Auditory-verbal therapy

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Auditory-verbal therapy is a method for teaching deaf children to listen and speak using their residual hearing in addition to the constant use of amplification devices such as hearing aids, FM devices, and cochlear implants. Auditory-verbal therapy emphasizes speech and listening.

Auditory verbal therapy enables deaf and hard of hearing children to participate more fully in mainstream school and hearing society. In 2006, Rhoades[1] published an article looking at whether the Auditory Verbal approach was justified. Using Frattali’s system for weighing the strength of treatment evidence based on the degree of scientific rigour, she found 7 studies concerning the AV approach of class II level evidence.[2][3][4] She concluded that even with the minimal number of studies, there was evidence "for the validity and effectiveness of the A-V intervention model". Following on from Rhoades’ work, Hogan et al. (2008;[5] 2010[6]) published outcomes for children in an AV programme which were essentially quasi-experimental studies in that the assessment tool used had been standardised on typically developing children and so a comparison could be drawn between the age equivalence scores obtained by the children on the study and their chronological or ‘hearing’ age. (The hearing age of a child is the duration of time since the child has had optimal access to sound.) In these studies, the average rate of language development increased significantly during the time on the programme compared to the average rate of language development prior to embarking on the programme. Dornan et al. (2009)[7] reviewed the evidence for Auditory Verbal Therapy and concluded that while it was not possible to demonstrate a cause and effect relationship between the intervention and the outcome, increasing the strength of evidence for outcomes was vital. In 2010, Dornan et al. published a longitudinal study comparing the outcomes of 29 children enrolled on an AV programme with age-matched controls. They found AV to be an effective intervention.

First Voice (a membership body which represents organisations that provide listening and spoken language therapy in Australia and New Zealand) published a study in February 2015 based on information on more than 600 children with hearing loss. When listening and spoken language outcomes of children with a hearing loss were compared to those with typical hearing most children attending AVT had ‘scores within or above the average range for typical hearing children for language (74.4%-75.6%), vocabulary (79.6%) and speech performance (71.5%). When children with additional disabilities were removed from the analysis, the number of children within or above the average range for typical hearing children increased, except for speech performance (language performance=77.9%-80.2%; vocabulary performance= 83.1%; speech performance=73.1%).’ (First Voice, 2015 pp 5).[8]

In the UK, access to auditory verbal therapy is currently available at two cochlear implant centres (Paediatric Cochlear Implant Programme, Manchester Auditory Implant Programme and Midlands Hearing Implant Programme - Children's Service). Outside of the NHS AVT is available via a national charity called Auditory VerbalUK (AVUK)(Oxfordshire and London), The Speech and Hearing and Language Centre, Christopher Place in London and at the Auditory Verbal Lounge in Nottingham.

References

  1. Rhoades E. (2006) Research Outcomes of Auditory-Verbal Intervention: Is the Approach Justified? Deafness Educ. Int. 8(3), 125–143
  2. Dornan D , Hickson L , Murdoch B , Houston T, and Constantinescu G. (2010). Is Auditory-Verbal Therapy Effective for Children with Hearing Loss? Volta Rev. 110(3), 361–387 Eriks-Brophy, A. (2004). Outcomes of auditory-verbal therapy: A review of the evidence and a call for action. Volta Rev 104(1), 21–35.
  3. Goldberg DM, Flexer C (September 2001). "Auditory-verbal graduates: outcome survey of clinical efficacy". J Am Acad Audiol 12 (8): 406–14. PMID 11599875.
  4. Rhoades E, Chisholm T. (2000) Global language progress with an Auditory-Verbal approach for children who are deaf or hard of hearing. Volta Rev. 102, 5–24
  5. Hogan S, Stokes J, White C, Tyszkiewicz E, Woolgar A. (2008) An evaluation of Auditory Verbal Therapy using rate of early language development as an outcome measure. Deafness Educ Int. 10,143–167
  6. Hogan S, Stokes J and Weller I. (2010) Language Outcomes for Children of Low-Income Families Enrolled in Auditory Verbal Therapy. Deafness Educ Int. 12 (4) 204-216
  7. Dornan D, Hickson L, Murdoch B, Houston T. (2009) Longitudinal study of speech and language for children with hearing loss in Auditory-Verbal Therapy programs. Volta Rev. 109,1–25
  8. First Voice (February 2015). "Sound Outcomes: First Voice speech and language data.http://www.firstvoice.org.au/userfiles/file/150302_Sound_Outcomes_First_Voice_Speech_and_Language_Data.pdf

Additional Resources

Rhoades, EA; Chisholm, TH. (2001). Global language progress with an auditory-verbal approach for children who are deaf or hard of hearing. Volta Review, Volume 102(1), Pgs. 5-25