Provision of auditory verbal therapy

Background

Auditory verbal therapy (AVT) is a specialist programme which coaches families to develop deaf children’s listening and spoken language. It is one of several approaches to maximising hearing technology to improve speech and language development for deaf children.

It is focussed on supporting children to learn how to make sense of the sound they receive through technology like cochlear implants and hearing aids. It is delivered by teachers of the deaf, speech and language therapists and audiologists who have undergone additional post-graduate training.

AVT is considered an early intervention strategy and is usually delivered to children under five years of age. The National Deaf Children’s Society notes that professionals who promote AVT believe that by working intensively with children in their early years they will require much less support as they get older. It specifically aims to ensure that deaf children develop age-appropriate language by the time they start school.

Further information on AVT is provided by Auditory Verbal UK, a charity which is calling for every family with a deaf child to have the option to access AVT through publicly funded services in their local area. Auditory Verbal UK also provides training for those seeking to become a certified Auditory Verbal Therapist. In September 2023 Auditory Verbal UK updated their Auditory Verbal Therapy Position Paper.

Further information

• The National Deaf Children’s Society (NDCS) has a range of resources to support families with language and communication, including pages written for children and young people: ndcs.org.uk. Their freephone helpline is 0808 800 8880
• The NDCS has published an information sheet about deaf children and young people in the UK (PDF) (February 2021)
• Auditory Verbal UK is a charity that supports deaf babies and children to learn to listen and speak through auditory verbal therapy: avuk.org
• The Ewing Foundation is a charity promoting inclusion and achievement of deaf children through listening and speaking ewing-foundation.org.uk

There are more than 50,000 deaf children in the UK and it is estimated that around 7,200 are under the age of 5 (see Auditory Verbal UK’s position paper on AVT). Even though deafness is not a learning disability, there is a significant attainment gap facing deaf children during their time at school (The educational outcomes of deaf children in England, Education Policy Institute, March 2023).

The term ‘deaf’ and ‘hearing loss’ have been used in this briefing to describe all levels of hearing loss in children, including a partial or total loss of hearing. This includes those who may describe themselves as having a ‘hearing impairment’.

Provision of auditory verbal therapy

Local authority duties

Under section 17 of the Children Act 1989, local authorities in England have a duty “to safeguard and promote the welfare of children within their area who are in need…by providing a range and level of services appropriate to those children’s needs.” A child is defined as in need if they are disabled and the Act says a child is considered disabled if they are deaf.

The Act further requires local authorities to provide services designed to minimise the effect on disabled children of their disabilities and give disabled children the opportunity to lead lives which are as normal as possible (Schedule 2, paragraph 6).

Local authorities are responsible for determining what services to provide for children in need. Generally, families do not have the right to insist on a certain type of support being provided.

Local authorities have a duty to publish information about the support available in the area for disabled children and children with special educational needs. This should be set out in a ‘local offer’ available on the authority’s website.

The National Deaf Children’s Society notes that the availability of Auditory Verbal Therapy (AVT) through local authorities “is growing but it is, as yet, not widely available.” It advises families to check their area’s local offer to what support is available. It adds that in some cases local authorities may provide funding to help a child access AVT.

Special educational needs provision

The Children and Families Act 2014 provides the statutory basis for the system for identifying children and young people (age 0-25) in England with special educational needs (SEN), assessing their needs and making provision for them.

The statutory Special Educational Needs and Disability (SEND): Code of practice sets out detailed information on the support available for children and young people aged 0 to 25 under the 2014 Act.

In March 2023 the Government published its SEND and Alternative Provision Improvement Plan, setting out a mission for more children and young people to have their needs met effectively in mainstream settings.

The Government said in the Plan it would fund up to 5,000 early years staff to gain an accredited Level 3 (A level or equivalent) early years SENCo qualification to support the early years sector, with training running until August 2024.

The Improvement Plan also announced the introduction of ‘Early Language Support for Every Child’ (ELSEC) pathfinders. ELSEC is a two-year workforce development programme to fund improved early identification and support for children and young people with speech, language and communication needs within early years and primary school settings. The Department of Health and Social Care is also working with the Department of Education to take a joint approach to SEND workforce planning in recognition of the demand for specialist services (see PQ 202724, 19 October 2023).

Further background can be found in the Library briefings Special Educational Needs: support in England, and the Special Educational Needs and Disabilities and Alternative Provision Improvement Plan.

On the 22 March 2023 there was a Westminster Hall debate on Special Educational Needs and Disabilities: Specialist Workforce. The Library produced a briefing ahead of this debate, as did the Royal College of Speech and Language Therapists (PDF).

NHS audiology services

Audiology services in England are commissioned by NHS integrated care boards (ICBs), who are responsible for meeting the needs of children with hearing loss.

Commissioning Services for People with Hearing Loss was published by NHS England in July 2016 to support NHS commissioners to provide consistent, high quality and integrated care.

In response to a PQ about AVT in October 2023 the Government said there are currently no plans to assess the accessibility of auditory verbal therapy (AVT) (see PQ203354, 18 October 2023).