AVT Flashcards
What is AVT?
auditory verbal therapy
form of early intervention used with infants and young children (<7) with hearing loss and their families
follow 10 principles outlined by AGBell Academy
guide and coach the listening partner and child in the use of strategies to scaffold auditory learning and achieve AVT goals
application of strategies, conditions, and procedures that promote the optimal acquisition of listening skills so newly acquired auditory potential can be maximized and spoken language can be developed through listening
What is auditory/language deprivation?
lack of language/sound exposure as a result of hearing loss
immediate
can cause reorganization of sensory processing centres in the brain
Who does AVT prioritize?
parents = primary agents of change
alleviating parental stress around communication
help parents learn how to make spoken language easy to hear
helping parents learn that LSLLOs (listening and spoken language opportunities) are abundant during naturally occurring conversations
What are some of the characteristics of AVT?
evidence-based
follows developmental milestones of children who are not DHOH
holistic, social interactions are essential for development and functioning
individualized to meet needs of child and family
emphasizes development of listening and spoken language through natural play, singing, games, routines, and daily family life
What are the 6 domains of development in AVT?
audition - what does the child hear, localize, understand, and remember
speech - what speech sounds are heard and need to be targeted
language - expressive and receptive
cognition - non-verbal and verbal cognitive skills
communication - how does the child communicate wants and needs
literacy - reading, writing, drawing
What are some variables that influence AVT outcomes?
child’s hearing and overall health
intervention skills of professionals
collaboration between professionals
health literacy and education of parents
parental trust in services
adverse childhood events
child intelligence and learning style
type degree and configuration of hearing loss
age of diagnosis and beginning intervention
consistency of hearing technology use
What does the research show are positive factors for success in AVT?
consistent hearing aid use
early intervention and amplification
higher non-verbal IQ
higher parental education
What are some things an AVT practitioner would want to know about a new child on caseload?
birth, health, and developmental history
etiology of hearing loss/audiologic profile
chronological and hearing age
how child communicates
child’s interests
languages spoken at home
parent’s desired outcomes
What are the 6 (7) goals of an AVT practitioner?
create positive listening environment
enhance auditory perception of speech
facilitate listening in auditory only condition
facilitate auditory processing
promote knowledge of language
facilitate spoken language and cognition
stimulate independent learning
What do we look for when watching an AVT session?
do they detect sounds?
do they identify sounds?
do they follow directions?
what do they say/do to communicate?
how would you describe listening conditions?
did the practitioner or parent use any strategies?
How do we verify auditory access and functioning in AVT?
six sound test (m, oo, ee, ah, sh, s)
talk about thing before showing/doing
look for signs of detection, discrimination, identification, and comprehension
tell parents what we see until they can assess themselves
What is auditory brain change?
process brain goes through when adjusting auditory signals provided by hearing technology
initially very distorted and messy, with listening practice and education the brain and listener can sort it out
- why hearing age is important
When does best LSL learning happen?
during repetitive, enjoyable, and meaningful activities
brain is adaptable and will learn in positive conditions with repetition and practice
What are some strategies to enhance speech perception (aka acoustic highlighting)
whispering the word
internal rehearsal (auditory feedback loop)
elongate sound or put stress on a sound or word
singing word or phrase
auditory contrasts
change speed of phrase
What are some strategies that facilitate auditory processing?
wait!!!
ask “what did you hear”
3 strikes and then repeat
adjust speech rate
chunk/segment longer phrases
reword or provide alternative messages
What strategies facilitate listening in auditory only conditions?
sit beside listener on side of hearing technology
use auditory hooks
use visual distraction techniques
What are some conditions that can be altered/controlled by the practitioner during AVT?
type, familiarity, length, loudness, location, and delivery of auditory signal
rate and clarity of speech
task type
auditory attention
distance between listener and speaker
characteristics and consistency of listening environment
number of signals
How are goals set in AVT?
long term goals
- every 6 months
- from informal and formal assessments
- in one of target domains
short term/session goals
- weekly
- in same target domains
What are some considerations for goal setting?
current performance
zone of proximal development
developmental hierarchies
communicative effectiveness
hearing age
chronological age
family culture
What is the LSL Gain expectation rule?
6-12 months worth of gain in first 6 months
12 months worth of gain in second 6 months
12-24 months worth of gain in third 6 months
What are some topic areas in audition?
detecting and localizing speech sounds
localizing speakers during conversation
responding to music
auditory memory
auditory sequencing
following directions
sound object association
What are some topic areas in speech?
developing suprasegmental features
develop specific vowels/consonants
eliminate sound omissions or substitutions
reduce specific phonological process
establish automaticity
enhance vocal quality
What are some topics in language?
ask and answer questions
expanded vocabulary use
use prepositions
use varying tenses/morphological markers
use pronouns
develop any syntactic structures
expand utterance length
What are some topics in cognition?
demonstrate play skills
comprehend games
basic concept knowledge
categorization abilities
identify what’s missing/doesn’t belong
perform motor activities
problem solving
What are some topics in communication?
turn taking
ability to vocalize wants and needs
conversational repair
social courtesies
eye contact
joint attention
pragmatics
What is the AVT session cycle?
state short term objectives
explain activity and strategies to achieve short term objectives
demonstrate activity and discuss strategies again
pass over activity to parents - observe and coach
jointly evaluate and discuss strategies/outcomes
Is counselling in the AVT scope?
with feelings related to hearing loss
sometimes intertwined with feelings unrelated to hearing loss - refer for additional support when in doubt
can initiate reflective conversations
okay to offer hope and praise
How can we increase the health literacy of parents?
ensure readability of materials
use plain language, avoid professional jargon
have them teach it back to you
smile, lean forward, maintain eye contact
What are some barriers for the family/therapist connection?
professional
- conflicting feelings of empathy and professionalism
- lack of time for counselling
- lack of training for sensitive/patient centered care
- don’t want to give false hope
- don’t want to overstep boundarie
parents
- no time to grieve
- too much information making it hard to understand
- loss of hope/direction/drive
- inability to get to therapy sessions or do homework tasks
What behaviours trigger disconnect in the sessions?
with parents
- limited eye contact
- stoic expression
- fidgety habits
- multi-tasking while parent shares
- negative body language
- unclear communication
- excessive control
- unprepared for session
- providing too much info
with children
- background noise
- stoic expression
- too close or too far
- inconsistent rules
- use of broken toys
- excess talking
- not at child’s level
- ignoring communication attempts
