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Auditory Verbal Therapy (AVT/LSL)

AVT=specialized therapy for people with hearing loss/ hearing devices such as cochlear implant(s) and hearing aid(s)

My AVT Story

I often get asked how I got into this specialty of AVT and it all started with my mother. My mother was born deaf (profound hearing loss) and was the only person with hearing loss in her family. My grandmother was determined that my mother would be able to speak and did her research at the local library (pre-google). It was the 1960’s at the time and cochlear implants weren’t invented yet, but my grandmother found an “auditory oral” program in California and moved the family so that my mom could attend this school. Auditory-oral means learning to understand others through lip reading and using residual hearing and visual-tactile methods to learn to speak. My mother recalls learning how to make a “p” sound by puffing on a feather and watching it move and touching her teachers' throats to learn how to turn her voice on. She grew up wearing hearing aids and only received only slight benefit from it. 

When I was a little girl, I remember feeling sad for her sometimes that she didn’t get to hear music the way I could or hear her loved one's voices. Every birthday wish and dandelion wish, I would silently wish that my mom could hear. Once, I told her that I would make these wishes, and she said, “that’s sweet of you, and I wish I could hear your voice too, but I like things quiet sometimes and would want to be able to turn my hearing off and sleep peacefully or simply enjoy the peace and quiet.” This always stuck with me because it gave me so much perspective that she saw the beauty in her hearing loss and even appreciated her deafness. 

Fast forward roughly 25 years later, she agreed to try a cochlear implant and now both our wishes are granted. She can now hear my voice and the ocean and dances along to music for the first time in her life, she can even tell the difference between different birds chirping! Yet, still one of her favorite features of her cochlear implant is being able to take it off when she wants deep peaceful sleep or just some peace and quiet. 

My mother’s hearing journey is fairly unique, but it has given me profound perspective and personal understanding and empathy in my role as an AVT. When we were attending her pre-surgery appointments, I recall drilling her surgeon with questions and being genuinely anxious that everything would go according to plan, even though I’d walked hundreds of families through the process prior to her. When it was my own family member, it made it all the more real and scary and personal. Her bravery to get the surgery as a 60 year old woman and determination in therapy and follow up after inspires me to be the best coach, advocate, and cheerleader for my clients and families I can be. 

If you or your loved one has hearing loss, I would be honored help you and your loved one through your journey with hearing loss and help them be the best listener and communicator they can be. Reach out to schedule a free call and I'd be happy to answer your questions. 

Auditory Verbal Therapy (AVT/LSL): About Us
mom and maeve CI.jpg

 Common Questions About AVT/CI

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Auditory Verbal Therapy (AVT/LSL): FAQ

What is AVT?

AVT stands for auditory verbal therapy and is also called LSL (listening and spoken language) and is essentially speech therapy for people with cochlear implant(s) and hearing aid(s) that focuses on listening and speaking. It is conducted by an auditory verbal therapist aka listening and spoken language specialist (LSLS).

What is the difference between AVT and speech therapy? 

AVT is a specialized form of speech therapy designed to grow listening skills in order to facilitate natural speech and language development. AVT is tailored for hearing loss and considers brain and listening development as well as management of hearing devices and auditory equipment such as streaming and FM systems. An auditory verbal therapist is essentially a hybrid of an audiologist and a speech language pathologist. AVT teaches speech and language through listening as a developmental approach rather than a remedial approach, such as in traditional speech therapy. A developmental approach teaches language in a natural developmental order and starts as soon as possible, while a remedial approach often only provides goals and therapy for what is delayed (e.g. child not producing “l” sound yet or has delayed vocabulary at 2 years old).

How soon do you begin AVT services?

Often as soon as the child (or teen) receives hearing devices (hearing aids, cochlear implants, etc.) I have seen infants as young as 6 months old, and parent coaching sessions as young as 3 months old. It is essential to set children up for success by building the auditory cortex and developing early listening skills. There is a critical listening and language development window from 0-3 years old where the brain is still developing its different cortexes and if it deprived of one sense (such as hearing or vision), the others grow stronger. Meaning, if one does not have access to hearing and listening development before age 3, it becomes much more difficult to develop natural speech and spoken language, because the auditory cortex never fully develops.

How do I get AVT services?

AVT’s often work at cochlear implant centers, sometimes in schools, and often in private practice. Ask your audiologist or you can find a local certified AVT through the Agbell website here:

I am available for one on one virtual AVT services in CA via Zoom. 

How does one become a certified AVT?

Becoming an AVT is a dedicated and involved process that requires a masters degree in Speech Language Pathology or a degree in special education as well as a certification through the AG Bell Academy. This certification entails 900 clinical supervised hours of providing direct AVT to families, 40 hours of evaluated AVT sessions from an AVT mentor, 70 hours of specialized continuing education hours, and passing a 300 question final exam.

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