Updated: Dec 17, 2021
AVT is a specialized therapy approach specifically designed for young children with hearing impairment. The philosophy of the approach lies in utilizing hearing as the primary mode of stimulation to teach the child speech and language. It also believes in facilitating a holistic development of the child and integrating them into the society.
Auditory verbal therapy (AVT) is a specialized therapy given to children with hearing impairment. In order for the child to hear, the child is fitted with a hearing aid or a cochlear implant. When a child has hearing loss, the auditory system is not stimulated. This also means that, the part of the brain that processes sound is not stimulated. When this happens, the parts of the brain that are surrounding the auditory area of the brain take over the auditory area. This is known as cortical reorganization.
AVT is based on the belief that the auditory system be stimulated before cortical reorganization takes place. Hence, early intervention is of utmost importance. The Joint Committee of Infant Hearing (JCIH) recommends that every child be screened for hearing loss by 1 month of age, a detailed diagnosis be done to confirm the presence of hearing loss by 3 months of age if the child fails screening, and in presence of hearing loss, intervention program be planned for speech, language and hearing development of the child by 6 months of age. Hence, AVT is recommended to be started before the age of 3 years for maximum benefit.
When a child has severe to profound hearing loss and is obtaining limited benefit from hearing aids i.e., is not able to hear well enough using hearing aids, cochlear implants are recommended. Cochlear implants are surgically placed devices that aid in listening through electrical stimulation. They facilitate natural hearing. The use of cochlear implants in children is especially useful as it helps in listening to all the sounds in the environment and in developing speech and language effectively.
Listening seamlessly is learning to talk and communicate effectively!
With the use of cochlear implants, the child can undoubtedly hear well. However, there is a lot of lost information due to lack of stimulation from birth until implantation. Hence, the child requires special training to hear. The child must be taught to pay attention to the sounds coming in the environment, and to learn speech sounds. Eventually, the child also needs to be taught what to focus on and what not to pay attention to. Such skills are extremely important once the child is old enough to go to school where the child is expected to listen to the teacher’s class with a lot of other acoustic activity going on in the background such as fan noise, noise from traffic outside, classmates talking, etc. Hence, it is important that the child is given some special training for listening and talking, and to compensate for lost time at an early age. Children below three years of age have maximum plasticity of the brain and can therefore pick up new information quickly and retain that information easily. It is therefore extremely important that their hearing loss be identified and addressed ASAP.
The auditory verbal therapy is one of the several therapy approaches given to children with hearing impairment. AVT is an evidence-based and evidence-informed early intervention approach for infants, toddlers, and young children who have hearing impairment. The intervention highlights the active participation of child’s family and respects parents as the primary agents of change and primary case managers in the lives of their children. It focuses on development of audition (listening) to understand and learn language, and using speech and language as the primary mode of communication. It highlights on the importance of hearing in efficient acquisition of speech and language. It also stresses upon mainstreaming the child into the society and integrating the child into a regular school. The philosophy of the approach firmly lies in the belief that hearing loss should not limit the child’s ability to participate and obtain equal opportunities in the society. AVT is a holistic intervention program in which social interactions are essential for the development of independent cognitive and linguistic functioning of the child. It also emphasizes the development of listening and spoken language through natural play, singing, games and daily routines, and all the excitement of daily family life. Consequently, AVT can take place anywhere and anytime*!
AVT carried out in a systematic manner and is based on 10 principles that ensure best hearing access, most functional auditory skills, and the most intelligible spoken communication. This holistic procedure ensures that the child has all the access to obtain literacy, academic prowess, interpersonal relationships, and the unlimited and independently made choices offered over a lifetime*.
In summary, AVT is a holistic therapy approach that emphasizes the importance of listening and using hearing as the primary mode to learn speech and language so as to facilitate development of speech and language, cognition, literacy and academic skills and be integrated with the rest of the society. In order for this to be effective, it is important that the child is identified with the presence of hearing loss and intervened immediately if he has hearing loss. This highlights the importance of universal new born hearing screening, where every child that is born is screened for the presence of hearing loss.
Give your child an early start!
*Source: Estabrooks, Morrison and MacIver-Lux. Auditory-Verbal Therapy: Science, Research, and Practice. 2020.