Auditory Verbal Therapy: We're All in This Together

The World Health Organization (WHO) estimates that by 2050 there will be more than 900 million people worldwide with hearing loss greater than 40 dB HL—double the number of 2018. Today, there are 34 million children who are deaf or hard of hearing and this number may also double by 2050. Therefore, speech and hearing, and education professionals, will continue to be in great demand to help parents help their children to achieve listening, spoken language, and literacy at levels like those of their hearing peers, should the parents choose such expected outcomes. Fortunately, scientific and technological advances make these outcomes possible for many children who are deaf or hard of hearing, provided that appropriate intervention is available.

Auditory-Verbal Therapy (AVT) is one of the early intervention approaches that meets the needs of children who are deaf and hard of hearing and their families both for today and for the future. AVT has advanced in tandem with the development of early identification and fitting of children with sophisticated hearing technologies, scientific research, and artful early intervention AVT practices, to make the outcomes of listening and spoken conversations for children who are deaf or hard of hearing a greater reality than ever before. Furthermore, the ever-increasing numbers of practitioners around the world who have dedicated themselves to attaining the Listening and Spoken Language‒Certified Auditory-Verbal Therapist credential (LSLS Cert. AVT), have accelerated great interest in AVT and created an evolution in its global knowledge and professional practice patterns.

AVT is driven by 10 Principles of Practice. These principles are based on 4 primary aspects: (1) early identification and fitting with hearing technology for optimal auditory access; (2) family-centered intervention with parents as the primary agents of change and case managers of their children; (3) the development of auditory skills as the basis for spoken language communication following typical developmental trajectories; and (4) participation in regular education settings from early childhood onward.  The LSLS Cert. AVT coaches and guides parents in holistic (whole child) strategies that help their child acquire auditory skills, intelligible spoken communication, literacy, academic learning, and the ability to forge interpersonal relationships and make independent choices over a lifetime.

Families practice AVT strategies in social interactions in the context of natural play, early literacy, singing, games, and daily routines and family life. AVT can take place anywhere and anytime. Finally, AVT is diagnostic, which means several things: each interaction with a child alerts  the practitioner and/or the family about what the child needs at that moment; regularly conducted assessments; focus on the whole child; and a treatment plan that can be amended based on assessment data and family input—all to ensure that a child reaches their potential in the healthiest and most appropriate manner possible.

Effective AVT calls upon knowledge and skills from across a variety of disciplines—speech and hearing science, counselling and psychology, child development, education, audiology, and speech-language pathology and education. AVT can only take place with the active participation and engagement of the child’s immediate and, often, extended family; AVT practitioners and families work in partnership with other professionals—physical and occupational therapists, psychologists, social workers, doctors, teachers et al. We are all in this together.

Auditory-Verbal Therapy: Science, Research, and Practice, a new book about AVT from Plural, provides a contemporary and comprehensive examination of the underlying science, outcomes, and practice of AVT. This book is a collection of works by a committed and interprofessional consortium of scientists and researchers, audiologists, Auditory-Verbal therapists, mentors and coaches, innovators, and advocates who have all contributed to the practice of AVT and documentation of AVT outcomes and effectiveness—professionals who are in this together.

Auditory-Verbal Therapy: Science, Research, and Practice is intended for practitioners and families who currently engage in AVT and for those who wish to know more about this evidence-based and evidence-informed approach. The book may best serve as a text for university preparation courses in aural habilitation for students in the communication sciences fields—education of the deaf and hard of hearing children, audiology, and speech-language pathology, and as a resource for those who are already practicing.

The opening chapter of the 27 chapters in this book provides an introduction to AVT and a description of the history and principles of AVT, along with the results of a global survey of the LSLS Cert. AVT community regarding current practice patterns and expectations of future needs and challenges for the profession. The concluding chapter brings the reader full circle back to the beginning and the expected outcomes of AVT, with an in-depth examination of data that demonstrate the cost-benefit of AVT.

 Auditory-Verbal Therapy: Science, Research, and Practice is presented in five parts:

·         Foundations and fundamentals: history, principles of AVT, neurological bases, and peer-reviewed research that documents the outcomes and effectiveness of AVT

·         Ensuring auditory access: audiology, hearing technologies, and speech acoustics

·         Developmental domains of AVT: audition, language, speech, play, cognition, and literacy

·         The How of AVT: strategies to develop listening and spoken language;  strategies for coaching parents and caregivers; planning/ delivery/evaluation of the AVT session, assessment in AVT, and social and educational inclusion in early childhood settings

·         Extending and expanding AVT: unique hearing issues; children with additional challenges; multilingualism; child/family diversity; telepractice; and mentoring of professionals

On behalf of everyone involved in Auditory-Verbal Therapy: Science, Research, and Practice, we invite you to gain new knowledge and insights, consolidate what you already know, feel encouraged, appreciated, inspired, and hopeful, and experience a sense of wonder as we all move forward in this new decade—a most exciting time for children with hearing loss and their families, for Auditory-Verbal practitioners and those who aspire to be, and for the practice of Auditory-Verbal Therapy.