Auditory-verbal therapy for promoting spoken language development in children with permanent hearing impairments

A Technology-Assisted Language Intervention for Children Who Are Deaf or Hard of Hearing: A Randomized Clinical Trial

BACKGROUND AND OBJECTIVES

Children who are deaf or hard of hearing (DHH) often have persistent language delays despite early identification and interventions. The technology-assisted language intervention (TALI), which incorporates augmentative and alternative communication technology into a speech-language therapy model, was designed to support language learning. The study objective was to evaluate the impact of the TALI on spoken language outcomes in DHH children.

METHODS

Children aged 3 to 12 years with mild to profound bilateral hearing loss were enrolled in a single-site randomized controlled trial. Children were randomly assigned to receive the TALI or treatment as usual (TAU) (with no change in current care) and were followed for 24 weeks. Primary outcomes included spoken language measures elicited from language samples. Secondary outcomes included standardized assessments. Intention-to-treat analyses were used.

RESULTS

Analyses focused on 41 children randomly assigned to TALI (n = 21) or TAU (n = 20). Among all participants, mean age was 6.3 years (SD 2.5). Over 24 weeks, children in the TALI group, compared with those in the TAU group, had significantly greater increases in the length of phrases they used to express themselves (β = .91 vs .15, respectively; P< .0001). Similar findings were seen with conversational turn-taking and number of different words spoken.

CONCLUSIONS

Providing visual supports for language concepts that are typically challenging for DHH children to acquire allowed children to process and comprehend spoken language more fully. Such strategies can mitigate persistent language delays with the goal of improving lifelong outcomes and independence across settings.

Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices

Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.

Feasibility of a Recasting and Auditory Bombardment Treatment With Young Cochlear Implant Users

PURPOSE

There is little to guide clinicians in terms of evidence-based interventions for children with cochlear implants who demonstrate morpheme errors. This feasibility study tested the utility of a treatment targeting grammatical morpheme errors.

METHOD

Three children (ages 4-5 years) received Enhanced Conversational Recast treatment, a version of conversational recast treatment that focuses on a single morpheme error at a time, emphasizes attention to clinician input, and uses high linguistic variability with clinician input. A period of recasting was followed by 24 auditory presentations of the target morpheme in short sentences. After an initial baseline period, children were treated in individual sessions over 21-26 days.

RESULTS

All children showed improved use of targeted grammatical morpheme use, both in elicited contexts and in terms of spontaneous use. Spontaneous use was best for the 2 children who were implanted earliest and whose audiograms showed the best hearing postimplant. Performance by a 3rd child diagnosed with auditory neuropathy spectrum disorder was more variable but still showed positive change.

CONCLUSIONS

The results indicate that the treatment can be effective for children with cochlear implants. The pattern of results across children also suggests potential variables that may moderate treatment effects.

Efficacy of auditory-verbal therapy in children with hearing impairment: A systematic review from 1993 to 2015

OBJECTIVES

Auditory verbal therapy (AVT) is one of the primary treatment approaches for developing spoken language in children with hearing impairment (HI), but its outcomes have not been thoroughly investigated. The current study aimed to systematically review past studies investigating AVT outcomes in children with HI.

METHODS

A systematic search was conducted in six databases. Fourteen articles that met the final inclusion criteria were grouped under three categories based on the outcome measures: receptive and expressive language development, auditory/speech perception and mainstreaming.

RESULTS

Articles under "receptive and expressive language development" category indicated AVT can even help children with HI beyond three years of age to develop age appropriate language skills and catch up with their hearing peers. Articles under "auditory /speech perception" category suggested that children receiving AVT can learn to recognize words accurately even in the presence of background noise. Articles grouped under "mainstreaming" category indicated that children receiving AVT can be successfully mainstreamed.

CONCLUSION

Although studies suggest that AVT can have a positive impact on developing speech and language skills in children with HI, it is difficult to generalize these findings due to limited evidence. Future studies should utilize well-controlled group designs to minimize the role of external variables as well as strengthen the evidence-base for AVT.