Auditory Verbal Therapy for Children With Hearing Loss
Authors: CADTH  
Published: July 2024

What Is the Issue?

Children with hearing loss may experience delays in language, speech, and cognitive development, which can have long-lasting implications if unaddressed.
Early hearing detection and intervention programs aim to identify and avoid long-term impacts of hearing loss for infants and children. Interventions include the use of hearing devices (e.g., cochlear implants, hearing aids) and habilitation with the intent to minimize delays in development.
Auditory verbal therapy (AVT) is a specialized habilitation intervention that focuses on improving listening skills while avoiding visual cues to communicate. The overall goal is to minimize the difference in speech and language capabilities between children with hearing loss and their peers without hearing loss. It requires certified professionals to deliver.
The effectiveness of AVT for children with hearing loss compared to other habilitation approaches remains unclear.

What Did We Do?

To inform decisions regarding the use of AVT, we summarized evidence that compared the effectiveness of AVT to alternative habilitation approaches for children with hearing loss using cochlear implants, bone-conduction hearing devices, or conventional hearing aids. We also sought to identify evidence-based guidelines regarding appropriate habilitation approaches for this population.
We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2019. One reviewer screened articles for inclusion based on predefined criteria.

What Did We Find?

For children with cochlear implants, AVT may result in better speech and language outcomes than standard habilitation, oral communication, total communication, or the bilingual-bicultural approach. However, AVT did not result in a significant difference in speech and language skills compared to sign and spoken language (1 systematic review).
AVT may result in better executive function compared to standard auditory training for children with cochlear implants (1 randomized controlled trial).
We did not find any evidence-based guidelines regarding appropriate habilitation approaches that met the predefined criteria for this rapid review. We also did not identify relevant evidence for children using bone conduction hearing devices and conventional hearing aids.

What Does It Mean?

Limited and low-quality evidence suggests that AVT is more effective than some alternative habilitation approaches for children using cochlear implants. High-quality studies are needed with rigorous methodology, detailed reporting of results, and analysis controlling for confounding factors to make definitive conclusions about the performance of AVT against alternative habilitation for this population.
Although the literature comparing AVT to alternative approaches is limited, findings from before-and-after studies suggest that AVT improves speech, language, and executive function for children with cochlear implants. Decisions around the use of AVT may also depend on the individual needs and goals of the child and their parents or guardians and the resources needed to ensure capacity to deliver AVT, such as time and costs to certify professionals.