Auditory Verbal Therapy (AVT) is a specialized early intervention approach designed for children who are deaf or hard of hearing. Its primary goal is to help these children develop listening and spoken language skills on par with their hearing peers. This therapy focuses on the auditory brain, teaching the child to interpret the signals received through sound to develop communication. The approach relies on the child using appropriate assistive hearing technology, such as hearing aids or cochlear implants, to maximize their residual hearing potential.
Foundational Principles of Auditory Verbal Therapy
The core philosophy of AVT is that the brain’s natural capacity for language acquisition is activated through listening. This approach deliberately avoids visual cues like lip-reading or sign language, forcing the auditory system to become the main channel for learning. The process begins with early detection, ideally through newborn hearing screenings, followed by immediate intervention. This timing takes advantage of the brain’s sensitive period for auditory development, as research suggests that sound deprivation during the first three years of life can prevent optimal language function.
A fundamental principle is the immediate and consistent use of state-of-the-art hearing technology to provide the child with access to the full spectrum of speech sounds. The technology enables the child to hear sound, but AVT teaches the child to listen and attach meaning to those sounds. Practitioners guide families to integrate listening and speaking into all daily activities and environments. This immersion constantly stimulates the child’s auditory brain, following natural developmental patterns for speech, language, and cognition.
The Essential Role of the AVT Professional and the Parent
Auditory Verbal Therapy sessions are distinct from traditional speech therapy, centering on the parent or caregiver rather than the child alone. The AVT professional, a certified Listening and Spoken Language Specialist, functions primarily as a coach and guide. They observe the child’s responses, conduct ongoing diagnostic assessments, and model specific strategies for the parent to implement.
The parent is considered the child’s first and most important teacher and primary language facilitator. They are present for every session, learning the techniques and the rationale behind them directly from the professional. This parent-centered approach ensures that the strategies and skills practiced in the clinic are seamlessly carried over into the child’s natural environment throughout the week. The goal is to empower parents to create a listening and language-rich home environment where every routine becomes a teaching moment.
Common Techniques Used During Sessions
Therapy sessions employ specific, evidence-based strategies to develop the child’s ability to hear, process, and use spoken language.
Acoustic Highlighting
Acoustic Highlighting is a technique where the adult subtly emphasizes a specific sound, word, or phrase through changes in pitch, duration, or volume. For instance, a parent might slightly raise their voice on a target sound like the /s/ in “snake” to draw the child’s auditory attention.
Auditory Sandwich and Auditory Closure
The Auditory Sandwich is used when a child does not understand a word or instruction purely through listening. The adult first provides auditory input, then offers a visual cue (the “filling”), and finally removes the visual cue to repeat the auditory input. This ensures the child ends with a successful listening experience. Conversely, Auditory Closure encourages the child’s expressive language by leaving a predictable word or phrase unfinished. The adult begins a familiar song or sentence, such as “Ready, set,…” and pauses for the child to fill in the missing word, “go.”
Auditory Bombardment and Feedback Loop
Another technique is Auditory Bombardment, which involves intentionally providing the child with numerous opportunities to hear a target sound or word in a meaningful context. This constant, purposeful exposure helps establish a strong “auditory impression” in the child’s brain. The Auditory Feedback Loop encourages very young children to hear their own voice and monitor their speech production. The adult repeats the child’s vocalization, sometimes with acoustic highlighting on a missed sound, prompting the child to refine their spoken attempt.
Long-Term Goals of Auditory Verbal Therapy
The ultimate vision for AVT is for the child to achieve language and communication skills that allow them to live independently in the hearing world. A primary long-term goal is the development of age-appropriate spoken language, often resulting in receptive and expressive language scores within the typical range for their peers. Success in AVT frequently leads to the child’s seamless integration into mainstream education settings.
Children are also taught to become self-monitors, learning to check their hearing technology and evaluate their speech quality through listening. This process builds self-reliance and fosters self-advocacy skills. These skills are necessary for the child to communicate their needs regarding their hearing loss and technology as they grow older. By the time they complete the program, children are equipped with the foundational listening and language abilities required for lifelong learning, literacy, and social competence.