Stacy Crouse
Coaching Parents in Auditory Verbal Therapy
Empowering parents to become the primary facilitators of their child's speech and language development is a critical component of therapy for children with hearing loss that are learning to listen and speak. While the therapy itself is important, the other 167 hours in the week are where a child truly makes progress, and where that progress really matters. In fact, 6 of the 10 Principles of Auditory Verbal Therapy begin with the exact phrase, "Guide and coach parents..." A Listening and Spoken Language approach is one that teaches parents to provide the services that the child needs throughout the day. Gone are the days of parents waiting in the waiting room or watching behind a one-way mirror. An Auditory Verbal Therapist actually focuses the session on coaching of the parent, rather than teaching the child.

I'll be sharing the session structure that I was taught while pursuing my Listening and Spoken Language Specialist (LSLS) certification, but many of the concepts and ideas can be utilized with students or clients that do not have hearing loss. Additionally, where I refer to parents, please note that you can substitute the word for any other involved family member, stepparent, friend, caregiver, or guardian. Depending on individual circumstances, any or all of these people play a very significant role in a child's life and development. There can be multiple parents or caregivers present in an AVT session, and even siblings can often participate too!
The session begins by reviewing with the parent how the previous week has been. Have they seen any changes (positive or negative) in their child's listening and spoken language development? Have they noticed something that the child is struggling with? Have there been any equipment issues? Has the child responded well to an activity or strategy that the parent used? I can then help to problem solve or provide guidance on any issues that have been brought up, as well as praise a parent for their efforts at home over the last week. Additionally, this information is valuable for learning about a child's progress and the next steps.
Once I have conversed with the parent to learn more about the current victories and/or challenges, it's time to introduce the first activity. Before the activity is even shown, I tell the parent what the activity will be, what the goal is, and how the goal will be addressed through the activity. I also share a language, speech or listening strategy that can be used to help make the child successful in the task. The strategy might be new to the parent, in which case I can provide more explanation, or it might be a strategy that the parent has learned in a previous session that can be applied to the activity.
I then begin the activity with the child, in order to provide a visual model for the parent. However, the goal is to quickly turn the activity over to the parent to complete with the child. Why? People almost always learn better by doing, not watching. Additionally, this provides the opportunity to truly coach the parent right there in real time. As the parent works through the activity with the child, I can provide positive feedback, such as "I love how you gave her choices when she wasn't able to answer your question," as well as guide the parent on how to best support the child in the activity. For example, I can coach a parent by saying, "She seems to be having trouble with using the plural 's' on 'cats.' You could try to highlight that sound to see if that helps." By providing feedback, I'm able to help the parent make tweaks to ensure that the child is successful in working on the goal. In addition, feedback for the parent could mean helping them modify an activity to be more challenging if the child is showing proficiency with the original task.
The final step of the activity is recapping how it went. I can ask the parent how the child demonstrated progress (on the specific goal or in their overall language, speech, or listening abilities), what made the child more successful, and what the next step on the overall goal might be. Another key component would be helping the parent identify ways to target the skill at home. Oftentimes, the parent may not realize that the goals and strategies can effortlessly be implemented within play and routines that they are already doing on a daily basis. Helping the parent to identify these possibilities is going to promote carryover of skills.

The same steps discussed and shown in the above graphic are repeated for each activity completed throughout the session. One tip is to provide a page for the parent to make notes on throughout the session, so that they can recall all that was discussed and share the information with other caregivers. Check out the free parent notes sheet in my TpT store!

As you can see, the relationship between a LSLS and the parents of the children they serve is very collaborative. Parents have a lot of valuable information to provide, and unlike a therapist, they are able to continue targeting goals every single day. As a therapist, sitting back and observing a session feels very wrong for many of us. However, coaching a parent on how to confidently provide quality therapy day in and day out to their child means you're succeeding in making changes in that child's life....just from a different angle.
