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The auditory-verbal approach is a philosophy where the child is taught spoken language auditorily. The auditory-verbal approach differs from auditory training in that auditory-verbal is a way of life; in contrast, auditory-training is often a supplement to other cues such as lipreading or signing (Pollack, Goldberg, & Caleffe-Schenck, 1997). The success of the auditory-verbal approach is dependent upon early diagnosis of hearing loss as well as early intervention (Auditory-Verbal International, 1991). Early diagnosis and intervention of hearing loss is crucial because the critical language and speech learning years take place during infancy and the preschool years (Pollack et al., 1997, p. 189). The child is fitted with hearing aids or a cochlear implant and is enrolled in individualized auditory-verbal therapy (Estabrooks, 1994a).

Auditory-verbal therapy is a family-centered approach, where the parents are active partners in the teaching process (Flexer & Richards, 1998). Additionally, the auditory-verbal therapist provides guidance to the parents, teaching them how to utilize and integrate the principles of auditory-verbal therapy into their lives (Estabrooks, 1994). There are nine principles of auditory-verbal practice which are integrated into the lives of auditory-verbal families. The principles are as follows: early detection, identification, and management of hearing loss; appropriate amplification; a parent partnership with the auditory-verbal therapist; total integration of listening into the child’s personality; one-on-one therapy; acoustic feedback; the following of an auditory hierarchy; teaching which is continually diagnostic; and the implementation of mainstreaming as appropriate (Auditory-Verbal International, 1991).

The auditory-verbal approach is diagnostic; that is, each therapy session evaluates the progress of the parents and the child (Estabrooks, 1994a). Since the goal of auditory-verbal therapy is that the children “grow up in typical listening and learning environments that enable them to become independent, participating, and contributing citizens in mainstream society” (Goldberg, 1996, pp. 290-291), the auditory-verbal approach “integrates listening into the child’s total personality” (Auditory-Verbal International, 1991, p. 15). Since the auditory-verbal approach stresses that the child grow up to be a part of mainstream society, the child is typically mainstreamed in his or her local school (Estabrooks, 1996).

The child is “stimulated with sound all the time” (Pollack et al., 1997, p. 143). In order for the child to focus on the auditory sense, the auditory-verbal therapist and parents often make use of a hand cue. The parent or therapist will briefly cover his or her mouth while speaking; this signals that the child needs to listen (Estabrooks, 1994b; Natural Communication, Inc., 1998). An additional aspect of auditory-verbal therapy is that normal patterns of development are followed (Natural Communication, Inc., 1998). The children can develop fluent spoken language skills and have a good grasp of the rules that guide spoken communication and language (Robertson & Flexer, 1993).

The focus on audition is not without reason. Stewart, Pollack, and Downs (1964) stated that “no amount of lipreading or kinesthetic training can develop normal skills of vocal usage; these must be heard to be reproduced” (p. 153). An additional benefit of this focus on audition is that children who follow the auditory-verbal approach have “normal inflection patterns and a pleasing voice in contrast to the ‘deaf’ voice quality usually associated with severe hearing impairments” (Pollack et al., 1997, p. 63). Documentation has shown that 95% of children with hearing loss have residual or remaining hearing (Rhoades, 1982). If this hearing is not utilized during the critical language learning years, the ability to comprehend auditory information deteriorates because of physiological factors such as the deterioration of auditory pathways (Goldberg, 1993).