When some people think about auditory-verbal therapy, they envision people walking around talking with their hands covering their mouths, at all times. This is not the case. The purpose of auditory verbal therapy is to work on enhancing listening skills so that the child becomes reliant on the auditory information that he/she receives from the hearing technology. But, by no means is it meant to be unnatural. While there is a need for covering the mouth/face during auditory therapy, it is not necessary for it to be all of the time. In order to become a natural communicator, it is equally important for a child to learn about the pragmatics of communication, such as facial expression and body language.
The purpose of listening and spoken language therapy is to maximize a child’s auditory skills so that speech and language skills can develop in a natural progression. At times, this does require limiting a child’s access to visual cues. This can be done by covering the mouth OR it can be done more naturally, by sitting side by side or behind the child as you speak. As a child is working to move up the auditory hierarchy, it is crucial to ensure that the child is using audition, rather than other visual cues. However, goals during listening and spoken language sessions generally don’t focus on listening in a “vacuum”. In addition to working on listening, they focus a variety of different speech and language skills including vocabulary, grammar, articulation and pragmatics.
When the goal of an activity is auditorily based (such as discriminating sounds, detecting word endings for grammatical usage, or hearing differences in inflection for questions), visual cues should be minimized. However, when the goal of an activity is another language skill, visual cues may be necessary. For example, when working on social pragmatics the child may need to see facial expression and body language in order to learn how to read these cues. In terms of articulation, a child may need to see how the articulators need to move in order to accurately produce a sound.
It is the job of the auditory therapist to determine whether an error is due to an issue with hearing. If so, then discrete practice of that skill using audition alone is necessary. At times, a child may have difficulty learning a skill using audition alone. Then, the auditory sandwich technique is suggested.
- Present the stimulus auditory only
- Re-present the stimulus providing visual and tactile cues as needed
- Re-present the stimulus auditory only
This allows for the child to receive the prompting needed to obtain the skill, but then returns to audition to ensure that the child again hears and focuses on the sounds (knowing what is expected).
Keep it Natural
Especially at the initial stages of auditory learning it is important to place an emphasis on listening and using every bit of the auditory information that a child receives from the technology. However, be sure to keep it natural so other language skills can emerge.