Quiet spaces provide the deaf or hard of hearing child with the clearest listening opportunities. These are moments where the speech signal is received without competing noise. 

This nineteenth episode, draws on Shefali Shah’s in-person practice and follows through on a father’s insight, that: “In order for a child to talk clearly, she must hear clearly.”

However, life is noisy. School settings, playgrounds, birthday parties, and restaurants are filled with competing sounds. Background noise masks the clarity of speech, making it harder for a deaf or hard of hearing child to listen, pay attention, imitate, understand and respond appropriately. Listening in noise is not only harder, it is more tiring. This “auditory fatigue” can drain a child’s focus and energy long before the day is over.

Shefali recommends asking your child’s audiologist for strategies to make classrooms acoustically supportive and how the hearing technology on your child’s devices can support her at school. She further recommends choosing school placement carefully as smaller, more acoustically friendly classrooms and accessories such as remote microphone systems can support your deaf child. She also shows how Auditory-Verbal Therapy prepares children for real-world noise, training their listening skills so they can thrive in the hustle and bustle of everyday life.

Noise may compete for attention, but with the right support and practice, your deaf or hard of hearing child can learn to cope so that she enjoys life!

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 19

Time Stamps:

00:00:00 Introduction
00:01:33 90% of deaf children are born to hearing parents
00:01:42 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:15 AVT facilitates age-appropriate development
00:02:44 Abundant choices open up through AVT
00:03:11 Early identification and the fitting of early and optimal amplification.
00:03:17 A life free of limitations
00:03:30 Show notes, Top tips and Time Stamps
00:03:38 Links and contact details
00:03:43 Resources
00:03:52 Listening in quiet
00:04:38 Listening in noise
00:04:49 Listening in noise gets tiring
00:05:14 School settings and playgrounds are noisy
00:07:49 Noise detracts from the clarity of the speech signal
00:08:09 Choosing school placement
00:08:40 Participating in games on the playground
00:09:01 Explaining the rules of games
00:10:04 Practice listening in noise
00:11:14 Acoustic treatment at school
00:11:42 Accessories on hearing devices and setting up FM systems at school 
00:12:56 Reflection
00:13:34 Our next episode: Passive Listening or Overhearing

Resources:

In this essential eighteenth episode, Shefali Shah takes us on an auditory journey, sharing authentic sound bites from her own AVT practice. We listen in as infants and toddlers progress through the natural stages of pre-speech: from early vocal play, to babbling,  jargon, imitation and first words as they thrive in environments that support their listening, learning and talking.

The episode offers a rich understanding of how listening, language, and speech are closely intertwined. Talking is the outcome of a consistent period of listening time. Language and speech development follow a universal hierarchy in which listening precedes speech. Speech sounds too follow a natural sequence, with early emerging speech sounds invariably preceding and preparing for the emergence of later developing sounds. 

A couple in Shefali’s online practice, shares their delight in the emergence of intelligible speech in their cochlear-implanted toddler as they discover that there is a universal order to the production of speech sounds and learn what to expect and how to monitor and support their daughter’s age-appropriate speech development.

Clear speech is the result of diligent preparation.

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 18

Time Stamps:

00:00:00 Introduction
00:01:10 90% of deaf children are born to hearing parents
00:01:25 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:01:50 AVT facilitates age-appropriate development
00:02:02 Abundant choices open up through AVT
00:02:47 Early identification and the fitting of early and optimal amplification.
00:02:53 A life free of limitations
00:03:06 Introduction to this episode
00:03:42 Show notes, Top tips and Time Stamps
00:03:54 Links and contact details
00:04:00 Resources
00:04:45Development in infants with typical hearing 
00:05:19 We talk as we hear
00:06:34 Talking presupposes listening
00:09:39 Your baby will talk when she is ready to talk
00:09:56 Speech readiness
00:11:40 Pre-speech development
00:13:29 Vocalisations
00:14:10 Babbling
00:15:01 Vocalisation Vs Babbling
00:15:27 Delayed or absent babbling
00:15:53 Babbling develops with social interaction
00:17:18 Jargon
00:20:08 First words
00:20:24 new word combinations emerge
00:21:08 Sentences emerge
00:21:30 Conversation is both the base plate and the apex of the Spoken language development 
00:22:40 The Hierarchy of speech sound production
00:25:10 Monitor your growing child’s speech development
00:29:19 Engaging your baby through Conversation 
00:29:46 Reflection
00:30:57 Our next episode: Noisy Spaces

Resources:

• Estabrooks, W., MacIver-Lux, K., & Rhoades, E. (Eds.). (2020). Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them (2nd ed.). Plural Publishing.

Self-monitoring is the invisible skill that allows children to reflect, adapt, and regulate, so as to learn independently and grow.

In this seventeenth episode, Shefali Shah demonstrates with three-and-a-half and four year old deaf children  how Auditory-Verbal Therapy systematically fosters the ability to self-monitor speech intelligibility and language usage.

As listening becomes deeply internalised, a deaf or hard of hearing child begins to observe herself, spontaneously modifying her language and speech, to align with increasing accuracy with the patterns she hears around her. This intentional shift in responsibility is central to Auditory-Verbal Therapy and is in accordance with Principle 8.

Self-monitoring is both subtle and powerful as it characterises the independent learner.

Time Stamps:

00:00:00 Introduction
00:01:30  90% of deaf children are born to hearing parents
00:01:39 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:14 AVT facilitates age-appropriate development
00:02:40 Abundant choices open up through AVT
00:03:07 Early identification and the fitting of early and optimal amplification.
00:03:15 A life free of limitations
00:03:23 Show notes, Top tips and Time Stamps
00:03:34 Links and contact details
00:03:43 Resources
00:03:49 Principle 8 of AVT: Self-monitoring
00:04:07 Meaning of self-monitoring
00:05:17 Self-monitoring critical to independent learning
00:05:30 An efficient tool to maintain speech intelligibility
00:06:08 Self-Practice
00:07:34 Intentional pull back
00:08:05 Analysis of short demo
00:14:13 Reflection
00:15:02 Our next episode: Clear Speech

Resources:

• Paul, R., & Norbury, C. (2012). Language Disorders from Infancy through Adolescence.

Your six month old infant is ready to be read to!

In this delightful sixteenth episode, Shefali Shah is joined by Simi Rughani and Rashi Sanghi to experience the joy of reading aloud to their toddler. Follow Shefali’s practical guidance on how to choose developmentally appropriate books, to harness your child’s wholehearted participation.

Books open up new worlds. The research shows that early reading is a strong predictor of lifelong academic success.

Enjoy listening to mothers reading to their toddlers, moving beyond mere labelling to unlock the subtle messages of the story. Witness an emerging Theory of Mind(ToM), as the toddler demonstrates his emerging appreciation of perspective.

Reading is fun! Share the fun of reading with your child! 

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 16

Time Stamps:

00:00:00 Introduction
00:01:28 Introducing our guests in this episode: Simi Rughani and Rashi Sanghi 
00:02:00 90% of deaf children are born to hearing parents
00:02:10 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:49 AVT facilitates age-appropriate development
00:03:12 Abundant choices open up through AVT
00:03:37 Early identification and the fitting of early and optimal amplification.
00:03:44 A life free of limitations
00:03:53 Show notes, Top tips and Time Stamps
00:04:03 Links and contact details
00:04:11 Resources
00:04:42 Suggested reading for young children
00:04:50 Reading score is a reliable predictor of lifelong academic achievement 
00:05:24 Reading to infants
00:06:41 Move away from mère labelling as you read to your infant
00:07:00 Making each page come alive
00:08:27 Reading to toddlers
00:09:08 Transitioning to books with involved plots
00:10:58 Comprehending the subtleties of the storyline
00:11:10 Understanding Perspective
00:11:39 Emerging Theory of Mind
00:17:07 Reflection
00:17:21 Our next episode: Self-monitoring

Resources:

Play offers children a safe and imaginative space to explore, express emotions, experiment, and fail, all without consequence. It is the perfect stage on which your deaf or hard of hearing child can practice talking, thinking, problem-solving and learning.

In this fifteenth episode, Shefali Shah shares a delightful conversation with a young couple from her online AVT practice: parents of a cochlear implanted toddler, as they reflect on how their play epiodes have evolved. Through real-life play sequences, Shefali coaches them to move beyond factual exchanges, to expand play themes, embrace unpredictability, and fuel their child’s imagination.

By modelling new ideas, introducing “Sabotage” to disrupt predictable patterns, and allowing space for their child to resolve play scenarios, the family discovers how imagination and language take flight together. They laugh, learn, and marvel at how creative their child has become!

Move away from realistic routine and take flights of fantasy! Once you open up those doors you’ll be amazed by how quickly your child grabs these opportunities and flies with them, so that you can fly together!

Time Stamps:

00:00:00 Introduction
00:01:17 90% of deaf children are born to hearing parents
00:01:26 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:01:58 AVT facilitates age-appropriate development
00:02:28 Abundant choices open up through AVT
00:02:54 Early identification and the fitting of early and optimal amplification.
00:03:01 A life free of limitations
00:03:11 Show notes, Top tips and Time Stamps
00:03:20 Links and contact details
00:03:28 Resources
00:03:34 Auditory-Verbal Techniques
00:03:50 Auditory-Verbal Techniques: Sabotage
00:04:15 Auditory-Verbal Techniques: Modelling
00:04:47 Engaging your child in play
00:05:16 Introducing our guests in this episode
00:05:44 Pretend Play
00:06:05 Keeping Conversation alive through play
00:07:35 Firing imagination
00:09:05 Young children playing together
00:10:00 Exploring non-factual themes
00:10:53 Pure imagination in play
00:14:12 Sabotage: Disrupting play with a disaster
00:14:38 Variations in the same play theme
00:20:24 Play out play sequences in dreams
00:21:47 Reflection
00:22:15 Our next episode: Reading: Beyond Words

Resources:

The uphill climb of the early days is now behind you. As new vistas open up, you’ll find that  the gradient has eased and the pace of your child’s learning has gained considerable momentum.

As comforting as it may be to linger in the familiar, growth thrives in novelty. By balancing observation with intuition, you can stretch and challenge your deaf or hard of hearing child without overwhelming her. Let go of repeating the same routines the same way. Instead, favour fresh turns of phrase, richer vocabulary, and more complex thinking. This fluidity makes your child nimble minded.

Plan and marvel at how your child embraces this change of pace: staying attentive, curious, and receptive to every new idea that she discovers!

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 14

Time Stamps:

00:00:00 Introduction
00:01:42 Introducing our guests in this episode
00:02:00 90% of deaf children are born to hearing parents
00:02:10 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:38 AVT facilitates age-appropriate development
00:03:10 Abundant choices open up through AVT
00:03:38 Early identification and the fitting of early and optimal amplification.
00:03:46 A life free of limitations
00:03:56 Show notes, Top tips and Time Stamps
00:04:05 Links and contact details
00:04:13 Resources
00L04:36 Trust that your child is listening with optimal amplification
00:05:08 Subtle signs of comprehension
00:05:15 Pacing is key
00:05:30 Move forward
00:08:11 Stay intuitive
00:08:38 Keep changing the manner in which you convey familiar content
00:11:00 Stretch and challenge
00:15:41  Learning in session
00:16:40 An enthusiastic listener
00:17:58 Reflection
00:18:44 Our next episode: Firing imagination through play

Resources:

Progress is at the heart of effective early intervention. 

The only way to determine whether a child is progressing is to measure development objectively: with data. Auditory-Verbal Therapy recommends administering internationally standardised assessments annually, to quantify developmental progress and track age-equivalent performance in children who are deaf or hard of hearing.

In this thirteenth episode, Shefali Shah is joined by Rashi Sanghi in an honest, penetrating conversation on how to plan for progress. Through coaching and guidance, Rashi has evolved into a confident, discerning, and responsive parent who now leads her child’s intervention journey with insight and purpose. Her transformation, from being dismissive to deeply appreciative of her child’s perspective, is a testament to what becomes possible when parents drive AVT.

Children with congenital hearing loss often begin life at a developmental disadvantage, as hearing begins in utero by 20 weeks. That means we need more than 12 months of developmental progress in 12 months of time to close this gap.

Auditory-Verbal Therapy facilitates this through an active, intentional, and responsive process. It places parents at the centre of services, providing a structured framework and treatment plan that evolves continuously to meet the child’s changing developmental needs.

Auditory-Verbal Therapy centres the parent. And when parents take the wheel, children thrive.

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 13 

Absorb                                                                                                                              Consolidate                                                                                                              Demonstrate

Time Stamps:

00:00:00 Introduction
00:00:1:10 Introduction to this episode 
00:02:10 90% of deaf children are born to hearing parents
00:02:20  Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:49  AVT facilitates age-appropriate development
00:03:16 Abundant choices open up through AVT
00:03:48 Early identification and the fitting of early and optimal amplification.
00:03:55 A life free of limitations
00:04:04 Show notes, Top tips and Time Stamps
00:04:15 Links and contact details
00:04:22 Resources
00:04:43 Measuring progress with data
00:05:54 Standardised assessments
00:07:40 Congenital hearing loss has an inherent developmental delay
00:09:12 Closing the developmental gap
00:09:46 Systematic and on-going planning
00:10:38 The Auditory-Verbal Treatment Plan
00:11:25 Demonstration of mastery
00:12:21 Introducing our guests on this episode
00:13:05 Transitioning caregivers to driving therapy
00:15:03 Confident parenting
00:15:30 Appreciating your child’s perspective
00:16:22 Inviting parent participation in planning
00:20:22 Delivering at least 12 months’ progress in 12 months’ time
00:20:53 Pace of progress
00:21:54 Reflection
00:22:40 Our next episode: Keeping up with my child

Resources:

Do you worry that your deaf or hard of hearing child is not talking as yet or that she is not talking enough? Listen to this episode: My deaf child isn’t talking which directly addresses your concerns and guides you through them.

Shefali Shah's conversation with Sheena Kurian in this twelfth episode, guides listeners through the natural developmental sequence of language acquisition, emphasising that comprehension precedes expression. Just like children with typical hearing, your deaf or hard of hearing child will speak, with optimal amplification, once she has built a sufficiently strong foundation of listening and understanding.
 
With clear examples and practical insights, Shefali constantly reminds the listener that expressive communication is built on the bedrock of enriched family conversations. 

AV Techniques such as Modelling, Waiting, and Sabotage create opportunities that invite spoken responses, sparking and fulfilling your child’s communicative intent. Perceptive observation offers the insight you need to support your child’s expressive language development.
 
Most importantly, this episode reframes the AV Technique of Waiting, not as weakness, but as a stage, onto which to invite your child to talk.

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 12 

Time Stamps:

00:00:00 Introduction
00:01:09 90% of deaf children are born to hearing parents
00:01:18 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:01:50AVT facilitates age-appropriate development
00:02:21 Abundant choices open up through AVT
00:02:48 Early identification and the fitting of early and optimal amplification.
00:02:54 A life free of limitations
00:03:05 Show notes, Top tips and Time Stamps
00:03:12 Links and contact details
00:03:18 Auditory-Verbal Techniques
00:03:36 AV Technique: Sabotage
00:04:00 AV Technique: Modelling
00:04:33 Introduction to this episode
00:05:08 Does your child have sufficient access to the speech signal?
00:05:57 Optimal amplification
00:06:44 Timely intervention 
00:07:31 Aided audiogram
00:08:00 CI assisted audiogram
00:08:27 Amplification to facilitate clear imitation
00:08:59 The Pragmatics of spoken language communication
00:09:24 Introducing our guests on this episode: Sheena Kurian
00:09:43 The human brain wants to learn
00:09:58 Communicative Intent
00:11:32 Typical patterns of speech development
00:13:42 The AV Technique: the Wait Cue 
00:16:08 The AV Technique: Sabotage
00:16:53 The AV Technique: Modelling
00:19:12 Embed in Conversation
00:22:09 Reflection
00:22:49Our next episode: Is my deaf child progressing?

Not understanding is not a calamity!

In this eleventh episode: Does my deaf child understand?, Shefali Shah in conversation with families in her in-person therapy sessions in the UK and India, guides them to offer simple, clear explanations to their child for information they did not understand, without asking test questions, interrupting or simplifying content. These break the flow of interaction and dilute meaning. Instead, Shefali guides them to observe, listen, and believe.

Engage completely with your child so that whatever you’re doing together feels relevant, meaningful, and engaging. With optimal amplification and early intervention, trust that your child is listening and then lean into that trust.

Your child will let you know when something isn’t clear. 

This builds connection and genuine understanding.

This is The Sound Steps Podcast.

🎧 Top Tips from Episode 11

Time Stamps:

00:00:00 Introduction
00:01:2090% of deaf children are born to hearing parents
00:01:30 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:02:10 AVT facilitates age-appropriate development
00:02:33 Abundant choices open up through AVT
00:02:58 Early identification and the fitting of early and optimal amplification.
00:03:10 A life free of limitations
00:03:15 Show notes, Top tips and Time Stamps
00:03:25 Links and contact details
00:03:31 Introducing and thanking our guests on this episode: Rebecca Rajkumar
00:04:38 Why would your child not understand?
00:05:11 Connect to your child
00:05:37 Ask: Does this interest your child?
00:06:27 Engaging your child
00:07:40 Talk through the day about what your child is about to do
00:08:07 Stay relevant
00:07:28 Children let us know when they don’t understand 
00:08:26 Observation and recognition of engagement
00:09:48 Optimal amplification
00:10:03 The Speech String Bean
00:10:19 Detect and comprehend soft conversation
00:10:24 Detect and comprehend conversation at a distance
00:10:26 Listening in noise
00:11:16 Trust that your baby is listening 
00:11:32  The OWL Strategy (Hanen Centre)
00:12:12 Do not test your child
00:12:26 Interruptions
00:13:28 Blurring auditory memory
00:14:40 Not understanding is not a calamity!
00:15:54 Suspend doubt
00:16:51 Explaining
00:17:27 Do not dilute your message!
00:20:18 Reflection
00:20:46 Our next episode: My deaf child isn’t talking.

Resources:

RESOURCES: Supporting Language Comprehension

Cole, E. B., & Flexer, C. (2019). Children with hearing loss: Developing listening and talking birth to six, 4thed. San Diego: Plural Publishing. 

Madell, J., Flexer C., Schafer E., and Wolfe J., (2019), Pediatric Audiology: Diagnosis, Technology and Management, 3rd Edition, Thieme, NY.

Madell, J. R. (2015), The Speech String Bean, Hearing Health and Technology Matters.

Madell, J. R. (2012) Speech Perception -The Basics, Hearing Health and Technology Matters. https://hearinghealthmatters.org/hearing-and-kids/2012/speech-perception-the-basics/

Meaningful content engages children. They stay attentive. Variety in our use of vocabulary and language forms, builds deeper and more extensive learning pathways. 

In this tenth episode, Generalisation: Following up on targets in Auditory-Verbal Therapy, Shefali Shah and Rashi Sanghi bring this concept to life with real-world examples. Their conversation shows how frequency and variety are essential in building a child’s comprehension and ability to talk fluently.

Generalisation refers to the sufficient and varied use of a language form so that a deaf or hard of hearing child can understand and use it spontaneously in everyday life, beyond structured practice.

Embed learning across diverse moments and forms in every day, to enrich your deaf or hard of hearing child’s experience of life, language and learning.

This is The Sound Steps Podcast.

Time Stamps:

00:00:00 Introduction
00:01:10 90% of deaf children are born to hearing parents
00:01:21 Choosing Auditory-Verbal Therapy for your deaf or hard of hearing child
00:01:52 AVT facilitates age-appropriate development
00:02:22 Abundant choices open up through AVT
00:02:47 Early identification and the fitting of early and optimal amplification.
00:02:57 A life free of limitatio
00:03:03 Show notes, Top tips and Time Stamps
00:03:13 Links and contact details
00:03:21 Introduction to this episode
00:03:37 Frequency of use and variety are key to understanding language
00:06:21 Gaining, engaging and holding attention with live voice
00:07:09 Redundancy in parent-child interaction
00:07:39 Abundance brings gaiety
00:07:59 Doubt
00:08:55 Heart-to-heart exchanges
00:09:55 Staying on target
00:10:37 Introducing our guest on this episode: Rashi Sanghi
00:11:29 Using different forms of language to convey the same meaning
00:12:36 Enriching language comprehension
00:13:12 Providing the language that matches the child’s experience in the moment
00:13:28 Context conveys meaning
00:13:58 Using vocabulary in a variety of ways: not merely labelling
00:14:48 Talking in complete sentences
00:15:17 Accelerating learning
00:15:35 Sufficiency of usage
00:16:24 Generalisation facilitates comprehension
00:17:39 Reflection
00:18:23 Our next episode: Does my child understand?

Resources: