“Minimally Invasive Therapy” (Rethinking Equal Talk Time)

When I began studying auditory verbal therapy, one concept I learned was the “equal time pie” or “equal talk time,” — the idea that all three participants in an AVT session (child, parent, and therapist), should each be doing roughly 1/3 of the talking during the session.  For years, I tried to self-monitor during my intervention to make sure this was happening.  But then I started teaching students about AVT at the university level.  After weeks of hearing me drive home the point that families are their children’s first and best teachers, one student raised her hand and asked a question that revolutionized the way I think about sharing talk time in sessions…


“If auditory verbal therapy is all about families, shouldn’t the therapist be talking less?”




She was absolutely right.  I’d love to say that it was my masterful explanation of family-centered therapy that led her to this understanding, but really she was my teacher in this moment!


And thus began my shift from making sure I only took up about a third of the “airspace” in each therapy session to making sure I spoke as little as possible, jumping in to the parent-child interaction only when necessary to provide guidance or coaching that would help propel the family toward their goals.  Less of me in the session means more of that precious parent-child interaction, and that is key!

Encourage and enhance

I call it “minimally invasive therapy.”  Just as minimally invasive surgery attempts to heal the body with as little interference as possible, minimally invasive therapy attempts to create the smallest disturbance possible in the beautiful ecosystem that is a family’s life, only intervening when specialized knowledge is required to guide and coach the family toward their desired outcome for their child.  That family’s ecosystem may not look like mine, but that doesn’t necessarily mean it needs fixing.  The goal of auditory verbal therapy is to encourage and enhance, not rewrite, the story of how families interact with their children.  So even though I got into this field because I love, love, love talking, I’ve found that when I’m taking up less of the talk time pie, some really terrific things start to happen!

2 thoughts on ““Minimally Invasive Therapy” (Rethinking Equal Talk Time)

  1. The simplest and most effective way I have found to reduce MY input is the table/floor layout. That is, not placing the child in the center of the two adults. Have the child seated where he/she is comfortable, have parent on child’s best side of listening and then have the AVT therapist beside the parent. It enhances the AVT’s role as ‘coach’ rather than active participant, and sorts out the problem of the child’s divided attention. Best Wishes, S

  2. Thank you! This is an excellent suggestion, and I agree — sometimes simple changes to the room layout can have a big effect on our practice patterns.

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