l. Early diagnosis of hearing impairment: this capitalizes on the rapid learning that occurs in the early period brain development

2. Early fitting of hearing technology: hearing aids, frequency transposer aids, FM systems and cochlear implants can provide most young children with hearing which can be used to maximize speech and language development.

3. A parent/caregiver centered approach: the parent-child bond is the focus of communication learning. Through parent participation in therapy sessions, the child learns to talk in daily living experiences at home and in the community. Parents learn to be the child’s primary source of language.

4. Individualized one-on-one therapy: children are seen individually in therapy and receive a customized treatment program.

5. Speech development through the child’s hearing sense: children learn to hear their own voices and imitate the speech of others. In therapy and at home, the child's communication skills develop in a similar fashion as hearing children. First he child learns vocal play, which is followed by babbling and the production of words, phrases and sentences. Lip-reading is not formally taught, although most children use visual information to supplement what they hear.

6. Use of speech: spoken language is used to teach spoken language. Sign language and cued speech are not used. Research shows that ones dependence on visual communication can slow progress in auditory learning. If a child’s attention is saturated with visual information, it is restricted from using sound in a meaningful way.

7. Language processing is developed through the habitual and maximal use of hearing: the child is taught to use hearing in activities designed to build confidence in listening. Children expand their skills to include auditory attention, auditory discrimination, feedback, memory and sequencing, and more complex auditory functions used in language comprehension and production. With the guidance of a therapist and devoted parents, the language of the child’s community come to life.

8. Independent functioning is the long-term goal: social and educational mainstreaming are fostered when possible. The hearing-impaired child is enrolled in a play group, preschool or school with normally hearing and speaking children in order to hear and participate in lots of normal conversation.

Adapted from Auditory-Verbal International, Inc., 1993, AVI Principles and Rules of Ethics. Easton, PA: Author.