Auditory-verbal therapy (AVT) is notably one of the most popular approaches to improve communication skills of children with hearing impairment . Focusing on audition as the primary input for learning spoken language without relying on speech reading and gestures, AVT requires children with HI to wear amplification devices on a regular basis. The main differences between AVT and other oral-based rehabilitation approaches are that AVT is tailored to suit the individual needs of each client and that it requires the child’s parent or caregiver to be present at each session . From the time the first report on AVT was published in 1993 , AVT has been the choice of parents of children with HI for learning spoken language. Like any other treatment approach, it is imperative to evaluate empirical evidence to determine the efficacy of AVT.
A detailed review of studies on AVT outcomes conducted from 1993 to the present reveals a lack of strong evidence supporting the efficacy of this approach. Ten studies on AVT outcomes in speech and language development report that:
children with HI receiving AVT can successfully learn spoken language
socioeconomic status has no effect on AVT outcomes
hearing-impaired children over 3 years old can catch up with their hearing peers in terms of speech and language.
Cupples, L. et al. International Journal of Audiology. Published online: 14 September 2016
Objective: This study examined language and speech outcomes in young children with hearing loss and additional disabilities.
Design: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs).
Study sample: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part.
Results: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes.
Conclusions: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.