Getting Your School to Provide the AV Approach

One of the most frequent questions I receive is from parents asking how to get their school to provide the AV Approach for their child. Most of the time the child is already receiving AV services from a private therapist; the parent just wants the school to pay for it. I'm not a lawyer, just a parent who has won similar battles with the Insurance company & the Air Force (whom we convinced to relocate us due to a lack of appropriate services for our child). To some degree, we also won this battle with the school district, but you can read about that further down. None of this is to be taken as legal advice. For that, see a lawyer who specializes in Special Ed.

Above all else, remember that Auditory Verbal Therapy is just one component of an Auditory Verbal Lifestyle... it is not just a method or a bunch of techniques and strategies.

Here is basically the path I took, and what helped me. If you click on underlined text, you'll be taken to that document, or the relevant parts of it.

First of all, I read my rights, the IDEA, and some parts of the ADA. I didn't just read it, read it again and again till I knew it and could understand much of it. Another document which I classify as a Must Read is How the Individuals with Disabilities Education Act (IDEA) Applies To Deaf and Hard of Hearing Students - on the the Clerc Center website. I credit the author (or should I say blame?), with teaching me much of what I know and I was delighted when she wrote it. Don't just read it once, it's too much to absorb in one reading. Read it at least 2-3 times till you know it.

I read one other document: OSEP Policy Guidance on the Placement of Children Who are Deaf. OSEP is a sub-branch of the United States Department of Education and are responsible for ensuring States' compliance with and implementation of the Individuals with Disabilities Education Act (IDEA). Normally, OSEP Policy Guidance is considered informal guidance and is not legally binding, but this one is specifically mentioned in IDEA '97, and so it virtually takes the force of statute. For more on OSEP Policy Statements, please visit How much weight does an OSEP policy statement have?

Parents are an equal member of the IEP team and what we have to say must be seriously considered and not just brushed aside. If they do turn down something we propose, we are entitled to Prior Written Notice - in other words, they have to justify, in writing, why they turned it down.

Choosing what regs to quote to support what you're asking for can be tricky. For example:

IDEA '97 says:
§300.19 Native language
"(b) For an individual with deafness or blindness, or for an individual with no written language, the mode of communication is that normally used by the individual (such as sign language, braille, or oral communication)."

That's not much help if your child does not yet have language or the child and family wish to change the mode of communication the child now uses. Compare it with:

OSEP Policy Guidance on the Placement of Children Who are Deaf
"The Secretary believes it is important that State and local education agencies, in developing an IEP for a child who is deaf, take into consideration such factors as:
1. Communication needs and the child's and family's preferred mode of communication"

Get as many Goals and Objectives into the IEP as possible that directly relate to AV goals, while not allowing any in for speech-reading or sign language. This makes it easier to keep your child out of a TC classroom, as it could be argued that sign language is a modification of the general education curriculum which is not specified in your child's IEP. For example, some of your Gs & Os might be to increase the intelligibility of speech by 20% as measured by the CID Picture SPINE, increase spoken vocabulary by 200 words/grading period, improve listening comprehension as measured by (insert the name of an appropriate test), ask appropriate questions orally to request information or clarification, and so on.

Documents you bring to the table can be helpful too, like letters from your child's doctor, surgeon, or audiologist (the only warning I'll give on this is that they should not contain the words 'maximum benefit', because the Supreme Court has ruled that school districts don't have to give you the 'best' or 'maximum', only what is 'appropriate': "the furnishing of every special service necessary to maximize each handicapped child's potential is, we think, further than Congress intended to go."

In an IEP, these are considered Independent Educational Evaluations. §300.502c of IDEA '97 tells us "(c) Parent-initiated evaluations. If the parent obtains an independent educational evaluation at private expense, the results of the evaluation (1) Must be considered by the public agency, if it meets agency criteria, in any decision made with respect to the provision of FAPE to the child."

If they try to tell you AV doesn't work (I've heard that one too), Outcome Survey of Auditory-Verbal Graduates: Study of Clinical Efficacy is handy to have on hand. Also see Language Progress with an Auditory-Verbal Approach for Young Children with Hearing Loss by Ellen Rhoades, published in International Pediatrics, 16 (1), 2000.

Now read some similar case rulings. What you're doing here is learning how these things are applied in real life situations similar to yours. You're looking for the terminology, like 'Unique Individual Need' vs 'the best'. You're looking to learn the proper procedures for IEP's, what things work and don't work, how to approach getting your child his Unique Education Needs met as part of a Free and Appropriate Services (FAPE) in his Least Restrictive Environment.

D.D. vs FOOTHILL SELPA - We have AG Bell's Educational Advocacy Initiative to thank for this one. Here is an excerpt from page 5:

"The real question is where the personnel designated by the FOOTHILL SELPA to provide the services offered have the necessary background, training, and experience to implement an appropriate auditory/verbal program for Petitioner. The answer is that they do not.

While the Foothill SELPS personnel have the requisite credentials, credentials alone do not necessarily qualify an individual to provide all possible services under that credential. Conversely, the lack of a credential does not necessarily render a person unqualified to perform a service. If that person has a proven record of success, they are qualified to do the work."

Eureka Union Sch. Dist./Placer County Office of Educ - The hearing officer examined the proposed district program for the student and concluded it was inappropriate. The district program was not designed to address the student's need for improvement of his listening and auditory skills and would have required him to learn a new form of communication. The district program emphasized sign language, which the student did not need to communicate and would possibly result in the regression of the student's listening and speaking skills. The private program provided the student with a FAPE, since it addressed his listening and auditory skills.
[Student] v. Branford Board of Education - Based on all the documentary evidence and witness testimony, it was concluded that the IEP offered by the Board was not reasonably calculated to provide the student educational benefit. Although the IEP offered by the Board seemed to be the best it could offer, it was not designed to address the student’s unique needs as a profoundly deaf, cochlear implant child who has successfully acquired the entirety of his speech and language by means of auditory-verbal therapy, including committed parental participation, and attendance in the regular education preschool setting.
California Case No: 1076 - The Hearing Officer concluded that student's unique needs, along with the unique needs of her family, include auditory-verbal therapy and a regular education preschool setting.
California Cases No: 1383 and 1581 - The Hearing Officer concluded that student requires a program that recognizes his auditory and oral skills and focuses on developing those skills and that a DHOH class would, instead, provide student instruction in sign language, a mode of communication the evidence established student did not need.
California Case No: 593 - The Hearing Officer concluded that a preschool class with 1:1 auditory training, 1:1 speech and language services, classroom carry-over, and parent education--addressed student's unique needs and that a preschool class with emphasis on the teaching and use of sign language, even though the District identifies the class as using a total communication approach, did not.
Illinois Case #001231 (summary) - "Parents requested hearing on the issues of FAPE, specifically the district’s failure to provide Auditory-Verbal Therapy and a sound field system for their 4 year-old hearing impaired child and failure to place the child in a regular preschool classroom with non-disabled peers. The hearing officer held for parents on the issues of Auditory-Verbal Therapy and placement and for the district on the issue of provision of sound field system. District was ordered to pay for private AVT and preschool tuition and to reimburse parents for past payment of these expenses." This ruling was upheld on appeal in Federal Court.
Illinois Case # 002204 - Illinois District Court Judge orders school system to pay for AVT services and reimburse day care costs for a child with a cochlear implant.
Jalen v. Alief Independent School District - The school district was ordered to provide 12 months of compensatory speech therapy & A-V therapy and to coordinate with and consider retaining his current AVT.

Many times parents tell me the school told them the only option they would provide was a TC (Total Communication) classroom.

OSEP Policy Guidance on the Placement of Children Who are Deaf states: "This overriding rule regarding placement is that placement decisions must be made on an individual basis. As in previous policy guidance, the Secretary emphasizes that placement decisions may not be based on category of disability, the configuration of the delivery system, the availability of educational or related services, availability of space, or administrative convenience."
In Doe v. Board of Education of the Detroit Public Schools, a hearing officer had this to say: "In developing an IEP for a child who is deaf, OSEP noted it is important to take into consideration such factors as: the communication needs and the child's and family's preferred mode of communication; linguistic needs; severity of hearing loss and potential for using residential hearing; academic levels; and social, emotional and cultural needs, including opportunities for peer interactions and communication. OSEP went onto state that: "any setting, including the regular classroom, that prevents a child who is deaf from receiving an appropriate education that meets his or her needs, including communication needs, is not the LRE for that individual child.'"

What if they say your child doesn't qualify for services because her needs don't impact her educational performance?

The American Speech-Language Hearing Association (ASHA) website has a brief discussion about this on their School Services: Answers to Frequently Asked Questions (FAQs) page (you must now be an ASHA member in order to view this page). At the bottom of the page it reads: "The term "education performance" has been interpreted by the Department of Education and is not limited to "showing of discrepancies in age/grade performance in academic subject-matter areas. The extent of a child's mastery of the basic skill of effective oral communication is clearly includable within the standard of "educational performance" set by the regulations. Therefore, a speech-language impairment necessarily adversely affects educational performance when the communication disorder is judged sufficiently severe to require the provision of speech pathology services to the child." If communication skills are a required part of the school's curriculum, and considered to be a basic skill necessary for all children attending school, then children who have a speech or language impairment would have a disorder that adversely affects educational performance. State or local school districts may apply different interpretations to "adversely affects educational performance."
Denial of Eligibility Because of Gifted Intellectual Ability and/or Lack of Failure - OSEP Policy Letter. The OSEP policy letter states that "Underachievement is measured against the student's own ability, and not against a normative performance standard." For those whose children are not failing because they are receiving outside help and they're trying to convince the school district to provide that help, the OSEP letter goes on to state that "Generally, it would be appropriate for the evaluation team to consider information about outside or extra learning support provided to the child in developing the written report required at 34 CFR § 300.543, as such information may indicate that the child's current educational achievement reflects the service augmentation, not what the child's achievement would be without such help." In other words, it doesn't impact her educational performance BECAUSE she is getting outside therapy.
Another OSEP Guidance Letter Developing Rules for Determining Whether a Student with an Impairment Needs Special Education and Related Services states: "In determining whether a child's impairment adversely affects educational performance, the multidisciplinary team must consider non-academic as well as academic areas. Therefore, the assessment is more than the measurement of the child's academic performance as determined by standardized measures. While State operational criteria are useful in determining whether a child needs special education and related services because of an impairment, the multidisciplinary team must have the ultimate authority to make such determinations using their professional judgment based on the child's evaluation."
Your child might be doing well because she has a dual exceptionality, and the area she is ahead in covers the deficit in another area. Here is a list of characteristics of gifted students with specific disabilities (including hearing impairment) from the ERIC database: Dual Exceptionalities. If this is the case with your child, the IEP should reflect this and both areas of exceptionality should be addressed.

If they say they can't provide AV Therapy because they don't have an AV Therapist on staff, the rulings I've already mentioned clearly show that if the school can't meet a child's Unique Educational Need, then they have to pay to get it from a private source.

Each time I went into an IEP meeting, I went in able to list my son's Unique Educational Needs, private evaluations or letters from professionals proving that he had those needs, IDEA's Implementing Regulations showing the school district had an obligation to meet those needs, OSEP Policy Guidance Letters (whenever possible) clarifying IDEA's regulations relating to those needs, & rulings in situations similar to my child's where the ruling was that the school had to provide for those needs or pay for someone else to provide for them. (Even if you don't live in that court's jurisdiction, these rulings can be considered advisory).

Once of the comments you'll hear in an IEP meeting, as we did, is that their therapist can provide AV or do everything an AV Therapist can. Here is the argument we used when we heard this:

The Documents:	My Reasoning:
Definition of and Competencies for Aural Rehabilitation - from the American Speech-Language-Hearing Association (ASHA). I won't list the minimal competencies in this document, you can visit and read that for yourself. It is worth mentioning though that in their conclusions they state: "In examining the present certification standards, it is this Committee’s opinion that they do not require sufficient training of either audiologists or speech-language pathologists to meet the minimal competencies as proposed."	This document outlines the training ASHA feels is necessary to be qualified to provide Aural Rehabilitation, and states that they don't believe a traditional SLP has the training to meet the minimal competencies.
ASHA's Code of Ethics - for Speech-Language-Hearing Professionals states (in part): Individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience. Individuals shall prohibit any of their professional staff from providing services that exceed the staff member's competence, considering the staff member's level of education, training, and experience. Individuals shall not misrepresent their credentials, competence, education, training, or experience. Individuals shall prohibit anyone under their supervision from engaging in any practice that violates the Code of Ethics.	If the school SLP is a member of ASHA, they should not engage in Aural Rehabilitation unless they meet the qualifications listed in the above document. If they're not but their supervisor is, this code of ethics still applies.
Qualifications for AV Certification Testing As determined by AVI, as of July, 2000, to qualify to take the 3-hr A-V certification written examination, candidates must meet the following criteria: A Masters Degree or equivalent post-baccalaureate education documented by a diploma in Audiology, Speech-Language Pathology, Education of Children with Hearing Loss, or related fields as approved by the Certification Council. Previous or present holder of the American Speech-Language-Hearing Association (ASHA) Certificate of Clinical Competence in Audiology (CCC-A), Speech-Language Pathology (CCC-SLP), or the equivalent license or credentials in Audiology, Speech-Language Pathology, or Education of Children with Hearing Loss. A minimum of three (3) calendar years of professional experience within the past six (6) years in an auditory based practice without the use of formal visual communication systems such as cued speech, sign language, or formal instruction in speechreading. These three (3) calendar years of professional experience must include a minimum of 2400 clock hours in activities supporting families utilizing the Auditory-Verbal approach with their children with hearing loss. These required hours are based on a 40 hour week with a minimum of 20 clock hours/week over at least a three (3) year period or 10 clock hours/week over a six (6) year period. A minimum of 2000 of these clock hours must be in the delivery of one-to-one parent/child centered direct auditory-based therapy. The remaining 400 hours may be in communication assessments, parent conferences, consultations with and inservice of related professionals, home and school visits, and assistance with audiological services. The three (3) calendar years of professional experience needs to be completed regardless of the number of clock hours you complete in excess of the 2400 required. It must also be acquired after receipt of your professional degree. A minimum of eighty (80) hours of coursework, observation, internship, or study in Auditory-Verbal theory and practice within the last three to six years. This is considered only a minimum number of hours and does not represent sufficient training for competency in Auditory-Verbal practice. Documentation for activities described in points a. through f. must be submitted with your application. Appropriate activities include: Attendance at AVI sponsored workshops, conferences, or special programs. Attendance at sessions of a major conference (ASHA, AAA, EAA, AG Bell, etc.) which are focused on Auditory-Verbal development and Auditory-Verbal intervention strategies and techniques. Observation of Auditory-Verbal Therapy conducted by a currently Certified Auditory-Verbal Therapist (Cert. AVT). This can be done via videotape where travel to the Cert.AVTs’ practice is not possible. Completion of a professional development week at an established Auditory-Verbal center or conducted by Certified Auditory-Verbal Therapists. Participation in a local study group under the guidance of a Cert.AVT reviewing Auditory-Verbal literature and case reviews of Auditory-Verbal Therapy. Completion of graduate level coursework in Auditory-Verbal theory, practice and techniques at a university/college. For the most current Qualifications for A-V Certification Testing, please visit the AVT Certification page on the AVI Website.	A person who is certified as an AV therapist has the additional training suggested in the Definition of and Competencies document and has demonstrated this additional knowledge by passing the AV Certification Testing. (Remember, anyone can call themselves and AV Therapist, but they can't say they're an AVT-Cert.) I personally think of it as being a melding of the 3 professions, as diagrammed below.

Did this approach work for us? We've used it three times. Once with the Air Force to convince their program for Exceptional Family Members that our son was not receiving required services, once with the school district and once with the insurance company. It worked without any problems with the Air Force and insurance company. With the school district, it depends on how you look at it as to whether it worked or not. After I presented them with a copy of the Definition of and Competencies document, they replied that state law didn't require them to do that (which I've found is something that they like to say when faced with having to do something they don't want to do).

We countered with the next 2 items, of course it helps that the head of the special ed department of speech/language was at that meeting, and after I presented these, I asked her if she had her C's. That's all it took. They offered to have our son's services provided by someone who was working towards certification and that his services were overseen by a certified AVT located in a town that was in another part of the state. Since we had an opportunity to send our son to the mainstream program of a private oral school which provided everything we had asked for (including services by a certified AVT), after 6 years of fighting with schools for services for our child, we chose to disagree with the IEP, put our son in the private school, but not contest the IEP, and be done with it.

In our letter spelling out why we disagreed with the IEP, we stated that we did not agree that our son's program could be properly overseen by someone 6-8 hours away, had never met our son, would never meet our son, etc. I also mentioned that this AVT wannabe, who was a member of the IEP team and had directed the goals and objectives that were included in their IEP proposal, had not included one goal or objective that related to improving his listening skills, which by their own testing showed to be his greatest area of deficit. I have no doubt that had we taken this to due process, we would have won.

Read a couple more cases here: School Districts and AV Therapy

You may not have thought AV was an option for your child because of a lack of AV providers in your area. You should know that Ellen Rhoades offers a service where she will come in and do workshops, and then mentor one person from the workshop. For more info on this service, please visit Auditory Verbal Training & Consulting.

OK, If you have all this material in your knowledge, readily accessible, and have a list of what your child needs, proof that he needs it, the regs showing the school district is obligated to meet those needs, OSEP documents, and Rulings that show other children with similar circumstances have had rulings in their favor, you should be armed with the tools to get AV services paid for by your school district.

Even with all of this, there are some school districts that just won't go for it without putting up a fight. If worse comes to worse and moving is your only option, Ellen Rhoades has compiled a list of school districts who actually have AVT-Certs on staff: Where Can I Secure Free Auditory-Verbal Therapy (AVT) Services for my Child? This list doesn't include schools who contract out with private providers for AVT services.