Auditory Verbal Therapy Vs. Speech-Language Therapy: What's the Difference?
I am so excited to welcome Gabrielle Charron (superhearoslp), a Speech-Language Pathologist (SLP) in Ottawa, Canada with a passion for working with children with hearing loss to learn to listen and speak. Gabrielle works at a hospital-based clinic, exclusively providing auditory verbal therapy (AVT) to young children and their families following cochlear implant activation or hearing aid fitting. She is also nearing completion of her Listening and Spoken Language Specialist (LSLS) certification!
Welcome Gabby 🤗
My friends say I talk a lot… I mean, I wouldn’t disagree. I was blessed with the Gift of the Gab. Speech-Language Pathology, a career where you can help children learn to talk. YEP, sounds perfect. Little did I know, auditory verbal therapy (AVT) was making its way into my life where number of words spoken (… my “gift”) and number of words heard by the child are key factors in language development.
We take for granted how many words are heard by a child with typical hearing – the more words a child hears, the more they are exposed to language. In AVT, we highlight the number of words a child hears per day since the child needs to MAKE UP the time they weren’t amplified (i.e., without hearing aids/cochlear implants).
When a child is identified as having a hearing loss, the parents are presented with choices. Among those, they can choose the sign language pathway or the listening and spoken language pathway (AVT). In AVT, the child is fit with advanced hearing technologies (hearing aids, cochlear implants, etc.) and learns language through listening following typical developmental speech and language milestones. Want to learn more about AVT and how to get certified? Check out the A.G.Bell website.
Whenever I visit friends who have children, I often hear “Wow… you talk to them a lot!” When I hear that, I get the urge to share WHY! The more words the child hears and the more you (as a parent/clinician) repeat songs, words, stories, etc., the more the child learns language! The common misconception is that auditory verbal therapy strategies and material wouldn’t necessarily be helpful for children without hearing loss.
AVT strategies can easily be incorporated into any activity or routine and could benefit any child to help with attention skills, listening skills, receptive and expressive language skills, etc. – however, it is the BEST approach for kids with hearing loss to develop spoken language.
Some strategies include:
Wait time
Narration
Repetition
Acoustic highlighting (sound, syllable, word and phrase level)
Expectant look
Joint attention
Sabotage
Seize the moment
Expansion and Extension
Auditory closure
Auditory sandwich
Auditory first
One difference between speech-language therapy and AVT is the amount of parent coaching. Many of my sessions, especially when working with babies and young infants, focus on coaching the parent to be the child’s primary facilitator rather than solely teaching the child. The parent is an active participant in ALL AVT sessions under the guidance of an auditory verbal therapist – parents need to learn to advocate for their child before their child can advocate for themselves. Read more about parent coaching in AVT here.
Just like speech therapy, an AVT session incorporates speech, language, literacy and cognition goals, but uses AVT strategies to highlight listening while targeting those goals. Research suggests that babies who are optimally fit with hearing technologies and who have access to all sounds of spoken language can develop excellent auditory processing abilities. Our job is to promote hearing aid/cochlear implant use and to coach parents to use strategies to help develop their child’s speech and language. Auditory skills are not developed independently. The holistic approach that AVT offers promotes the use of developmentally-appropriate activities in the child’s natural learning environment – this in turn enhances learning.
“Learning to listen is the basis for learning to talk.”
Similar to the field of speech pathology, early intervention is also critical in AVT. The earlier that a child is identified with hearing loss, the earlier that intervention can start. Children with hearing loss need the same language foundation as children with typical hearing.
Play-based therapy with a focus on audition is a great way to build this foundation. Incorporating AVT strategies into play-based activities requires a lot of skill, practice and reasoning, however to the untrained eye, may appear like the clinician is “just playing”. When well designed, an AVT session will look just like play, but this is where valuable learning takes place.
Play-based therapy allows for natural parent coaching opportunities. By playing, the clinician and parent can incorporate listening strategies into the child’s favorite activities, making learning to listen as natural as possible through the child’s play. This playful environment helps the child’s listening and spoken language skills to improve at a fast rate.
As said before, listening skills develop along side other developmental domains and therefore cannot be targeted in isolation. AVTs are skilled professionals that come from a range of disciplines (SLP, Audiologist, teacher of the Deaf and Hard of Hearing). In AVT, the child is seen as soon as they are identified with hearing loss and/or when parents choose the listening and spoken language approach. Because the primary goal is to close the gap before the child begins school, there is usually no wait time for beginning AVT.
AVT is a family-centered approach to intervention for children with hearing loss where the clinician guides and coaches the parents to incorporate listening and AVT strategies into their daily routines. The goal is to teach the child to listen through natural communication and during meaningful listening activities. With a strong foundation of listening skills, children with hearing loss can close the gap and catch up to their peers with typically hearing. Early intervention is key to academic success.
Early intervention is KEY. Parental participation is KEY. Consistent therapy is KEY. Learning through audition is KEY.
Of course there is A LOT more about AVT that I haven’t mentioned here. Make sure to check out Stacy’s blog posts to learn more.
To learn more about AVT from Gabby, follow her on Instagram at @superhearoslp!
