Click HEREfor a PDF of this article from UNC School of Medicine Ear & Hearing Center.
An auditory-based therapist can consist of three professionals: audiologist, speech-
language pathologist and/or a teacher of the hearing impaired. However, it is important to
know that not everyone in these professions has received training and/or has experience
in developing spoken language through listening. As parents, you are the most
important advocates for your child. You must ensure that the therapist/teacher working
with your child is qualified. The following are questions to help:
Is the therapist focused on helping the child acquire and use auditory information,
and does the therapist expect the child to gain most information through listening?
Does the therapist: • Draw the child’s attention to new and novel sounds?
• Include different types of listening activities, use whispered speech and recorded speech and music, help your child discriminate sounds and speech in
noisy and quiet environments • Observe and coach you as you speak to or work with your child, pointing
out problems and solutions and teaching you how to make sound meaningful
to your child all day long
Is the therapist aware of how the environment affects listening?
Does the therapist: • Explain how background noise can interfere with understanding • Instruct you about how to care for and maintain hearing aids/ FM systems/
cochlear implants, check batteries and do listening checks? • Require your child be seen for periodic checks of the hearing technology? • Suggest that family members become good monitors of the auditory
environment and support the attitude that parents expect the child to hear? • Work to help the child be aware of his/her own voice so that they work to match
what he/she says with he/she hears others say
Does the therapist encourage the parent to think of the child’s speech and
language in terms of normal development?
Does the therapist: • Talk naturally with the child, speaking without exaggerated facial
movements (especially mouth and tongue) and without sign language? • Emphasize the sounds of speech in games of vocal play the way that mothers do
with infants who hear normally?
• Have high expectations for the child to eventually learn to follow speech
through his/her hearing aids or cochlear implant and learn to talk? • Use auditory age-appropriate language? • Use natural expressions appropriate to the child’s age and language level? • Use familiar books, nursery rhymes, songs, and other culturally based materials
in therapy? • Have knowledge of the levels of normal developing speech and language and base explanations of your child’s progress on these developmental models? • Explain language, speech, and listening in parent-friendly language? • Understand, use and teach effective listening strategies, such as pausing in expectation of hearing something meaningful. • Encourage the your child to use babbling and jargon as normal hearing infants do, rather than push the child to imitate speech sounds, syllables or words? • Help your child participate educationally and socially with children who have normal hearing by supporting them in regular education classes
Does the therapist have a good understanding of how children learn through their
Does the therapist: • Note instances when your child has perceived some meaningful aspect of sound
and draw this to the parent’s attention • Encourage the child to develop an auditory memory for familiar sounds in the
environment and familiar voices, and provide opportunities to use developing
auditory memory skills? • Avoid touching or tapping the child to obtain his or her attention and speaking
to your child even when his/her eyes are focused away from the clinicians’ face
•Repeat a message auditorilly, if vision was first needed to gain the child’s
attention or used to help the child understand?
Does the therapist demonstrate a positive relationship with parents, family and
child and is the therapist concerned about developing a healthy, informative, and
supportive parent guidance program?
Does the therapist:
• Encourage you to ask questions regarding what the therapist is doing without
making you feel uncomfortable? • Encourage parents to meet other families and adults who live with profound
• Discuss weekly goals in terms of long-term goals so that parents understand
how auditory processes are developed over time? • Encourage parents to be objective about their child and his/her program and
discourage feelings of dependency upon the therapist?
• Explain all these things in words that you understand?
A Parent’s Guide to Auditory-Verbal Therapy, The Auditory-Verbal Network,
Inc., Denver, CO, 1988
50 Frequently Asked Questions about Auditory-Verbal Therapy, response by
Marian Ernst, M.A., CCC-SLP-A, Cert. AVT, Edited by W. Estabrooks
·Detection is the
ability to respond to the presence or absence of sound. It is the essential first step in learning to
·Detection may be
achieved through conditioned play response or spontaneous alerting response.
·Conditioned play response requires the
child to perform an action upon hearing a sound. (Example: placing a block in a bucket,
stacking rings on a pole, or putting a plastic animal in a bucket of water)
oThe activity is first
demonstrated for the child. After the
therapist has demonstrated and assisted the child in completing the activity
multiple times, the child is then encouraged to complete the activity himself
·Spontaneous alerting response includes
behaviors such as: searching for the sound, turning eyes or head toward the
sound, or vocalizing.
·The ultimate goal is
the child’s spontaneous use of audition throughout the day.
·Discrimination is the
ability to perceive similarities and differences between two or more speech
activities, same-different tasks are often used. (Example: dog vs. dogs, “Do they sound the
same or different?”)
·The child learns to
respond differently to different sounds.
·Identification is the
ability to label by repeating, pointing to or writing the speech stimulus
the suprasegmentals & segmentals of speech.
·Suprasegmentals include speech
patterns such as: duration, loudness, pitch, rhythm, stress, or
·Segmentals are the vowels and
consonants in speech. Segmentals
include: initial sounds of words, words varying in number of syllables, one
syllable words that differ in vowels and consonants, and stereotypic messages
such as familiar expressions or directions.
·Comprehension is the
ability to understand the meaning of speech by answering questions, following
directions, paraphrasing, or participating in a conversation.
demonstrated by the child when his/her response is qualitatively different than
the stimuli presented.
·Comprehension requires auditory memory and follows an auditory
and common phrases
directions and two directions
oSequencing three directions
oSequencing three events
in a story
about a story: closed set and open sets
oListening in noise
Compiled by Denise Wray et. al., University of Akron, 2007 from:
Erber, N. (1977) “Evaluating Speech Perception Ability in Hearing Impaired Children” [Bess, Fred H. (ed): Childhood deafness: Causation, Assessment, and Management.] New York, Grune & Stratton.
Estabrooks, W. (2006). Auditory-Verbal Therapy and Practice. Washington, DC: A.G. Bell