Auditory Verbal Parents

Category IconCategory Icon  
Research Spurs Comments

Amy: Recently, two studies came to our attention. They highlight why Auditory Verbal Therapy continues to be the best methodology for teaching deaf children to listen and speak, if those are the goals for that child. We parents are often accused of “audism,” or of being mean-spirited individuals who focus on speech to the detriment of brain development and the “natural” language of the deaf. We are accused of being overly focused on speech and the medical model of deafness.

We see the future, and we see how easily our children have learned to speak when we utilized IT as their natural language. Rather than seeing it as cruel, we see it as offering them what they deserve– the ability to do everything that their hearing peers and siblings can do. And we see them scoring very high in tests which indicate very normal development, whether it’s higher-level French language tests, state testing for Math, tests of reading ability, and so on. We posit that their development was far more normal that it ever would have been if they had been using a manual language in families which had previously never studied that language!

Below, we discuss the studies.

Web address:
Auditory Regions Of Brain Convert To Sense Of Touch, Hearing Loss Study Finds

ScienceDaily (Mar. 25, 2009) — Virginia Commonwealth University School of Medicine researchers have discovered that adult animals with hearing loss actually re-route the sense of touch into the hearing parts of the brain. (follow above link to read entire article)

Amy: This study is further proof that early implantation and use of the auditory pathways for auditory function is crucial in children (and adults!) with hearing loss! The rewiring, while assistive if there is no alternative, means that the auditory pathways will not utilize the new technology as well. The parents who take a “wait and see” approach with a child who is clearly profoundly deaf are allowing for this rewiring.

Melissa: This is proof of the fallacy in the argument used by many in the deaf culture that we should wait until the children are old enough to decide for themselves to get a cochlear implant. While we have known for many years now that those who were the early recipients of CIs, teens using ASL in schools for the deaf, did not succeed with them and gave them a bad reputation in the deaf community initially, this research now proves what we have seen. This combined with what research has shown for years, that the first three years of life are critical for language learning and establishing the auditory pathways, tells us that children need to be implanted as young as possible and then receive Auditory-Verbal therapy to take advantage of the implant. It also means that it is way past time for the FDA to lower the guidelines for age of implantation from 12 months to 6 months or at least 9 months.

Amy: It IS way past time. While I understand why certain babies would need to wait, based on prematurity, weight or inconclusive audiological testing, for those of us whose kids were clearly profoundly deaf (and even without residual hearing, in our cases!) and whose surgeons felt that they were headed for surgery, the FDA approval age being lowered would assist in insurance requests. Today, it is insurance more than anything which seems to be holding the process up. We were extremely lucky in implanting Oliver at 6 months of age.

This article is also more evidence to show that mixing methodologies, while hoping for audition and speech, is the wrong way to go. Visual and touch areas CAN and DO convert those regions of the brain. With the ability of kids today to hear well and use their auditory function appropriately, the Deaf Culture extremists who insist that we ought to be using sign along with speech are uninformed about the latest research. If we wanted a purely signing child, we would sign. Our point of speaking is to develop a child who is naturally good at using speech. The goals are very different, and the outcome of mixing methodologies serves to create the so-called “failures.”

Recently, another blogger was complaining that speaking people don’t use her language in the workplace (ASL) and wondered why that is fair. The reality is that any workplace will use the language most commonly learned in that area of the world. The sheer lack of numbers of ASL using persons in the world is the reason that people don’t use that language with her, and it is clearly the reason that I do not want it to be my child’s native language. We might expect safety officers to know Spanish, but would we expect them to know Cantonese? Deaf children can and have easily learned the language of their peers and family, which is the expected outcome of using that language on a daily basis. It has not been extraordinarily difficult. My were ready and ahead of peers by age 3, thanks to early implantation.

Melissa: We also saw the difference that earlier implantation makes. In 1996, the FDA guidelines still specified age 2, but our surgeon at NYU was willing to implant Jessica at age 15 months. She was 16 months younger than Rachel was when she received her CI, and yet the difference amounted to more than just 16 months. Rachel did not graduate from AV therapy until age 10, and even then she still had a slight language delay. Jessica, on the other hand, graduated from AV therapy at age 6 with language that was age level to above. I have since seen Amy’s sons. Again, Oliver was implanted at age 6 months, 9 months younger than Jessica was, and yet he completed AV therapy at an age 4 years younger than she did. The difference that early implantation combined with AV therapy makes is exponential.

Neuropsychologia. 2008 Sep 9. [Epub ahead of print]
Visual stimuli can impair auditory processing in cochlear implant users.
Champoux F, Lepore F, Gagné JP, Théoret H.

Centre de Recherche en Neuropsychologie et Cognition, Université
de Montréal, Montréal, Québec, Canada; Ecole d’Orthophonie et
d’Audiologie, Université de Montréal, Montréal, Québec, Canada.

It has been shown that visual stimulation can activate cortical regions normally devoted to auditory processing in deaf individuals.  This neural activity can persist even when audition is restored through the implantation of a cochlear implant, raising the possibility that cross-modal plasticity can be detrimental to auditory performance in cochlear implant users. To determine the influence of visual information on auditory performance after restoration of hearing in deaf individuals, the ability to segregate conflicting auditory and visual information was assessed in fourteen cochlear implant users with varied degree of expertise and an equal number of participants with normal-hearing matched for gender, age and hearing performance. An auditory speech recognition task was administered in the presence of three incongruent visual stimuli (color-shift, random-dot motion and lip movement). For proficient cochlear implant users,  auditory performance was equal to that of controls in the three experimental conditions where visual stimuli were presented simultaneously with auditory information. For non-proficient cochlear implant users, performance did not differ from that of matched controls when the auditory stimulus was paired with a visual stimulus that was color-shifted. However, significant differences were observed between the non-proficient cochlear implant users and their matched
controls when the accompanying visual stimuli consisted of a moving random-dot pattern or incongruent lip movements. These findings raise
several questions with regards to the rehabilitation of cochlear implant users.

Amy:  The cross-modal reorganization, while a coping mechanism of the body, is not good when a person’s goal is to continue hearing and speaking with a cochlear implant or hearing aid.  Hearing impairment is a neurological disorder. Treatment needs to occur as quickly as possible!

Filed under: Amy,Melissa — Amy Kwilinski @ 2:17 pm


  1. Amy and Melissa — I love the “dialog” format you have in this blog. It’s unique among blogs but it’s sort of like The View! (Although to be like The View, I think you’d need an opposing viewpoint. :-)

    Comment by Lydia — April 7, 2009 @ 11:48 am

  2. Thanks! I LOVE being compared to famous TV shows. LOL! But you are right. We are comfortable because we agree. We aren’t ready for that much differing sentiment…

    I came up with the back and forth idea because LITERALLY that was how our conversations have gone for years. In fact, if we run out of ideas for blogs we can probably just copy and paste our old email conversations! We have had the comfort of knowing that at least one person will understand and agree whenever AVT issues come up! :-P We have probably had thousands of back and forth discussion issues.

    Comment by Amy Kwilinski — April 7, 2009 @ 8:35 pm

RSS feed for comments on this post.

Sorry, the comment form is closed at this time.