Auditory Skill Hierarchy
· Detection is the ability to respond to the presence or absence of sound. It is the essential first step in learning to listen.
· 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)
o The 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 or herself.
· 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 stimuli.
· In discrimination 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 heard.
· Identification involves the suprasegmentals & segmentals of speech.
· Suprasegmentals include speech patterns such as: duration, loudness, pitch, rhythm, stress, or intonation.
· 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.
· Comprehension is demonstrated by the child when his/her response is qualitatively different than the stimuli presented.
· Comprehension requires auditory memory and follows an auditory sequence:
o Familiar expressions and common phrases
o Following single directions and two directions
o Following classroom instructions
o Sequencing three directions
o Comprehension of multi-element directions
o Sequencing three events in a story
o Answering questions about a story: closed set and open sets
o Listening in noise
o Description of environmental sounds
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