Guide to Listening and Spoken Language


sherriEliToday’s blog is written by Sherri J. Fickenscher M.S., and Elizabeth Gaffney. Sherri is a Listening and Spoken Language Specialist Certified Auditory Verbal Educator (LSLS Cert. AVEd). She is an Education Support Specialist as well as Early Interventionist for Clarke Schools for Hearing & Speech/PA. Sherri mentors professionals seeking their certification as Listening and Spoken Language Specialists. Elizabeth is a Listening and Spoken Language Specialist and Certified Auditory Verbal Educator. Elizabeth holds both a bachelor’s and a master’s degree in Education of the Deaf from Vanderbilt University. She currently works as an Auditory Enrichment teacher in Cypress-Fairbanks ISD in Houston, Texas as part of the Northwest Harris County Cooperative for the Deaf and Hard of Hearing.


By Sherri J. Fickenscher and Elizabeth Gaffney.


Getting the news that your child has a hearing loss

In the field of hearing loss, professionals and parents alike are bombarded with terminology that can cause confusion and anxiety. Parents who have received the news that their child has a hearing loss begin down a path that is new and can be scary, especially in regards to all the professionals that become part of their life. Some of these people may be: a pediatrician, an audiologist, a service coordinator, a service provider, a teacher of the deaf, a speech language pathologist, an Early Interventionist, and a Listening and Spoken Language Specialist. The list may also include other professionals not directly tied to the child’s auditory, speech and language development, but to other developmental issues. Parents sometimes struggle to understand each professional’s role and how it relates directly to their child, especially when roles are shortened to letters such as SLP, TOD, LSLS, OT, PT or SC.


Learning about hearing loss

More than 90% of children born with hearing loss are born to hearing parents who typically have little to no knowledge of what effects hearing loss will have on their child. Many of these parents have the misperception that their child will not be able to develop spoken language well enough to be understood by others. (This is sometimes because family, friends, and some of the professionals who work with the child have little or no experience with childhood hearing loss.) Parents are unaware of the limitless possibilities that exist today for children who are deaf or hard of hearing. Parents are faced with decisions about their child’s communication opportunities when they do not fully understand the ramifications of each of these opportunities. Professionals have an ethical responsibility to ensure parents understand the full range of communication opportunities, but before this can occur, professionals themselves must have a clear understanding themselves!

So what is Listening and Spoken Language in regards to a communication opportunity?


Principles of Listening and Spoken Language

The primary goal of Listening and Spoken Language is for a child to use their hearing in order to develop spoken language. In order for this goal to be optimally met, the following principles must be in place:

  • Early identification of the hearing loss (ideally by one month of age) and diagnosis (by three months of age)
  • “Vigilant, ongoing, and kind audiologic management” (2007, Cole & Flexer p.14)
  • Access to trained professionals who guide and coach parents to be the child’s primary teacher


Trained professionals with the highest credentials in the field of educating children who are deaf or hard of hearing are Listening and Spoken Language Specialists (LSLS) with designations as either Auditory Verbal Therapists (LSLS Cert. AVT) or Auditory Verbal Educators (LSLS Cert. AVEd). The LSLS is a professional trained in Auditory-Verbal strategies and techniques who believes that the parent is the primary teacher of their child. The LSLS guides and coaches parents to develop their child’s listening and spoken language skills so their child may have the opportunity to learn alongside their hearing peers at the earliest possible age. The LSLS works in partnership with parents to achieve the best possible outcomes for each individual child (Cole & Flexer, 2007). The particular designation depends on the setting in which the LSLS provides services. Each designation has Guiding Principles that can be accessed through the certifying organization, the Alexander Graham Bell Academy for Listening and Spoken Language.

A LSLS has knowledge of the wide variety of auditory-verbal strategies and techniques and has the skill set to coach and guide parents and professionals in the best implementation of these strategies and techniques.


Strategy vs. Technique

The terms “strategies” and “techniques” are often used together, but they do not mean the same thing. A strategy is a specific plan utilized to achieve a goal. It is a plan to move from Point A to Point B. In order to choose the correct listening and spoken language strategy, the therapist must be able to continuously analyze the child’s strengths and needs, anticipate the child’s response, and implement the correct strategy at the correct time while helping the parent to develop this skill as well. Knowledge of a variety of the listening and spoken language strategies is the first step in a learning trajectory. A professional must not only know which strategy to use to reach a determined goal, but must have the ability to model for parents and other professionals, the ability to coach the appropriate use of the strategy, and the ability to be diagnostic in their choice of strategies.

A technique is the way a professional goes about using the strategies. A technique is a way of presenting information or a style of teaching that may vary from therapist to therapist and teacher to teacher. There are many techniques that a LSLS may utilize that are not considered strategies. Two examples of techniques are the use of Experience Books and planning sessions around the daily routines and experiences of a particular child and family. The work presented here is focused on auditory-verbal strategies to develop listening and spoken language skills in children who are deaf or hard of hearing.


Auditory Verbal Strategies to Build Listening and Spoken Language Skills

Children who are deaf or hard of hearing have reduced access to auditory input, in particular, to speech and language since speech is acoustically based. This reduced access creates not only a need for excellent hearing technology and audiologic management, but also a need to maximize opportunities for developing spoken language. Auditory verbal strategies assist professionals, parents and caregivers in delivering meaningful messages to the child who is deaf or hard of hearing in order to strengthen the neural pathways in the brain.

Listening and spoken language strategies are referred to consistently in the field of listening and spoken language, but not defined in one body of work. Auditory-Verbal strategies are used to strengthen a child’s ability to gain communicative competency through listening. They are a method for achieving a specified goal. For example, one strategy is expectant look. This strategy is used with the goal of eliciting some response from a child. The expectant look sends a non-verbal message to the child that some response is expected. The authors of this blog made an attempt to consolidate strategies in one resource with research references in order to further define and explain the strategies. Some of these strategies are: auditory closure, auditory sandwich, expectant look, joint attention, motherese, and repetition. A professional may refer to each strategy as needed when working with a particular child or family. This is not an exhaustive body of work and is not intended as a sole means to educate professionals who are unfamiliar with listening and spoken language development. This resource is titled Auditory Verbal Strategies to Build Listening and Spoken Language Skills.

This guide defines each strategy, summarizes its use, identifies the skills it supports, features a discussion on some of its intricacies and offers helpful examples of the strategy in practice.

In order to become effective therapists, interventionist, parents, and educators it is imperative that knowledge of the strategies that build auditory, speech and language skills be understood, embraced, and practiced everyday in effective and meaningful ways.



Cole, E., & Flexer, C. (2007). Children with hearing loss: Developing listening and talking, birth to six. San Diego: Plural Publishing, Inc.



About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 5 books, and written numerous books chapters and journal articles, and is a well known international lecturer.