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NHS 2002
2nd International Conference on Newborn Hearing Screening,
Diagnosis, and Intervention Como, ItalyMay 31, 2002
Progress in Specific Language Skills for Young Children in the
Auditory-Verbal Approach
Ellen A. Rhoades, Ed.S. & Helen A. McCaffrey, Ph.D.
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FOUR YEAR LONGITUDINAL STUDY Tertiary center-based A-V
program
No pre-selection of children or families
All communication options presented to parents prior to
initiation of A-V intervention services
Children typically received 1-2 weekly AVT sessions
Children received A-V services over a 1 to 4 year period
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To examine growth in lexical-semantic comprehensionas well as
morpho-syntactical development(both comprehension and
production),particularly as it pertains to children with hearing
lossas a result of auditory-verbal intervention. PURPOSE OF
STUDYTEST INSTRUMENTS Receptive & Expressive Language
Age-Equivalencies[Specific Language Measures with basal-ceiling
ages noted]
TEEM (3 - 8 yrs) Test for Expressive Emergent MorphologyTACL (3
- 10 yrs) Test for Auditory Comprehension of LanguagePPVT-R (2.6 -
90+ yrs) Peabody Picture Vocabulary Test
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1. What are the rates of progress in lexical-semanticand
morpho-syntactic language skills by children with hearing loss in
an auditory-verbal program?
2. How does progress in such specified language skills compare
to progress in global language skills as observed by Rhoades &
Chisolm (2001)?
3. What are the relationships between chronological age and
language-equivalent age as measured by testsof lexical-semantic and
morpho-syntactic skills?
4. How do these specific language skills compare among children
who were professionally released from auditory-verbal therapy and
those who continued?QUESTIONS
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TestTime PPVT TACL TEEMEntry 32 32 17Year 1 22 21 11Year 2 10 10
2Year 3 9 8 1Year 4 4 4 0
NUMBER OF CHILDREN PARTICIPATING IN TESTINGAT EACH TEST
PERIOD
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FINDINGS OFRHOADES & McCAFFREY1. Language growth in both
lexical-semantic and morpho-syntactical domains were significant
over each year of auditory-verbal intervention, and these data are
consistent with the findings of improved global receptive and
expressive language scores earlier obtained.
2. PPVT and TACL scores were submitted to a two-way repeated
measures analyses of variance (ANOVA). Statistically significant
growth in language occurred each year. TACL scores were
significantly higher than PPVT as a result of the first year.
3. TACL, PPVT, TEEM scores subjected to correlational analysis.
Correlation between CA and LA for each assessment gets stronger
over time. The strongest correlation is during the last year of
intervention.
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MORE FINDINGS OFRHOADES & McCAFFREY, 20024. There is
functional significance of language growth - unquestionably so that
language improves as a result of the auditory verbal approach,
since the growth rate exceeded that of normal maturation rate.
5. Formula to calculate rate of language growth:[(Score B -
Score A)/M] x 100where A = age equivalent score at first evaluation
B = age equivalent score at next evaluation M = number of months
between evaluations
Rate of language growth evidenced by TACL and PPVT show PPVT
growth is lower than TACL growth across all years of intervention.
TACL scores exceeded growth rate of normal maturation.
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STILL MORE FINDINGS OFRHOADES & McCAFFREY, 20026. CA-LA gap
decreased over time as a result of AVT.
7. For those children who had AVT for 3+ years with both TACL
and PPVT scores, CA and LA data were regressed for each child. Some
reached or exceeded CA performance on the TACL, but none on the
PPVT.
8. Professionally released children (n=14) all showed TACL
scores to exceed CA, with PPVT scores reaching equivalence to CA.
Similarly, data from this group were subjected to a repeated
measures analysis of variance (ANOVA) and no significant
differences were found between CA and LA. These data corroborate
global language outcomes. AVT= Auditory Verbal Therapy CA=
Chronological Age LA = Language Age
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AND MORE FROMRHOADES & McCAFFREY, 20029. For children who
completed all 3 tests (n=9), mean language age-equivalencies for
each test across time show that PPVT scores lagged behind TACL and
TEEM, with the highest growth rate in TEEM scores.
10. Typically, most children obtained basal scores on the PPVT
and TACL at the same time, but did not attain basal scores on the
TEEM until a year later. Exceptions were those children given AVT
as infants or those who experienced progressive deafness; they
obtained basal scores on the TEEM at the same time as basal scores
were obtained on the PPVT and TACL.
- YearSourceDfFp1Measure16.110.17*Time197.58
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MEAN CA & LA FROM PPVT TESTING OVER 4 YR PERIOD OF A-V
INTERVENTION
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MEAN CA & LA FROM TACL TESTING OVER 4 YR PERIOD OF A-V
INTERVENTION
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MEAN CA & LA FROM TEEM TESTING OVER 4 YR PERIOD OF A-V
INTERVENTION
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CORRELATION BETWEENLA & CA FOR EACH TEST GETS STRONGER OVER
TIMECORRELATIONALANALYSIS
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MEAN RATEOF LA GROWTH
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RELATIONSHIP BETWN CA & LAIN 7 CHILDREN FROM TACL OVER 4 YR
PERIOD
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RELATIONSHIP BETWN CA & LAIN 7 CHILDREN FROM PPVT OVER 4 YR
PERIOD
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RELATIONSHIP BETWEEN CA & LA FROM TACL AND PPVT IN 2 GROUPS
OF A-V GRADUATES
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MEAN PPVT, TACL, & TEEMLA ACROSS 2 YRS OF A-V
INTERVENTION
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The auditory-verbal approach is a viable option toward enabling
children with significant hearing loss to hear and speak.
Implementation of this communication approach, when based on
empirical evidence, can stimulate normal rates of language growth,
in both the lexical-semantic and morpho-syntactical domains.
Children who are hard of hearing and/or deaf, regardless of
whether they are hearing aid or cochlear implant users, can become
linguistic geniuses.
Children with hearing loss can claim their birthright to
function within normal limits in our hearing and speaking world.
...Ellen A. Rhoades & Helen A. McCaffrey, 2002
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For further information on the Auditory-Verbal Approach, go to
the web site
http://www.AuditoryVerbalTraining.com
To contact the investigators by e-mail, go to:
[email protected]
Progress in Specific Language Skills for Young Childrenin the
Auditory-Verbal ApproachbyEllen A. Rhoades, Ed.S., Cert. AVT&
Helen A. McCaffrey, Ph.D., Cert. AVT
