Auditory Verbal therapy - what is it and what are the outcomes?

The term Auditory Verbal therapy was coined by the Alexander Graham (AG) Bell Association for the Deaf in the 1970s in the United States[47].

Auditory Verbal (AV) therapy is a robust, evidence-based, early intervention approach which supports deaf babies and children to learn to listen and talk and builds on the advantage of early diagnosis and the use of optimally- fitted hearing technology. It is delivered by qualified Auditory Verbal therapists (who are speech and language therapists, teachers of the deaf or audiologists who have undergone additional post graduate training) and has a strong peer-reviewed national and international evidence base. Auditory Verbal therapy as an approach to early intervention consistently delivers excellent outcomes.

Auditory Verbal therapy can be delivered either in-person, using telepractice or a hybrid of both methods. Telepractice is the delivery of services using telecommunication and online internet technology to remotely connect families to healthcare providers for interventions and assessments. 

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Evidence of the outcomes of Auditory Verbal therapy

There is a wealth of evidence, both from the UK and internationally, for the effectiveness of the Auditory Verbal approach with more research being published every year: studies from Australia, Denmark and the UK have shown that approximately 80% of pre-school aged children using an Auditory Verbal approach develop age-appropriate language. A systematic review published in 2021[48] and 2023[49] suggests that there is strong evidence of the effectiveness of Auditory Verbal therapy on the development of all linguistic skills.

Outcomes for a group of more than 200 children who have followed either an Auditory Verbal, a total communication or an oral (listening with an intentional support of lipreading) approach has found that children following an Auditory Verbal approach outperform children who have followed an oral or total communication approach on a number of measures including speech-language, speech intelligibility and literacy[50]. A further analysis of a greater number of Auditory Verbal interventions has been conducted to highlight both their effectiveness and to direct future research[51].

Other research, albeit more limited, has also indicated that there are benefits of choosing an Auditory Verbal approach, even after the optimal intervention age. For example, late identified children have shown social interaction skills comparable to their hearing peers after Auditory Verbal intervention[52]. In the UK, the Early Intervention Foundation (now Foundations[53], the What Works Centre for Children and Families), has independently assessed the evidence from the research base and included Auditory Verbal therapy in its guidebook for commissioners of Early Intervention programmes[54].

In addition, both national and international research has shown that children with hearing loss who, together with their parents, receive telepractice sessions perform at least as well in multiple measures of language outcomes as those who receive in-person sessions[55]. Parents have been found to be more engaged during teletherapy than traditional sessions[56],[57], and may also favour telepractice because of the reduced disruption to their everyday routine.  Telepractice also breaks down geographical barriers and facilitates global communication[58].

Delivery of individualised Auditory Verbal therapy programmes via telepractice is common practice in North America, Australasia and for practitioners at AVUK.  Parental attitudes and spoken language outcomes for children have been investigated in peer reviewed papers. An AVUK audit of parental experiences with telepractice found that approximately 80% of parents felt their child was making good progress with telepractice sessions, while 89% of therapists felt that telepractice sessions were equally or more effective than in-person sessions. With appropriate technology, telepractice is a viable means of providing Auditory Verbal therapy (Find out more about telepractice | Auditory Verbal)