What is Auditory Verbal therapy for deaf children? Expand Auditory Verbal therapy is a family-centred, early intervention approach to developing spoken language through listening for deaf children. It supports pre-school deaf children, from birth to five years of age, learn how to make sense of the sound they receive through their hearing technology, like cochlear implants and hearing aids, and develop spoken language so they can learn to talk. Learn more about our Auditory Verbal Therapy programme or complete our enquiry form or call 01869 325000.
Who are Auditory Verbal UK? Expand Auditory Verbal UK (AVUK) wants all deaf children to have the same opportunities in life as their hearing peers. It supports deaf babies and children to learn to listen and speak through Auditory Verbal therapy and provides internationally accredited training in Auditory Verbal practice for health and education professionals. AVUK works to raise expectations and outcomes for deaf children and increase access to, as well as awareness and understanding of, Auditory Verbal therapy so that deaf children have the opportunity to access it through publicly funded services close to where they live. Find out more about AVUK’s mission.
How early should Auditory Verbal therapy begin for best results? Expand Auditory Verbal (AV) therapy is most effective when started as early as possible, ideally before 3.5 years of age. AVUK works with deaf babies and children from birth to five years old, benefiting from the brain’s neuroplasticity during early development. Research shows that the younger AV therapy begins, the better the outcomes for listening and spoken language development. Explore the research and evidence behind AVT.
What role do parents/caregivers play in Auditory Verbal therapy? Expand Parents and caregivers are central to supporting their child develop language and communication, and that includes learning to listen and talk with Auditory Verbal therapy. Auditory Verbal therapy works by supporting and coaching parents and caregivers with strategies to stimulate the auditory pathways in the brain, with their child’s listening and spoken language developed through play-based activities that can be used in everyday routines and life. It is continually tailored to the family based on formal and informal assessments that allow for progress to be monitored and evaluated in a way that is meaningful for the family. AVUK also offers parent-only sessions to reflect on progress and plan next steps. Discover how AVUK supports parents, or complete our enquiry form or call 01869 325000.
Is Auditory Verbal therapy available through the NHS or privately? Expand Currently, there is little to no provision of Auditory Verbal (AV) therapy through the NHS. AVUK is the only UK-wide charity offering AV therapy directly to families. While some therapists work within the NHS or local authorities, access is limited. AVUK’s mission is for all families who want their deaf child to listen and talk to be able to access Auditory Verbal therapy close to where they live. Read more about our Hear Us Now campaign.
What is deafness? Expand Deafness, or hearing loss, happens when one or more parts of the ear aren’t working effectively. The National Deaf Children’s Society (NDCS) share that the main types of deafness are: Sensorineural hearing loss is a hearing loss in the inner ear. This usually means that either the cochlea, the connection to the auditory nerve, or the auditory nerve itself isn't working effectively. Sensorineural deafness is permanent. Conductive deafness means that sound can't pass efficiently through the outer and middle ear into the inner ear. This is often caused by blockages such as wax in the outer ear, or fluid in the middle ear (glue ear). Glue ear is a very common condition, especially in pre-school children. Conductive deafness is usually temporary, but it can be permanent in some cases, such as with Microtia which is a congenital condition where one or both ears are underdeveloped. You can find out more information about this on Microtia UK website. It's possible for children to have a combination of sensorineural and conductive hearing loss. This is known as mixed deafness. One example of mixed deafness is when someone has glue ear as well as sensorineural deafness. Deafness in one ear only is known as unilateral hearing loss, which can also be referred to as single-sided deafness (SSD). Very few deaf children have no useful hearing. Most deaf children can hear some sounds at certain frequencies and loudness, and with the use of hearing aids or implants they are often able to hear more sounds. You can find out more about deafness on the NDCS website.
My child has been diagnosed as deaf / with a hearing loss. What should I do? Expand We understand that discovering your child has a hearing loss can be challenging for some families. Families often contact us soon after they have been told their child is deaf and feelings of shock and uncertainty are common. We offer a safe and non-judgemental place to share these feelings, so families can start to acknowledge and understand the rollercoaster of emotions they are facing. Early and effective support is vital so deaf children are able to develop their language and communication skills. All deaf babies and children should have access to early and effective support whether they use sign language, spoken language or both. Auditory Verbal therapy is one of the support options available to families of deaf children. At Auditory Verbal UK we support deaf babies and children to learn to listen and speak through Auditory Verbal therapy. Our family centred Auditory Verbal programme supports and equips parents and caregivers with the tools they need to help their deaf child process the sound they get from hearing technology, like cochlear implants and hearing aids, and develop their listening and spoken language in the first few years of their lives. If you'd like to find out more about our programme, sign up to one of our free online webinars, where you can meet one of our Auditory Verbal therapists, complete our enquiry form or call 01869 325000.
What is a newborn hearing screening? Expand The newborn hearing screening test helps identify permanent moderate, severe and profound deafness and hearing loss in all newborn babies, as early as possible (within the first 4-5 weeks after they are born), and it means parents can get the support and advice they need right from the start (NHS website). You can find specific information about how the newborn hearing screening works where you live on NHS websites: England Wales Scotland Northern Ireland
My baby failed their newborn hearing screening. What should I do? Expand Families often contact us soon after their baby has failed their newborn hearing screening. Feelings of shock and uncertainty are common, and we offer a safe and non-judgemental place to share these feelings, so families can start to acknowledge and understand the rollercoaster of emotions they are facing. Early and effective support is vital so deaf children are able to develop their language and communication skills. All deaf babies and children should have access to early and effective support whether they use sign language, spoken language or both. Auditory Verbal therapy is one of the support options available to families of deaf children. At Auditory Verbal UK we support deaf babies and children to learn to listen and speak through Auditory Verbal therapy. Our family centred Auditory Verbal programme supports and equips parents and caregivers with the tools they need to help their deaf child process the sound they get from hearing technology, like cochlear implants and hearing aids, and develop their listening and spoken language in the first few years of their lives. If you'd like to find out more about our programme, sign up to one of our free online webinars, where you can meet one of our Auditory Verbal therapists, complete our enquiry form or call 01869 325000.
Which websites can I trust to give me impartial information about hearing loss? Expand It is fantastic that there is so much information online about hearing loss, but it can be challenging to navigate yourself around and find information that you can trust. AVUK’s website can provide you with specialist information about the Auditory Verbal approach. The National Deaf Children’s Society provides impartial information about all levels of hearing loss, and the support that is available.
What do hearing aids do for babies and children with hearing loss? Expand Hearing aids typically work by amplifying sounds and making them clearer. Hearing aids are set by the audiologist based on the child’s individual hearing levels and very often each ear will have different settings, depending on the child’s audiogram. Auditory Verbal therapy supports deaf children process the sound they get from their hearing technology, like hearing aids, to develop language so they can learn to talk like their hearing friends. When deaf babies receive hearing technology, the brain needs to learn how to make sense of this sound as they don’t magically work on their own. If you'd like to find out more about our programme, sign up to one of our free online webinars, where you can meet one of our Auditory Verbal therapists, complete our enquiry form or call 01869 325000.
What do cochlear implants do for babies and children with hearing loss? Expand Cochlear implants allow the brain to access sound. The NHS explain that they work by turning sound into electrical signals and sending them to part of the inner ear called the cochlea. From here, the signals travel to the brain and are heard as sound. The implant has 2 main parts: a microphone behind the ear that picks up sound and changes it into electrical signals, which are sent along a wire to a device on the skin a device placed inside the skull that picks up the electrical signals from the device on the skin and sends them along wires to the cochlea Before having a cochlear implant, you'll have an assessment to find out if it will help. The implant will only work if the nerve that sends sound to the brain (auditory nerve) is working properly. Auditory Verbal therapy supports deaf children process the sound they get from their hearing technology, like cochlear implants, to develop language so they can learn to talk like their hearing friends. When deaf babies receive hearing technology, the brain needs to learn how to make sense of this sound as they don’t magically work on their own. If you'd like to find out more about our programme, sign up to one of our free online webinars, where you can meet one of our Auditory Verbal therapists, complete our enquiry form or call 01869 325000.
My baby can’t hear so why bother with hearing aids? Expand If your baby has a profound hearing loss and you haven’t seen any responses to sound yet, this doesn’t always mean he/she can’t hear at all. It is actually more common for children with a profound hearing loss to have some useful hearing still. The important thing is to make sure that your baby’s hearing aids are set so that she can use his/her hearing well. This happens by working together with your local audiologist. The sessions with your Auditory Verbal Therapist will then focus on teaching your baby to learn that sound is meaningful. See our YouTube channel to find out what babies with a profound hearing loss can do!
Do you work with children who have auditory brainstem implants (ABIs)? Expand AVUK has experience of working with several children who have auditory brainstem implants (ABI). We recognise the unique needs of children with ABIs and work closely with your auditory implant team to ensure that your child is getting the best access to speech through their implant. Goals are set on a regular basis and progress is closely monitored, with the aim of accelerating your child’s ability to make sense of sound through their ABI.
Our child is being assessed for a cochlear implant. Should we wait? Expand No, research shows that the earlier you start Auditory Verbal therapy, the better the outcomes for your child will be. AV therapy is a diagnostic approach which complements the routine tests carried out during cochlear implant assessment. The large majority of children with a profound hearing loss have some degree of hearing in the lower frequencies. Our role is to ensure that your child is making the very best use of their residual hearing as they await cochlear implant fitting. We do this by giving you auditory verbal techniques and strategies to use at home that maximise listening and speaking in everyday situations.
Help! My baby keeps pulling his/her aids out. Expand Don’t panic, this is a familiar situation for many parents and can be very frustrating at times. When a baby consistently pulls his/her hearing aids out, this can be an indication that there is an issue either with the way the hearing aids have been programmed or the hearing aid itself is uncomfortable. This is important information that you should share with your local audiologist to help them set your baby’s hearing aids appropriately. Our experience is that if a baby is getting auditory benefit from their hearing aids and they are comfortable to wear, they will not pull them out.
Can all children with hearing loss learn to listen and talk? Expand Learning to listen and talk is achievable for many deaf children, through a combination of early diagnosis, hearing technology and early and effective interventions. Being able to learn to listen and talk will depend in part on: Their age when their hearing loss begins and age at which their hearing loss is identified Whether their hearing technology is giving them access to all the sounds of speech Whether they are receiving support from an effective early intervention practitioner who specialises in listening and spoken language How much they use their hearing devices The learning environment they are in (at home and in educational settings) The presence of any additional needs that may impact the development of listening and spoken language. Where, through informed choice, parents and caregivers opt for listening and spoken language for their child, Auditory Verbal therapy offers a robust approach which has a strong evidence base and consistently delivers excellent outcomes.
Is an Auditory Verbal programme right for my family? Expand Our programme may be suitable for you and your family if: You would like your child to learn to communicate through listening and spoken language. Your child is 0 to 5 years old. Your child has a mild to profound hearing loss. Your child has been fitted with or will be fitted with hearing technology such as hearing aids or auditory (cochlear) implants. We have staff who support your family’s wellbeing and provide guidance for other aspects relating to your child’s deafness and family circumstances, such as supporting your application for financial assistance. If you'd like to find out more about our programme, sign up to one of our free online webinars, where you can meet one of our Auditory Verbal therapists, complete our enquiry form or call 01869 325000.
When is it best to start AV therapy? Should we wait until our baby is older? Expand At Auditory Verbal UK we work with babies and children aged up to five years old to maximise the vital development stage of the brain. For children who are born deaf, especially into hearing families with no experience of hearing loss, skilled and sensitive early support is vital if they are to develop the language and communication skills they need to be ready to start school alongside their hearing peers. Research shows the younger you start AV therapy, the better the outcomes will be for your child. See latest evidence here.
What is the difference between Auditory Verbal (AV) therapy and other approaches? Expand Auditory Verbal therapy is one approach for families of deaf children for developing spoken language. It differs from other spoken language approaches in how it is delivered and who it is delivered by. How an Auditory Verbal therapy programme works: It is a parent-coaching programme. Typically, during fortnightly sessions, for an average of 2 and a half years, your family is supported to develop your child’s language skills so that you can use the techniques at home. The best outcomes are achieved when your child’s hearing technology (hearing aids or cochlear implants) are working optimally through liaison and working closely with your audiology team. It is a play-based approach. Through play, we work to enable your child to listen and talk, and to improve your child’s confidence and their peer interaction. A strong basis in listening provides a solid foundation for the skills needed for learning to read and write. These are all important for time spent in the playground, the classroom and throughout their lives. It is individualised. The programme is designed for your child and their needs. The programme is designed for your child and their needs, and you and your child are seen together. Goals are set within a developmental framework and progress is closely monitored in partnership with your family and other professionals who work with you. We work together with you to share learnings with professionals, including your teacher of the deaf and speech and language therapist, so the whole team around you are working together to support you and your child. Find latest evidence and research on AV therapy and outcomes.
How will I know how well my child is progressing? Expand When starting therapy at AVUK, an Auditory Verbal therapist will carry out an initial assessment which will give families an indication of their child’s spoken language ability in comparison to their chronological age. Our aim is to accelerate spoken language development so we can close the gap as much as possible between a child’s spoken language age and their chronological age. Every certified Auditory Verbal therapist is trained to monitor a child’s current level of ability in listening, cognition, play, spoken language and sensory-motor development. The aim is to enable each area to develop in synchrony. Any areas that may not be developing as fast as others can be targeted specifically within sessions and at home or school. Sometimes, if needed, the therapist will refer families on to other specialists such as audiologists, occupational therapists, Child and Adolescent Mental Health Service or educational therapists if further investigation or support is required.
I want my child to learn British Sign Language (BSL) as well as speech with the AV approach. Is that possible? Expand Yes, it is possible for a deaf child to learn both spoken language and BSL. We support parental choice and the child’s right to an appropriately rich language environment. Auditory Verbal therapy supports deaf children to develop spoken language through listening as the primary route for learning. It is typically suited for families who choose listening and spoken language as their first and main choice of communication in the child’s home and educational settings. BSL is a language in its own right with its own word order and grammatical system. For families who want their child to use both BSL and spoken language, they will need access to BSL and spoken language across a variety of environments with a variety of people. Find out more about learning BSL. You can also find useful information and support about BSL from the British Deaf Association, as well as further information on the National Deaf Children’s Society website.
Can we embark on Auditory Verbal therapy if my child has additional needs? Expand At AVUK, the family of any deaf child who uses hearing technology, such as cochlear implants and hearing aids, including children with additional needs, can be given the opportunity to be supported in the Auditory Verbal approach, in order to develop listening and spoken language. Our family programme starts with an initial six-month diagnostic window. During this period, the parents or caregivers, therapist and, ideally, the other professionals working with the child, will collaborate to determine whether Auditory Verbal therapy is appropriate. If not, the parents or caregivers will be supported in seeking alternative approaches. Although the majority of children on AVUK’s family programme progress in their listening and spoken language skills, some children with additional needs may progress over an extended timescale. Around a third of the children currently on the AVUK programme who have additional needs are expected to continue to require additional support. Outcomes show that 1 in 2 deaf children with additional and often complex needs reaches age-appropriate language after attending the AVUK programme for at least two years, and those children who did not attain age-appropriate language after more than 2 years did, however, double their rate of spoken language development while on the programme. (Hitchins, A. R., & Hogan, S. C. 2018).
What are the benefits of Auditory Verbal (AV) therapy? Expand Auditory Verbal therapy supports deaf children to learn how to make sense of the sound they receive through their hearing technology (such as hearing aids or cochlear implants) and develop spoken language so they can learn to talk like their hearing friends. Auditory Verbal therapy is a family-centred, early intervention approach which equips parents and caregivers with the tools needed to support the optimum development of their deaf child’s listening and spoken language. Our most recent study shows that 80% of children who attended our programme for at least two years achieve age-appropriate language, and 97% of children without additional needs who attended our programme for at least two years achieve age-appropriate language. 1 in 2 children with additional and often complex needs reached age-appropriate language after attending the programme for at least two years, and all children with additional needs double their rate of language on the programme. Most children attend mainstream school and our 2022 report, Stepping Stones to Literacy, shows that deaf children on our specialist early intervention programme are attaining educational outcomes on a par with hearing children. The best communication outcomes for deaf children - whether spoken language, sign or both - are associated with early diagnosis and early enrolment in effective Early Intervention programmes. Without early and effective intervention, deaf children are at greater risk of leaving primary school without developing the expected standard of reading, writing, and mathematics, compared to their hearing peers. You can read more about the evidence base for AV therapy here.
What does a child need for Auditory Verbal therapy to be effective? Expand The foremost pre-requisite for Auditory Verbal therapy to be effective is that the child has supportive and encouraging parents or carers who will celebrate their child’s achievements. The people who know their child best are the parents or carer and they must be able to share their expertise of their child with their Auditory Verbal Therapist and incorporate the Auditory Verbal strategies into their everyday life, each and every day. An accurate diagnosis of the hearing loss together with the most appropriate and optimally programmed hearing technology (hearing aids or implantable devices such as a bone-anchored hearing aid (BAHA), cochlear implant (CI) or auditory brainstem implant (ABI)) are also essential components to get right at the start of the Auditory Verbal programme. Each parent must be confident with their child’s hearing technology and the child must be happy to wear their hearing technology consistently. Lastly, early intervention is vital if a child is to develop the language and communication skills they need to be ready to start schools alongside their hearing peers.
How effective is AVT for children with Auditory Neuropathy Spectrum Disorder (ANSD)? Expand Auditory Verbal therapy is especially useful for children with Auditory Neuropathy Spectrum Disorder (ANSD) as it equips you with the tools you need to be able to check your child’s listening at home whenever you feel your child’s hearing levels have changed. This enables you to make adjustments to your input and environment and these techniques can be used in the home as well as by staff in nursery or school. With the changeable nature of ANSD, it is really important that as much information is gathered as possible so that you can make a decision and a plan about how best to manage your child’s hearing loss as soon as possible. For children with ANSD we offer a diagnostic period for three months to look specifically at what your child is hearing day to day and what they can functionally do with their listening and we train you as the parent/carer to be the best observer of your child so that you can confidently judge when he or she is or isn’t hearing you and how well he or she is hearing you. We have a large number of children on our caseload with ANSD who are showing, with the appropriate amplification, that they have the ability to learn to listen and talk. For further information, see https://alicesears.com – a blog written for parents of children with Auditory Neuropathy Spectrum Disorder (ANSD). Alice graduated from Auditory VerbalUK in 2013 with age-appropriate language.
We cannot afford your fees. Do you offer financial support? Expand With little to no provision of Auditory Verbal therapy currently available through the NHS or publicly funded services, Auditory Verbal UK (AVUK) is the only UK-wide charity that provides this support directly to deaf children and their families. We provide a programme of support for deaf children across the UK whose families want them to learn to listen and talk. As a not-for-profit organisation, we fundraise to cover the costs of providing this support to families. We ask families to make a contribution to this cost based on household income, with the remaining balance funded by donations from our generous supporters. We receive no funding from central government. Nearly 80% of families on our programme receive financial support through the bursary scheme. Should you not qualify for a bursary or require further financial help, we offer support to find other financial options you can apply for. Some families have been able to secure partial or full funding to join the programme from other charitable trusts and organisations, for example the Moondance Foundation has supported families in Wales, and the Birkdale Trust has also supported families with grants. Other families have secured funding based on, for example, their employment, geographic location or specific circumstances of their child. Some families have received support with funding from their local authority through their Education, Health and Care Plan (EHCP). Click here to find out more. We have a dedicated team who can provide support and answer any questions you might have about the bursary scheme or other financial options. Contact us on [email protected] or call 01869 325 000.
Have you worked with families where the parent(s) also have hearing loss? Expand Yes, we have worked with families where the parent(s) also have a hearing loss. If you have any specific questions or concerns please do get in touch with one of the clinical team.
What happens if the Auditory Verbal therapy approach doesn’t work for our family? Expand The Auditory Verbal approach is diagnostic – this means that within each session, the AV therapist will be listening and watching with you as the child’s parent/carer, to evaluate the goals and expectations that were set for you and your child. Therapy goals are then tailored based on the needs of the family and the child. When a family first join the programme, they are advised that there will be a diagnostic period when the questions above can be addressed in detail. If, after this period, the joint conclusions of the family and the therapist is that the approach is enabling the child to listen and learn, then the child’s individualised programme will continue with on-going monitoring and review. If the programme is not working for you and your child, we think with you about the possible reasons and make a plan for what needs to happen next. We actively support families to find the most appropriate communication approach for their child and the best means of supporting your child’s learning at the earliest possible time.
We speak a different language at home. Can we work in our home language? Expand Auditory Verbal therapists at AVUK are highly experienced in working with families from a variety of cultural and linguistic backgrounds. We recognise the importance of the family background and will work together with you to find a package of care that best meets your needs. It is important that your child learns to speak the language that he or she will hear most at home. The Auditory Verbal techniques and strategies can be transferred to other languages. Our therapists have experience or currently work with families that communicate with their children in: Russian, Arabic, Hindi, Urdu, Bengali, Gujarati, Punjabi, Mongolian, Swahili, Kikuyu, Turkish, Swedish, Portuguese, Polish, Romanian, Latvian, Yiddish, Dutch, Greek, Spanish, French, Italian, Montenegrin, Maltese, Mandarin, Cantonese and Afrikaans.