Auditory Expectation

What does it mean to have an auditory expectation for children with hearing loss in therapy and in life? First of all, it means that I, the adult, have done my part in giving you the tools (auditory access and a good listening environment) to be successful. Once that has been established, an auditory expectation means: I trust your hearing.  I assume that you will listen.  It’s not a “set to listen” condition, where constant prompting is needed.

The famous “Listen!” cue in AVT (the adult says, “Listen!” while pointing to their ear) can be helpful to cue a new listener to perk up and pay attention to auditory information. As an example, let’s consider a fifteen-month-old baby who just received bilateral cochlear implants three months ago. The parent and Auditory Verbal Therapist are working together to help establish the child’s detection response. The child is sitting facing the mother, who points to her ear and says, “Listen!” Outside the room, the therapist knocks on the door. When the child demonstrates awareness of the sound (detection), the child and parent walk to the door to open it and let the therapist in. This is a “set to listen” condition.

But too much prompting to listen becomes a bad thing. Think about it: typically-hearing people with strong language and listening abilities aren’t always prompted to “Listen!” before receiving auditory information. If I said, “Listen!” every time I wanted to tell my colleagues something, they’d look at me like I was out of my mind. It’s not pragmatically appropriate. (“Listen! How are you today?” “Listen! Those reports are due at 5PM.” “Listen! What did you do this weekend?” … sounds weird, right?) Most people don’t consciously turn their listening ability on and off. Of course, we all tune out (consciously or unconsciously) from time to time, but you’re generally aware of what is going on in our listening environment. You alert to environmental sounds (phone ringing), answer questions people ask you, or turn if you hear your name.

So how do we get from a “set to listen” condition to auditory awareness? It’s not so black and white. Instead, I suggest that there are a range of strategies we can use to build auditory awareness. For a child who has less auditory awareness and requires more visual support, you might start by saying “Listen!” and giving the visual “Listen!” cue of pointing to your ear. Then, use just the verbal cue or the visual cue for “Listen!”. Next, eliminate “Listen!” cues altogether and just give a meaningful expectant look. For a child who has some established auditory awareness and requires less support, you might call their name, use an auditory hook (like saying, “Hey!” or “Guess what?” or starting your message with some emphasis or acoustic highlighting). Once the child really gets it and does have that auditory awareness orientation, just say your message!

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