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Early Identification and Effective Intervention: The Auditory-Verbal Approach

Early Identification and Effective Intervention: The Auditory-Verbal Approach. Kathryn Wilson, M.A., CCC-SLP, Cert.AVT Sara Lake, B.A., J.D. February 20, 2004 Washington, D.C. Presentation Topics. Auditory-Verbal Philosophy Principles of the Auditory-Verbal Approach

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Early Identification and Effective Intervention: The Auditory-Verbal Approach

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  1. Early Identification and Effective Intervention: The Auditory-Verbal Approach Kathryn Wilson, M.A., CCC-SLP, Cert.AVT Sara Lake, B.A., J.D. February 20, 2004 Washington, D.C

  2. Presentation Topics • Auditory-Verbal Philosophy • Principles of the Auditory-Verbal Approach • How A-VT Differs From Other Approaches, Interventions, and Therapies • Outcomes • How to Access A-VT Services, Professional Training & Certification • Case Presentation

  3. Auditory-Verbal PhilosophyAuditory-Verbal International, Inc. Position Statement • The Auditory-Verbal philosophy is a logical and critical set of guiding principles. These principles outline the essential requirements needed to realize the expectation that young children who are deaf or hard of hearing can be educated to use even minimal amounts of amplified residual hearing.

  4. Use of amplified residual hearing in turn permits children who are deaf or hard of hearing to learn to listen, process verbal language, and to speak.

  5. The goal of Auditory-Verbal practice is that children who are deaf or hard of hearing can grow up in regular learning and living environments enabling them to become independent, participating, and contributing citizens in mainstream society.

  6. The Auditory-Verbal philosophy supports the basic human right that children with all degrees of hearing impairment deserve an opportunity to develop the ability to listen and to use verbal communication within their family and community constellations.

  7. Tori • Fraternal twin • Familial history of hearing loss • Passed NHS • Age at identification: 15 months • First hearing aid fitting: 16 months • Began AVT at 18 months • Cochlear Implant at 4 years of age • Video: C.A. 8 yrs, 3 mo, 4 yrs post CI

  8. Expected Results of NHS and Technological Advances: • Average age of identification will decrease • Greater access to information about all communication approaches • Number of families seeking A-VT will increase • Need for Certified Auditory-Verbal Therapists will increase • More children will develop spoken language through the Auditory-Verbal approach

  9. Principles of Auditory-Verbal Practice Adapted from Pollack, D. (1985) & Ling, D. et.al (2003)

  10. Aggressive Audiological Management In an A-V approach: • Pursuit of best amplification • AVI Protocol for Audiological and Hearing Aid Evaluation

  11. Suggested Protocol for Audiological and Hearing Aid Evaluation Adapted from AVI, 2003 • Audiological Test Procedures • Amplification Assessment • Sound Field Aided Response • Probe Microphone Measures • FM Systems • Frequency of Assessment • Reports

  12. Appropriate Amplification Technology • Hearing Aids • Cochlear Implants • FM Systems In an A-V approach • Therapist must possess and apply in-depth knowledge of speech acoustics

  13. Favorable Auditory Learning Environments In an A-V approach • All therapy is one-to-one • Sessions are usually one time weekly for 1 hr. to 1 hr. 30 minutes. • Best conditions for verbal learning are provided

  14. “At no time in a child’s life are the physical and acoustic conditions as favorable for listening as in early infancy.” • Daniel Ling, Ph.D

  15. Integrating Talking and Listening into ALL Aspects of Daily Life In an A-V approach • Audition is the primary sensory modality • Use of hearing for language acquisition is unique to AVT • Emphasis on auditory learning vs. auditory training

  16. Ongoing Assessment, Evaluation & Prognosis In an A-V approach • All therapy is DIAGNOSTIC • An average or better than average rate of progress is expected

  17. Inclusion In Regular Schools In an A-V approach • Mainstream education is a critical component • Parents and AVT work in partnership to secure appropriate services and placement • Similar expectations are established for children who are deaf/hh and those with normal hearing

  18. Parents and/or Principal Caregivers as Primary Teachers In an A-V approach • Parents actively participate in ALL sessions • The parent is the primary student during therapy sessions • The parent is the primary teacher in day-to-day life

  19. Integration of Speech, Language, Audition and Cognition In an A-V approach • The normal developmental sequence is followed • Child’s hearing age serves as the baseline vs. chronological age

  20. An Auditory-Verbal approach embraces ALL the Principles

  21. Outcomes in Auditory-Verbal Therapy • Wray, Flexer & Saunders (1996) • Followed 19 children, ranging in age from kindergarten through 10th grade. • 84% reading on grade level • At an early age, all were mainstreamed with hearing children.

  22. Outcomes in Auditory-Verbal Therapy • Robertson & Flexer (1998) • Followed 54 school age children • 81% Mainstreamed totally in the regular school • 19% Mainstreamed partially • 43% Read better than average hearing child • 43% Read on the same level as the average hearing child • 9% Read below average • 5% Did not provide reading skill information

  23. Outcomes in Auditory-Verbal Therapy • Goldberg & Flexer (2001) • Surveyed 114 graduates of A-V programs in the U.S. & Canada • 94% had severe-to-profound or profound hearing loss • 95% had hearing loss at birth or before 3 yrs. of age

  24. Outcomes in Auditory-Verbal Therapy • Goldberg & Flexer (2001) (n=114) • Education • 86% mainstreamed in elementary school • 86% mainstreamed in middle or high school • 91% mainstreamed in their senior high school year • 78% attended a typical college or university program

  25. How to Access A-V Services • Auditory-Verbal International,Inc. (AVI) • A-V Therapy has been practiced by pioneers since the 1940s and 1950s • With more widespread early identification and improved technology, A-V Therapy is an option increasingly chosen by parents • Luetke-Stahlman & Moeller (1987) 90% of parents of children with hearing impairment are typically hearing individuals

  26. How to Access A-V Services • AVI is a worldwide membership association and information clearinghouse regarding the Auditory-Verbal approach located in the Greater Washington, D.C. area

  27. How to Access A-V Services • AVI founded in 1987 by three visionaries: Daniel Ling, Doreen Pollack & HelenBeebe who believed audition should be the primary sensory modality for the acquisition of language for most children with hearing impairment

  28. How to Access A-V Services • AVI offers a complete listing of all Certified Auditory-Verbal Therapists as well as other practitioners in the approach; and • Information regarding the approach, membership & free literature as well as A-V publications

  29. How to Access A-V Services • Through the AVI website, www.auditory-verbal.org • Or by contacting AVI at audiverb@aol.com or (703) 739-1049

  30. Certification in A-V Therapy • AVI administers an international certification program in the A-V approach with certified professionals on 5 continents • Currently, Certified Auditory-Verbal Therapists in 33 of the United States

  31. Certification in A-V Therapy • International Certified Auditory-Verbal Therapists are in Europe, China, the Middle East, the Far East and Latin America • Current certification standards and applications can be downloaded from the AVI website at: www.auditory-verbal.org/certification

  32. Professional Training in A-VT • Discipline of Auditory-Verbal Therapy is a hybrid one; combines elements of audiology, speech-language pathology & education of the deaf • Also includes elements of other disciplines such as parent guidance, child development and technology • Approach also a highly practical one

  33. Professional Training in A-VT • Proficiency in the approach involves both academic rigor and practical training

  34. Professional Training in A-VT • Training Opportunities • AVI Standardized Curriculum (2001) & AVI Mentor Referral Service • Refers professionals seeking A-V training to certified professionals providing such training; • Part of mentorship can be accomplished through video observation and critique

  35. Professional Training in A-VT • Auditory-Verbal Learning Institute (AVLI) • Offering quality A-V Distance Education products through an independent, yet AVI-affiliated institute • Products include CD-ROMs with lecture and A-V demonstrations, videos, parent kits and other A-V publications

  36. Professional Training in A-VT • Auditory-Verbal Learning Institute (AVLI) • 7205 N. Habana Ave.  Tampa, FL 33614 Phone: (813) 932-5209 E-mail: clisenby@avli.org Web: www.avli.org

  37. Professional Training in A-VT • AVI International Conferences • “Auditory-Verbal Techniques & Strategies: A Professional Training” May 26, 2004  Como, Italy Cert.AVTs Judith Simser & Tina Olmstead Immediately prior to NHS2004 • AVI Biennial International Conference Summer 2005 Toronto, Canada

  38. Professional Training in A-VT • Professional Training Weeks at Auditory-Verbal Centers • Auditory-Verbal Center of Atlanta (AVCA) • Bolesta Center, Tampa, Florida • Hear & Say Centre, Brisbane, Australia • Learning to Listen Foundation, Toronto, Canada

  39. Professional Training in A-VT • Auditory-Verbal specialization at the Masters level (degree in audiology, SLP, education of the deaf) as part of the Ling Institute at the University of Ottawa in Canada

  40. How to Access A-VT Services, Training & Certification • Auditory-Verbal International, Inc.2121 Eisenhower Avenue, Suite 402 Alexandria, VA 22314 USA (703) 739-1049  audiverb@aol.com • www.auditory-verbal.org

  41. C.A. 17 months CI Age 6 months A-V Age: 11 months Age at Identification: 3 months Degree of H.L. Profound Etiology: Genetic Age at Implantation 12 months Hearing Aid Use Consistent use from 4 months of age Device: Clarion Co-existing Conditions None Educational Placement At home with mother until age 5/mainstream kindergarten Case Presentation

  42. Discussion • The Principles of A-VT outline the essential components for young children to develop intelligible spoken language through listening. • The role of audition in processing spoken language and parents as primary models are two major differences in A-VT from other approaches.

  43. Discussion • Research supports the efficacy of the Auditory-Verbal approach. • Information regarding the Auditory-Verbal approach, certification, and professional training is available through Auditory-Verbal International, Inc.

  44. Conclusions • Children identified early and enrolled in Auditory-Verbal Therapy can acquire developmentally appropriate communication skills. • Auditory-Verbal Therapy is an effective intervention for newly identified infants, toddlers, and children whose parents have chosen spoken language as the desired communication outcome.

  45. Questions?

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