Guest Post: Working with Hearing Impaired Students with AVT

Today we have a guest post from Karen Parden, MS, CCC-SLP from The Speech Umbrella about her experiences Working with Hearing Impaired students/ Training in Auditory-Verbal Therapy... (Thanks Karen!)

Working with children with hearing loss is a passion of mine. I am a speech language pathologist, but have always had an interest in audiology.  My grandmother and cousin have cholesteatoma (Cholesteatoma is a destructive and expanding growth in the middle ear and/or mastoid process.) so I do have a history of hearing loss in my family.  I have not always worked with children with hearing loss. In fact, it has only been in the last four years that I have begun this journey.  I attended a workshop provided by the Alabama Ear Institute in the spring of 2008 that sparked my interest in Auditory Verbal Therapy. After that I attended all the trainings I could get my hands on.  The philosophy behind AVT is that parents must participate in sessions with the child and provide appropriate carry-over at home, the child should have contact and communication with speaking peers, and the child will need abundant opportunities to learn and practice speech communication skills in all aspects of life (Ling 1989). During these trainings, I learned the basics of Auditory Verbal Therapy to use with my hearing impaired students. The following are the AVT techniques I use in therapy with them everyday:

•    Create a listening environment (FM system, etc.)
•   Use of auditory feedback mechanism for speech imitation (self correcting)
•   Development speech, language, audition, cognition, and communication concurrently
• Modify acoustic information to highlight a particular feature
•  Hand cue
• Acoustic highlighting (sounds, words, phrases)
• Lowlighting (the vowel)
• Move close and soften voice
•  Use of parentheses, suprasegmentals (use at any age)
• Work on “best hearing” side/positioning
• Enhance listening by placing sound source near ear
• Direct child’s attention to auditory information before showing toy/action
• Pause time – time to process
• Expectant look
• Auditory-visual-auditory presentation (“Put back into hearing”)
• Develop confidence in listening abilities
• Assess auditory skills by integrating directions into natural routines and experiences rather than making them task oriented
• Ensure that therapy is diagnostic
• Work from the known to the unknown, audible to less audible
•   Give the child a reason to listen/communicate 

Taken from Alabama Ear Institute handout “Cheat Sheet: Auditory-Verbal Techniques and Strategies”

I absolutely love using AVT with my hearing impaired students. I love having the parents involved and knowing what to do at home. The progress has been phenomenal in my opinion and the statistics prove that fact. I have seen children with cochlear implants who have had consistent AVT and those who have not had consistent AVT. The differences between these groups are significant in their speech communication and auditory comprehension.  AVT must be consistent to be successful. Listening is a way of life, not a subject that is taught.  I have had one student who I could not use AVT with. He had Goldenhar Syndrome and was born with no auditory nerves. We used total communication with him. I do use AVT with all of my hearing impaired students who have cochlear implants or hearing aids. 

Picture compliments of BoysTown

Thank you Karen for this great blog post. Go show Karen some love! She's actually having a great St Patty's giveaway right now on her site ! Go check it out here! THANK YOU Karen! Anyone else work with individuals who are deaf or hard-of-hearing? Let us know!

picture compliments of Label&Learn

Don't forget to check out last week's Guest Blog Post from Katie at PlayingWithWords365 here! Check out her perspective on her family's success using sign language!