86% mainstreamed in elementary school
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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
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Auditory-Verbal International,Inc.
 (AVI)
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A-V Therapy has been practiced by pioneers since the 1940s and 1950s
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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
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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
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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
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AVI offers a complete listing of all
Certified Auditory-Verbal Therapists as well as other practitioners in the approach; and
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Information regarding the approach, membership & free literature as well as
A-V publications

How to Access A-V Services
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Through the AVI website, www.auditory-verbal.org
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Or by contacting AVI at
audiverb@aol.com or (703) 739-1049

Certification in A-V Therapy
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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
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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: www.auditory-verbal.org/certification

Professional Training in A-VT
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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
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Proficiency in the approach involves both academic rigor and practical training

Professional Training in A-VT
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Training Opportunities
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AVI Standardized Curriculum (2001)
& AVI Mentor Referral Service
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Refers professionals seeking A-V training to certified professionals providing such training;
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Part of mentorship can be accomplished through video observation and critique

Professional Training in A-VT
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Auditory-Verbal Learning Institute
(AVLI)
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Offering quality A-V Distance Education products through an independent, yet AVI-affiliated institute
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Products include CD-ROMs with lecture and A-V demonstrations, videos, parent kits and other A-V publications

Professional Training in A-VT
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Auditory-Verbal Learning
Institute (AVLI)
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7205 N. Habana Ave.  Tampa, FL 33614
Phone: (813) 932-5209
E-mail: clisenby@avli.org
Web: www.avli.org

Professional Training in A-VT
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AVI International Conferences
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“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
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Professional Training Weeks at
Auditory-Verbal Centers
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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
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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
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Auditory-Verbal International, Inc.
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2121 Eisenhower Avenue, Suite 402
Alexandria, VA 22314 USA
(703) 739-1049  audiverb@aol.com

Case Presentation
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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
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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
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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
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Research supports the efficacy of the
Auditory-Verbal approach.
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Information regarding the Auditory-Verbal approach, certification, and professional training is available through Auditory-Verbal
International, Inc.

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Conclusions
Children identified early and enrolled in
Auditory-Verbal Therapy can acquire developmentally appropriate communication skills.
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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.

Questions?