Making Auditory-Verbal Therapy Effective

15 January 2019

By: Shefali Shah

You are the most important element in the intervention for your hearing-impaired child. The key responsibility of the professionals who work with you and your family, will guide you to stay healthy, happy and well-rested so that your child receives the care s/he needs to develop spoken language skills. The pointers below will help you along.

Begin as close to birth as possible

The brain of the infant is most receptive to being sung and spoken to. Though it retains this plasticity (referred to as Neural Plasticity) as the baby grows, the pace at which the brain grows in response to auditory stimulation begins to slow down. The Longitudinal Outcomes of Children with Hearing Impairment, (LOCHI) study, shows that the progress of deaf children who received their cochlear implant/s at or before twelve months of age is significantly better than for those for whom intervention began later. Therefore, for those of you who want your baby with hearing impairment to learn and talk via listening alone, just like other children their age, it is critical that the intervention process begins as close to birth as possible.

Optimal amplification

Children will speak as clearly as they hear. Modern technology (hearing aids and/or cochlear implants) today is sufficiently sophisticated to make it possible for profoundly deaf children to talk clearly and to lead lives that their parents dreamed of for them.

When hearing impaired children do not speak clearly, we must examine the amplification to ensure that it is optimal. Optimal amplification allows your child to hear conversation in quiet, in noise and at a distance, clearly enough for him or her to understand and talk clearly. It is not enough merely to detect sound.

Technology however sophisticated, needs to be appropriate for your child’s hearing loss and it must be appropriately fitted. Your child’s audiologist will guide you to identify the amplification that is optimal for your child’s hearing loss. Your therapist will guide you to recognise your child’s responses to being spoken to, sung to and read to with this amplification.

Qualified audiologist and therapist

You are best supported when your child’s audiologist, therapist and other professionals working with your child, all have the skills and experience they need in working with babies and young children with hearing impairment and that they collaborate closely. They will partner you and your family as you work to raise your Auditory-Verbal child.

Clearly defined targets that are well understood

Your therapist will structure each week’s Auditory-Verbal therapy session around specific targets in audition, language, cognition, communication and speech that have been selected in light of your child’s current level of functioning.

Time spent discussing these targets to make sure that they are clearly understood, is well spent. Equally important is the discussion and brain-storming on how to generalise these targets within the context of your family and home situation, so that your daily schedule supports your child’s learning.

Generalising targets

The more varied one’s life experiences, the deeper the learning. I remember a child understanding the verb ‘to ride’ only in the context of a bicycle. When mother and I sat down to discuss this, she was surprised by how many more things could be ridden: bicycles, horses, ferris wheels, camels, bikes; even waves in the ocean!

Stay natural: Follow-up in the context of Play and Conversation

Young children learn best when information is both meaningful and relevant to them. Play and conversation provide the context in which this learning comes alive while continuing to be fun. Allow your therapist to weave session targets through well-chosen play activities that in and of themselves create the need to use or understand the chosen target. For example: Hide-n-seek is a wonderful game to reinforce the prepositions ‘under’ and ‘behind’.

Auditory-Verbal Therapy soon becomes a way of life for your family and everyone thrives!