Auditory Verbal Therapy Strategies Binder

Auditory-Verbal Therapy (AVT)
Strategies
Goal 1: Create a Listening
Environment
Strategy 1: Controlling the Environment
Definition: Making sure the environment in the
child's home is ready for listening and language
learning experiences during sessions and anytime
the child and parent are interacting outside of AVT
sessions.
How to incorporate this strategy in natural
environments: Parents are informed by Auditory-
Verbal Therapist how background noise can impact
the child's ability to learn. Also, for high ceilings and
floors, reverberation can occur so floor, window, and
wall coverings are encouraged to be used in the
home.
Strategy 2: Speaking Within Earshot

Definition: The person talking to the child is close
enough to them so that all speech sounds can be
understood and heard by the child.
environments: The parent when talking to the child
will be approximately 3 to 12 inches from the child
and positioned on the side of the child's better ear.
Goal 2: Facilitate Auditory
Attention
Strategy 3: Pointing to the Ear and Saying "I've heard
something!"
Definition: Pointing the ear is a visual cue that
allows the child know a speech and environmental
sound is occurring. Pointing with along with the
verbal cue "I've heard something!" helps with word
comprehension.
environments: When parents are interacting with
their child in play routine, they can get their child
ready to listen by saying "listen!" and pointing to
their ear.
Strategy 4: Presenting a Look of Concentration with

Verbal Prompt
Definition: Facial expressions can be cues for young
children. Facial expressions that are used in AVT
mostly are expressions to indicate anticipation or
listening such as tilting the head or leaning toward
the sound source.
environments: When parents are playing with their
child or they are in an area where after an
unexpected sound occurs, the parent can point to
their ear and say "Did you hear that?" while using a
facial expression to grab the child's attention.
Strategy 5: Using Auditory Hooks
Definition: Prompts that grab the child's attention to
want to listen to something and alert them that
something exciting is happening.
their child in routines, they can use a variety of
phrases, words, or fillers such as "Hey!", "Look!",
"That's cool!" to promote longer episodes of shared
or joint attention.
Strategy 6: Using Visual Distractors

Definition: Prompts used by the speaker that direct
or redirect the child's visual attention to something
else that is not the speaker's face.
their child in a grocery store they can point to an
object on a shelf, toward a window, or to another
person. Parents can also shift their bodies that can
be hard for the child to read the parents face.
Strategy 7: Preparing the Child to "Listen first and

Last"
Definition: Child listens to the spoken language
(auditory-message) first and if the child does not
understand the message after 3 times then a visual
reinforcer is used to help the child understand. Once
the child understands, the auditory message is said
again.
environments: Parent says "milk?" and waits for the
child's response such as saying or shaking head yes
or no. If child does not respond after parent says
"milk?" 3 times, parent will bring out the milk as the
visual reinforcer. Then parent will say "milk" again.
Goal 3: Enhance Auditory
Perception of Speech
Strategy 8: Speaking Parentese
Definition: Speech that is higher-pitched,
hyperarticulated, repetitive, rhythmic, melodic, and
has a slower tempo than typical speech.
environments: When parents are about to feed their
child, the parent can ask "Billy want milk?" instead
of "Does Billy want milk?".
Strategy 9: Engaging in Vocal Play

Definition: Vocal Play is when the child is playing
with their voice, this can show when a child
progresses from intentional cooing and vowel
utterances to "blowing raspberries" and making
sounds with their lips and tongues. It's important for
the parent to imitate this vocal play.
environments: When the child spontaneously
vocalizes, the parent will imitate the spontaneous
vocalization and then vary their own vocal play. Ex:
child says: baba, parent imitates: baba, child says:
baba, parent says: mama
Strategy 10: Associating Sounds With Objects and

Words
Definition: This process of recognizing and
identifying what we see and hear.
environments: Parent repeatedly saying in play.
“/b/b/b/” each time the child plays with a toy bus
(the object) or sees a real bus, helps the child
associate meaning with the phoneme /b/.
Strategy 11: Whispering
Definition: Whispering specific sounds, words,
and/or phrases can help children hear them more
easily, including high-frequency consonants such as
/h/, /s/, /t/, /k/, /f/, /p/, /sh/, and /th/, which
these frequencies can be difficult for those with
hearing aids to hear.
environments: Parents can incorporate whispering
high frequencies when they are using the earshot
strategy during play.
Strategy 12: Singing

Definition: Singing songs is enjoyable for children
and parents and facilities listening skills, spoken
language, speech, and cognitive skills such as
memory. It can also facilitate parent-child
interactions and social bonding.
environments: Parents can sing songs during play,
bath time, putting their child to sleep, and other
other routines. Songs do not have to be official like
"Wheels on the Bus" but can be made up by the
parent as long as the song is repetitive.
Strategy 13: Stressing Selective Morphemes,

Syllables, Words, and Phrases
Definition: All of these stressed are louder, longer,
and higher pitched and allows the child to focus on
that auditory input.
environments: Parents can say /no more/ after the
child has finished eating.
Goal 4: Promote Knowledge
of Language
Strategy 14: Focusing on the "Knowing" Rather than
the "Using"
Definition: Coaching parents on focusing on the
child's receptive language rather than the
expressive language.
environments: AVT therapists can coach parents on
how when a child uses a subtle gesture and the
parent instead of responding to the request right
away can label what the child is asking for such as
"milk" or "bubbles".
Strategy 15: Taking Turns
Definition: Turn-taking may not happen in
conversation like it does in a hearing parent and
hearing child interaction, however turn-taking can
still occur..
environments: The child learns to wait for his turn
after the parent presents an item in a play activity.
Also, the child learns that when it is his turn, he will
be able to freely manipulate the item for at least a
few minutes.
Strategy 16: Imitating the Child's Early Vocalizations
Definition: When the parent repeats what the child
says to provide positive-feedback to the child.
environments: While practicing the strategy for turn-
taking while the child is vocalizing the parent can
imitate and wait for the child to respond, once the
child stops vocalizing again the parent can imitate
again and expand on what the child is vocalizing.
Strategy 17: Verbalizing in Synchrony with Movement
Definition: Child can learn language when what they
hear with what they see.
environments: When playing with bubbles, parents
can says pop at the same time as actually popping
the bubble.
Strategy 18: Speaking the Language From The Child's

Angle
Definition: Adult uses parallel talk, talking about
what the child wants to say and follow the child's
lead in what their interests and apply that to all
routines.
environments: While brushing the child's teeth, the
child stops and points something on the parents
shirt such as a button and says "button", instead of
ignoring, the parents says "yes that is a button".
Strategy 19: Talking Before, During, and After the

Action
Definition: The adult talks before the action, allowing
the child to anticipate, then talk about what will
happen, and when the activity will stop.
environments: During lunchtime, the parent may
have a toy the child really likes in the lunchbox and
before opening it, says, “I have a toy in here.” The
adult looks in the bag without letting the child see it,
and says, “Yes, my toy is in here. It’s a wind-up
monkey. Do you want to see it?” Then the child looks
in the bag and can play with the toy while the adult
narrates what the child is doing.
Strategy 20: Pausing for Grammatical Spaces or
Stress Markers
Definition: Using phrasal intraturn pause such as
pausing at the end of phrases and sentences. Also
using the impact pause, such as waiting for the child
to respond.
environments: When talking to the child using
Phrasal Intraturn Pause: "This morning, I spilled my
juice on the floor." Impact Pause: "The wheels on the
bus go round and (wait for child to respond with
round)
Strategy 21: Transitioning Beyond the Comfort Zone
Definition: Adults expands on the what the child
already knows.
environments: While playing with blocks, the child
says blocks and the parents expands on that by
saying blue block.
Strategy 22: Recasting, Expanding, and Expatiating
on the Child's Words
Definition: Recast: restate the child’s utterance into a
different format, such as a question format. Expand:
repeat the child’s utterance but in a more
grammatical and complete way without modifying
the child’s word order or intended meaning.
Expatiate: expand on the child’s utterance, but with
the addition of new information.
environments: When child says "da-da bye-bye",
Parents can recast: "is daddy going bye-bye?"
expand: "yes, daddy is now going bye-bye" or
expatiate: "yes, daddy is going bye-bye. Daddy has
to go to work."
Strategy 23: Emphasizing Actions, Relations, and
Attributes
Definition: Putting emphasis on words that easily
observable or experienced instead of highlighting on
nouns.
environments: Parent describes how things feels,
sound, look, or move ex: "this feels so SOFT!" or
"wow this is HOT".
Strategy 24: Contrasting Meaning

Definition: Adults use opposites to help understand
differences and to facilitate contrasts and put
emphasis on the contrasting words.
environments: When brushing hair, the parent could
say "My hair is CURLY but your hair is STRAIGHT."
Goal 5: Facilitate Spoken
Language and Cognition
Strategy 25: Leaning Forward with Expectant Looks
Definition: Adult models listening behaviors to
encourage and establish joint attention, and signal
the child that a verbal response is expected.
environments: Parent says "hm" when sitting down
the table for lunch/dinner and waits for the child to
respond and parent may say "hm" again if child
does not respond after 5 seconds.
Strategy 26: Signaling With Objects

Definition: Using an object as a physical cue or
prompt to signal the child that it is his turn to talk.
environments: Adult uses a microphone to indicate
that it is the child's turn to talk either by a sound,
word, or phrase that needs to imitated or initiated.
Strategy 27: Providing Self-Statements

Definition: The child makes spontaneous
statements in response to adult self statements
simply described as the adult says a statement with
"I".
environments: Child points a bubbles and vocalizes
and parent says "You want those bubbles!" then
follows with self statement as "I want those bubbles
too!".
Strategy 28: Asking, "What Did You Hear?"
Definition: Child responds with "what" sometimes
when they fully do not understand something
instead of explaining right away the adult asks
"what did you hear?"
environments: Used in conversations with the child
so that they are able to fill in the missing pieces.
Strategy 29: Asking Age Appropriate Questions

Definition: Asking open-ended questions to the child
instead of just asking yes/no questions.
environments: Parent can ask open-ended
questions during Storytime, it is important for the
parent to not look at the child when asking the
question so the child has time to think and answer.
Strategy 30: Promoting Auditory-Verbal Closure

Definition: The adults pauses and waits for the child
to fill in missing portions of the spoken message
based on prior knowledge and familiarly of
language and topic.
environments: Having the child play auditory-verbal
closure games such as "Peek-a-boo. I see ......" child
fills in you.
Goal 6: Stimulate
Independent Learning
Strategy 31: Pretending Objects are Something Else
Definition: Using symbolic play: the ability of
children to use objects, actions, or ideas in their play
activities.
environments: Parent can use a toy banana as a
pretend phone and giving it to the child to imitate.
Strategy 32: Creating the Unexpected
Definition: Purposely messing something up and
having the child correct the behavior.
environments: When giving a snack during mealtime
the parent can give a snack that is hard to open for
the child and wait for the child to say open please or
gesture to have the snack opened.
Strategy 33: Talking with Imaginary Friends
Definition: Assigning roles to inanimate objects to
promote exchanges.
environments: Parent uses child's favorite stuff
animal to help the child eat and has the stuff animal
say "I'm hungry, I'll eat this sandwich" and has the
stuff animal pretend to eat the sandwich.
Strategy 34: Accepting and Making Mistakes
Definition: Making mistakes is part of learning
environments: When a child makes a mistake or
provides the wrong response the parent reassures
the child that everyone makes mistakes and
mistakes help them learn.
References
The AG Bell Academy for Listening and Spoken Language. (n.d.). About the LSL Specialist Certification. The AG Bell
Academy for Listening and Spoken Language. Retrieved from https://agbellacademy.org/certification/.
Brennan-Jones, C. G., White, J., Rush, R. W., & Law, J. (2014). Auditory-verbal therapy for promoting spoken language
development in children with permanent hearing impairments. The Cochrane database of systematic reviews, (3),
CD010100. https://doi.org/10.1002/14651858.CD010100.pub2
Blaiser, K. (2012). Supporting Communicative Development of Infants and Toddlers with Hearing Loss. Seminar in
Speech and Language, 33(4), 273–279.
Casoojee, A., Kanji, A., & Khoza-Shangase, K. (2021). Therapeutic approaches to early intervention in audiology: A
systematic review. International Journal
ofPediatricOtorhinolaryngology,150.https://doiorg.proxy.library.kent.edu/10.1016/j.ijporl.2021.110918
Estabrooks, W., MacIver-Lux, K., & Rhoades, E. A. (2016). Auditory-verbal therapy for young children with hearing loss
and their families and the practitioners who guide them. Plural Publishing, Inc.
Hitchins, A. R. C., & Hogan, S. C. (2018). Outcomes of early intervention for deaf children with additional needs
following an Auditory Verbal approach to communication. International Journal of Pediatric Otorhinolaryngology, 115,
125–132. https://doi-org.proxy.library.kent.edu/10.1016/j.ijporl.2018.09.025
Lim, S. Y. C., & Simser, J. (2005, January 1). Auditory-Verbal Therapy for Children with Hearing Impairment. ANNALS-
ACADEMY OF MEDICINE SINGAPORE, 34(4), 307–312.
Mohammad Esmaeilzadeh, S., Sharifi, S., & Tayarani Niknezhad, H. (2013). Auditory-VerbalmMusic Play Therapy: An
Integrated Approach (AVMPT). Iranian journal of otorhinolaryngology, 25(73), 197–208.
Smolen, E. R., Wang, Y., Hartman, M. C., & Lee, Y.-S. (2021). Effects of Parents’ Mealtime Conversation Techniques for
Preschool Children with Hearing Loss Who Use Listening and Spoken Language. Journal of Speech, Language, and
Hearing Research, 64(3), 979–992.

Auditory Verbal Therapy Strategies Binder

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Auditory Verbal Therapy Strategies Binder

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Auditory-Verbal Therapy (AVT)

Strategy 2: Speaking Within Earshot

Strategy 4: Presenting a Look of Concentration with

Strategy 6: Using Visual Distractors

Strategy 7: Preparing the Child to "Listen first and

Strategy 9: Engaging in Vocal Play

Strategy 10: Associating Sounds With Objects and

Strategy 12: Singing

Strategy 13: Stressing Selective Morphemes,

Strategy 18: Speaking the Language From The Child's

Strategy 19: Talking Before, During, and After the

Strategy 24: Contrasting Meaning

Strategy 26: Signaling With Objects

Strategy 27: Providing Self-Statements

Strategy 29: Asking Age Appropriate Questions

Strategy 30: Promoting Auditory-Verbal Closure

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