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The goal of the auditory verbal approach is to improve spoken language and listening skills without using lipreading's visual cues. The goal of the Auditory Verbal Approach is for the person to be able to fully communicate by speaking and listening.
Developing spoken language through listening, in a child with hearing impairment is an exciting process for everyone involved.
Strategies for Developing Listening Skills
The strategies used to develop spoken language through listening are outlined below.
1. Ensure hearing aids/cochlear implants are worn all day every day.
If your child is to develop spoken language, it is vital that her hearing device(s) is in excellent working order and is worn throughout the day.
2. Be close to the microphone of the hearing device when speaking
Be near the microphone when speaking to your child when they are first learning to listen so that she gets the most aural input. Being in your child's hearing range is important as this provides the best access to speech sounds and sets her up for success.
3. Have a quiet environment
Providing a quiet environment is important for starting to listen.
The child will have a lot of trouble accessing sound if the environment is noisy.
4. Use a sing-song voice
Using a singsong voice is a typical way where adults speak and naturally interact with every
young babies.
5. Establish eye contact
Eye contact with the baby is extremely important. Eye contact connects you with the baby, and accentuates the bond between you.
6. Establish joint attention
Successful communication requires each person to know how to initiate a topic, respect
the other person's choice of topic, maintain a topic, adapt to topic changes, and close a
topic appropriately.
7. Talk about daily routines
Your infant depends on you for all their early needs, including eating, using the bathroom, getting dressed, and talking. When language is focused on daily activities, it becomes more meaningful.
8. Develop turn taking
Turn-taking is an important pragmatic skill where you should vocalize, then wait for the baby to vocalize. Repeat the baby's vocalization, then add a different vocalization.
9. Have another person call the baby by name.
To widen the baby’s experience of listening, it's important to have another person call the baby’s name without varying in any way so that it provides an opportunity to reinforce her ability to localize and discriminate sound.
10. Cue into listening.
Cue into listening strategy focuses on alerting the child to the sound by pointing to the ear and saying “listen” or “did you hear that?”.
11. Have auditory input first.
Auditory pathway need to be stimulated in the early stages of life, if not their ability to develop may be lost, therefore it’s essential to commence sound stimulation early in life.
12. Use listening alone.
Hiding the mouth when the speaker is talking helps the child to focus on listening only and not lip reading.
13. Use acoustic highlighting.
Highlighting the key elements of a sentence louder than the other
words around it in the sentence are useful when introducing new vocabulary or a new language structure.
14. Alert to sound source.
This strategy is important because it alerts your baby to sounds when she may not hear them for herself. Baby starts to localize the sound by eye movement, pointing, head turn, etc.
15. Have one person speaking at a time.
Having one person speaking at a time is important so that the message clearly delivered.
16. Use repetition.
Repeating the same sounds, words, or phrases close to the microphone of the hearing device will make the message more accessible and helps to develop spoken language.
17. Use phrases and simple sentences.
It is important to use phrases or short simple sentences in the beginning, then move on to complex sentences as your child's language develops.
18. Use real names for the object.
Using a real name for the object helps your child to learn the correct name right from the beginning.
19. Encourage vocalization.
Encouraging the child to vocalize can develop the child’s interest to be a part of an ongoing conversation.
20. Capture your child’s attention
The child will be more receptive to learning if you create a situation that follows the child’s lead and captures their attention.
21. Use auditory stimulus or response activities
Auditory stimulus/response is a way of knowing exactly what sounds your baby can hear
across the frequency range of speech
22. Have two adults model the auditory stimulus/response activity
Here we use two adults to model what is required - one to provide the stimulus and one to respond. The person saying the sound should not respond or your child will be confused about what is expected.
23. Make it fun
Interesting activities need to be conducted to make the child’s learning experience fun.
24. Provide positive reinforcement
It is better to praise the positive action or response than to continually point out what your child is NOT doing.
25. Use pausing
Pause between phrases/sentences to give your baby time to process before hearing it again helps to emphasize the key part of a more complex linguistic sentence.
26. Use waiting
Turn-taking is an important part of a conversation. By incorporating waiting, the child gets time to respond vocally.
27. Model correct language
Modeling means using the correct grammar and pronunciation while speaking to the child and repeating their utterances. This provides the appropriate language in context.
28. Promote speech development
To promote speech development, children should be given correct models to imitate. As well as the use of the listen-to strategy, highlight, auditory bombardment, and so on will aid in the child’s speech development.
29. Extend vocabulary
In order for the child to develop a vocabulary, input from the adults acts as an important source. The parents or caretakers can include activities of daily living situations and provide new words for the child to learn.
30. Expand and extend the language
Expansion and extension are the strategies that will foster language development by using language that is slightly more complex than the current level of the child.
31. Use rephrasing.
when the child doesn’t understand the language used, rephrasing the sentence in an alternative way helps the child to understand better.
32. Use questioning.
Wh questions like what? Where? Or yes/no questions encourage the verbal response.
33. Auditory closure.
It is a strategy where the clinician initiates a sentence and waits for the child to complete the sentence.
34. Use a natural voice
In the early stages, it is necessary to use a singsong voice, and as the child develops it is best to use a natural tone, with appropriate stress, intonation, rate, and rhythm to develop natural-sounding speech.
35. Give your child time to process.
The child needs to be given some time to process the information if the child does not respond immediately rather than rephrasing or repeating the information.
36. Give the direction to the child only once through listening
With improving listening skills, the information should be said only once so that the child will take time to understand the message first and then respond
37. Ask the child to repeat for clarity
By asking the child about what was heard or asking them to repeat one can understand if the child has comprehended the message or was paying attention.
Summing Up
Since Auditory verbal therapy is a practiced science with quantifiable outcomes, therefore it supports parents in their efforts to assist their child in learning to speak by listening. As a result, the child has a wide range of options in life as an adult like any other normal child. Bangalore Hearing & Implant Institute offers dedicated Auditory Verbal Therapy (AVT) at Koramangala 5th Block, Bengaluru, India. Get in touch with us to know more!