Auditory-Verbal Music Play Therapy: An Integrated Approach (AVMPT)

Document Type : Original


1 Faculty of Linguistics, Ferdowsi University of Mashhad, Mashhad , Iran

2 PhD Student in Linguistics International Campus of Ferdowsi University of Mashhad, Iran


Hearing loss occurs when there is a problem with one or more parts of the ear or ears and causes children to have a delay in the language-learning process. Hearing loss affects children's lives and their development. Several approaches have been developed over recent decades to help hearing-impaired children develop language skills. Auditory-verbal therapy (AVT) is one such approach. Recently, researchers have found that music and play have a considerable effect on the communication skills of children, leading to the development of music therapy (MT) and play therapy (PT). There have been several studies which focus on the impact of music on hearing-impaired children. The aim of this article is to review studies conducted in AVT, MT, and PT and their efficacy in hearing-impaired children. Furthermore, the authors aim to introduce an integrated approach of AVT, MT, and PT which facilitates language and communication skills in hearing-impaired children.
Materials and Methods:
In this article we review studies of AVT, MT, and PT and their impact on hearing-impaired children. To achieve this goal, we searched databases and journals including Elsevier, Chor Teach, and Military Psychology, for example. We also used reliable websites such as American Choral Directors Association and Joint Committee on Infant Hearing websites. The websites were reviewed and key words in this article used to find appropriate references. Those articles which are related to ours in content were selected. 
Recent technologies have brought about great advancement in the field of hearing disorders. Now these impairments can be detected at birth, and in the majority of cases, hearing impaired children can develop fluent spoken language through audition. According to researches on the relationship between hearing impaired children’s communication and language skills and different approaches of therapy, it is known that learning through listening and musical plays  have great impact on children's communication skills, so that they can successfully join the mainstream society.
VT, MT, and PT enhance children’s communication and language skills from an early age. Each method has a meaningful impact on hearing loss, so by integrating them we have a comprehensive method in order to facilitate communication and language learning. To achieve this goal, the article offers methods and techniques to perform AVT and MT integrated with PT leading to an approach which offers all advantages of these three types of therapy. 


1.Estabrooks W. 50 frequently asked questions about auditory-verbal therapy. Toronto, Ont : Learning to Listen Foundation; 2001.
2.Sharma A, Dorman MF, Spahr AJ.A sensitive period for the development of the central auditory system in children with cochlear implants: Implications for age of implantation; Ear and Hearing 2002; 23(6): 532–59.
3. Spencer P.E, Marschark M.Editors. Advances in the Spoken Language Development of Deaf and Hard-of-Hearing children. New York: Oxford University Press; 2006
4. Dornan DA. Outcomes for Young Children with Hearing Loss in an Auditory-Verbal Therapy Program [Dissertation].University of Queensland, School of Health and Rehabilitation Sciences; 2010.
5. Hintermair M. Parental resources, parental stress, and socioemotional development of deaf and hard of hearing children.Journal of Deaf Studies & Deaf Education 2006; 11(4): 493–513.
6. Estabrooks W. Auditory-Verbal Therapy: For parents and professionals. Washington, D.C.: Alexander Graham Bell Association for Deaf and Hard of Hearing; 1994.
7. Rhoades E. Research outcomes of Auditory-Verbal intervention: Is the approach justified? Deafness Education International 2006; 8(3): 125–143.
8. Pollack D. Educational audiology for the limited-hearing infant.1st ed. Springfield IL: Charles C. Thomas; 1970.
9. Boothroyd A. Auditory development of the hearing child.Scandinavian Audiology 1997;26(46): 9–16.
10. Robbins AM, Koch DB, Osberger MJ, Zimmerman-Phillips S,Kishon-Rabin L. Effect of age at cochlear implantation on auditory skill development in infants and toddlers. Archives of Otolaryngology, Head and Neck Surgery 2004;130(5): 570–4.
11. LSLS Cert. AVT™. Alexander Graham Bell Association for Deaf and Hard of Hearing;2012.Availablefrom:
12. Mayne AM, Yoshinaga-ItanoC,Sedey, AL. Receptive vocabulary development of infants and toddlers who are deaf or hard of hearing. The Volta Review 1998; 100(5): 29–52.
13. Apuzzo M, Yoshinaga-Itano C. Early identification of infants with significant hearing loss and the Minnesota Child Development Inventory.Seminars in Hearing 1995; 16(2): 124–39.
14. Gravel J, O’Gara J. Communication options for children with hearing loss. Mental Retardation and Developmental Disabilities Research Reviews 2003; 9: 243–51.
15. Lim SYC, Simser J. Auditory-verbal therapy for children with hearing impairment Ann Acad Med,  2005; 34(4): 307–12.
16. Rhoades EA, ChisolmTH. Global language progress with an auditory-verbal therapy approach for children who are deaf or hard of hearing. The Volta Review 2000; 102(1): 5–25.
17. Yoshinaga-Itano C. A description of children in the acoupedic method.The Listen Foundation; Englewood, CO.1988.
18. Aldridge D. An overview of music therapy research.Complementary Therapies in Medicine 1994; 2: 204–16.
19. Bruscia K. Defining Music Therapy. Second edition.Gilsum, NH: Barcelona Publishers. 1996.
20. Gold C, Voracek M, Wigram T. Effects of music therapy for children and adolescents with psychopathology: A meta-analysis. Journal of Child Psychology and Psychiatry.2004; 45: 1054–63.
21. Maratos A S, Gold C, Wang X, Crawford M J. Music therapy for depression. Cochrane Database Syst Rev 2008; (1): CD004517.CD004517. DOI:10.1002/14651858.CD004517.pub2.
 22. Baker F A, Gleadhill L M, Dingle G A. Music therapy and emotional exploration: Exposing substance abuse clients to the experiences of non-drug-induced emotions. The Arts in Psychotherapy 2007; 34(4): 321–30.
23. Cevasco AM, Kennedy R, Generally NR. Comparison of movement-to-music, rhythmic activities, and competitive games on depression, stress, anxiety, and anger of females in substance abuse rehabilitation. Journal of Music Therapy 2005; 42(1): 64–80.
24. Edwards J. Music therapy in the treatment and management of mental disorders. Irish Journal of Psychological Medicine 2006; 23(1): 33–5.
25. Koelsch S, Fritz T, Schulze K, Alsop D, Schlaug G. Adults and children processing music: An fMRI study. NeuroImage 2005; 25: 1068–76.
26. SammlerD,Koelsch SD,Friederici A. Are left fronto-temporal brain areas a prerequisite for normal music-syntactic processing? Cortex 2010; 1-15.
27. Gates A, Bradshaw JL. The Role of the Cerebral Hemispheres in Music.Brain and Language 1977; 4: 403–31.
28. Retrieved January 5, 2013.http://www.
29. Hampton A, A Cognitive Crescendo - How Music Affects the Brain Chor Teach 2009; 2 (1): 1–4.  
30. Lassaletta L, CastroA, Bastarrica M, Pérez-Mora R, Herrán B,Sanz M,et al. Musical Perception and Enjoyment in Post-Lingual Patients With Cochlear Implants. ActaOtorrinolaringolEsp 2008; 59(5):228–34.
31. Cohen H, Ouellet C. Speech and language development following cochlear implantation. Journal of Neurolinguistics1999; 12(3-4): 271–88.
32. Kong YY, Cruz R, Jones JA, Zeng FG.Music perception with temporal cues in acoustic and electric hearing. Ear Hear 2004; 25(2):173–85.
33. Fujita S, Ito J. Ability of Nucleus cochlear implantees to recognize music. Ann OtolRhinolLaryngol 1999;108(7 Pt 1): 634–40.
34. Drennan WR, Rubinstein JT. Music perception in cochlear implant users and its relationship with psychophysical capabilities.J Rehabil Res Dev. 2008; 45(5):779–90.
35. Baggerly J, Ray D. Top ten play therapy research studies. Presentation at the Association for Play Therapy Conference, Hollywood, CA, 2007.
36. Bratton S, Ray D. What the research shows about play therapy. Int J Play Ther 2000: 9(1): 47–88.
37. Ray D, Bratton S, Rhine T, Jones L. The effectiveness of play therapy: Responding to the critics. Int J Play There 2001; 10(1): 85–108.
38. Landreth G, Sweeney D, Ray D, Homeyer L, Glover G. Play Therapy Interventions with Children's Problems. 2ndEd. Jason Aronson, Inc. Northvale, New Jersey. 2005.
39. Klein J D. Effect of Instructional Gaming and Reentry Status on Performance and Motivation (Brief Research Report); Contemporary Educational Psychology1992; 17: 364–70.
40. Whitehall B, McDonald B. Improving learning persistence of military personnel by enhancing motivation in a technical training program. Simulation & Gaming 1993; 24: 294–313.
41. Casby MW, McCormack SM. Symbolic play and early communication development in hearing-impaired children.Journal of Communication Disorders 1985; 18(1): 67–78.
42. Listen Learn and Talk another Cochlear Innovation. 2nd ed. Australia:cochlear limited; 2005.
43. AziziSA, Brain to music to brain. Neuroscience Letters 2009; 459: 1–2.