sound practice in action
No man is an island,
Entire of itself,
Every man is a piece of the continent,
A part of the main.
Although it goes without saying that an auditory-verbal therapist (AVT) and the family are integral components of a child’s spoken language development, the Audiologist also plays an important role. Audiologists fulfill the auditory needs of the child by providing ongoing audiological assessments, ensuring the use of appropriate hearing aids and/or cochlear implants and FM systems. These fall within the scope of audiology practice, as well as the guiding principles of auditory-verbal therapy.
Working with an auditory-verbal family and AVT requires the development of a symbiotic relationship that promotes the child’s spoken language development.
As an auditory-verbal graduate, I have been fortunate to benefit from the relationship between my Audiologist and my AVTs, who worked closely with each other and with my parents to create the best kind of opportunities for me to learn spoken language. As an Audiologist, I have been fortunate to have been in environments where the development of a relationship with Speech-language pathologists and AVTs not only is possible, but also encouraged. As a graduate audiology student, I had the opportunity to work closely with the AV clinic at my graduate institution.
First, in the therapy sessions with my fellow speech-language pathology classmates, I was also providing auditory-verbal/auditory-based habilitation, with a stronger focus on auditory skills development.
Second, during my audiology practicum clinic assignments, we shared information from the sessions with the child’s AV clinicians. If the child’s graduate SLP clinician was available to come to the audiological evaluation, it was not just welcome, but also encouraged. Through this relationship and inclusion in each other’s professional domains, we could see the relationship between access to sound and language/speech development.
It is these personal and professional experiences that lead me to the conclusion that having an Audiologist on the AV team is highly beneficial.
One of the key relationships in auditory-verbal practice is the one developed between the Audiologist and the AVT. The AVT will see the child on a very regular, frequent basis, such as weekly or even more, while the Audiologist may only see the child once a year or several times a year. The AVT can closely monitor the child’s auditory development and any changes in the child’s listening abilities during the AV sessions. If the AVT notices a change in the child’s perception of sound or speech production, one of the potential causes of this change in speech production or perception could be a change in auditory access. Ideally, the AVT would recommend that the family make an appointment with the child’s Audiologist.
Prior to the child’s audiological appointment, the AVT can provide the Audiologist with a list of phonemes or sounds that are being misinterpreted or are no longer being produced clearly. Armed with this information, the Audiologist can check the child’s hearing aids, reprogram them, or if the child is a cochlear implant user, re-map the child. All these would go toward the goal of ensuring that the child has full access to those phonemes.
Further, to ensure that the AVT and child’s caregivers know what access the child has to sound, the Audiologist can provide these partners in the child’s auditory development with the results of the audiological evaluation, hearing aid programming sessions, or cochlear implant mapping session.
By sharing this information with each other, the AVT and the Audiologist ensure that the child’s auditory skills and language development will continue to grow.
Not only do the Audiologist’s roles include the optimization of auditory devices and ongoing assessments, but also includes working with the family and the AVT to promote emerging auditory skills that carry-over into daily life. For example, telephone usage is one of the most challenging activities for individuals with hearing loss. In addition, ensuring that the child’s hearing aids or cochlear implant devices are compatible with the chosen telephone option, the Audiologist can work with the family and AVT to select appropriate telephone accessories, such as amplifiers or cords that connect the phone to the hearing aid/cochlear implant, etc. The Audiologist and AVT can also work together to ensure that these telephone accessories are appropriate and that the child’s hearing devices are effective for telephone use. The AVT could, for example, incorporate telephone practice into the auditory-verbal session, and provide the Audiologist with information about how the child was able to communicate on the telephone.
Working together, the Audiologist and AVT become partners and combine technology and practice to maximize the child’s listening abilities in different situations.
This is by no means the only way that Audiologists and AVTs can have a relationship that fosters the child’s development.
One of the other principles of auditory-verbal practice is also mainstreaming in a regular education classroom. Again, providing appropriate auditory access to educational material is important for language learning, as well as expanding world knowledge. The Audiologist can work with the auditory-verbal family to ensure that appropriate assistive technology (e.g., FM systems) are being used in the classroom.
Moreover, the Audiologist can work with the child’s school to make sure that the FM system is being used correctly by their teachers. The Audiologist can also provide in-service training to educate the child’s teachers about hearing aids, cochlear implants, FM systems, and the importance of auditory access in the educational environment, as well as be a part of the child’s IEP team.
As a guide through the child’s landscape of listening, the Audiologist can work with both the family and the AVT to navigate the intricacies of auditory skills, auditory perception, and hearing technologies.
Working closely with the AVT and the child’s caregivers allows the Audiologists to see the child’s developmental milestones, as well as the needs of both the child and the family.
Because hearing and auditory access are such critical components of auditory-verbal practice, the Audiologist is a part of the “continent” of auditory-verbal life.
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KAREN MACIVER LUX