Articles LSLS Featured Image

Published on August 9th, 2013


Listening and Spoken Language Specialists (LSLSTM)

By Anita Bernstein, M.Sc.(A), LSLS Cert. AVTTM
This article has been republished from the Summer 2013 issue of Communiqué.
Please note that this article was originally published when Speech-Language and Audiology Canada (SAC) was called the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA).

A Growing Specialty Within the Field of Hearing Health and Education

The past two decades have not only witnessed significant advances in hearing technology and universal newborn hearing screening, but also a corresponding increase in programs that provide supports and services for children with hearing loss who are learning to listen and speak. These advances have led to increased expectations for spoken language development, which has resulted in a growing awareness of the auditory-verbal (AV) approach as an option for children with hearing loss. In recent years, several studies have demonstrated that children who receive AV therapy are able to achieve spoken language levels commensurate with their same age peers who have typical hearing (Estabrooks, 2012).

Not so long ago in Canada, many families with children with hearing loss “tripped over” the AV option. Yet, once they did learn of it, it was often unavailable or unfunded in their community (Bernstein, 2009). Now in Ontario, AV is a funded communication option for children who are newly diagnosed with a hearing loss. It is the recommended intervention for children who have received cochlear implants and, in some implant centers, a patient’s commitment to intervention focused on spoken language acquisition is an important consideration when determining candidacy.

Listening and spoken language practitioners assist children who have a hearing loss develop spoken language and literacy skills primarily through listening, similarly to the way children who have typical hearing learn these skills. Professionals who support children with hearing loss are becoming increasingly familiar with the terms “Listening and Spoken Language specialists”, “LSLSTM practitioners”, “auditory-verbal approach”, “auditory-verbal educator” and “auditory-verbal therapy” as they have materialized in early intervention and special education documents. Consequently, an increasing number of hearing intervention centers, clinics and school boards are seeking speech-language pathologists (S-LPs), audiologists and teachers of the deaf and hard of hearing with AV knowledge and skills.

Who provides auditory-verbal intervention to children with hearing loss?

In 1994 Auditory-Verbal International (AVI) began a certification process to establish AV practice as a new specialty. Professionals eligible for this accreditation came from three educational tracks: speech language pathology, education of the deaf and hard of hearing and audiology. In 2005, AVI merged into the AGBell Academy for Listening and Spoken Language (The Academy), which is the organization that oversees the certification of listening and spoken language professionals worldwide.

Who are Listening and Spoken Language Specialists?

S-LPs, audiologists or educators of the deaf and hard of hearing who voluntarily choose to pursue LSLSTM certification adhere to the requirements and standards set by The Academy, which include: specialty education and experience in listening and spoken language theory and practice, mentoring by a certified LSLSTM for a minimum of 3 years and completing the LSLSTM certification exam.

There are two LSLSTM designations: Auditory-Verbal Therapists (LSLS Cert. AVTTM) and Auditory-Verbal Educators (LSLS Cert. AVEdTM). Both types of specialists require a common knowledge base and skills for certification.

LSLS Cert. AVTsTM usually work one-on-one with children and families in all intervention sessions. LSLS Cert. AVEdsTM also involve families in their practice and work directly with children in individual, group or classroom settings.

Currently there are over 650 certified LSLSTM professionals practicing in over 30 countries internationally; approximately 70% are LSLS Cert. AVTTM and 30% are LSLS Cert. AVEdTM.

As shown in the figure above, currently more than 80% of the certified LSLSTM professionals are speech-language pathologists or educators of the deaf and hard of hearing.

Where do LSLSTM Certified Professionals Work?

LSLSTM practitioners work in a variety of settings: home-based intervention, public schools, independent schools, private therapy, clinical centers for the deaf and hard of hearing, audiological and cochlear implant centers.

What do LSLSTM practitioners do?

These practitioners support children with hearing loss to develop spoken language and literacy primarily through listening.

LSLSTM professionals also guide and coach families to help their children develop spoken language through listening, and help them advocate for their children’s inclusion in mainstream schools.

LSLSTM professionals focus on education, guidance, advocacy, family support, use of hearing technology and strategies that promote optimal acquisition of spoken language through listening by newborns, infants, toddlers and children who have a hearing loss.

What additional knowledge and skills do LSLSTM practitioners need?

LSLSTM practitioners come to this specialty with the foundation knowledge and skills they developed in their primary profession as an audiologist, S-LP or educator of the deaf and hard of hearing. When these professionals choose to enhance their practice in this specialty they focus their study on nine domains that encompass the core competencies required for LSLSTM certification. Once certified, professionals from the three streams have comparable knowledge and skills to assist children with hearing loss develop spoken language through listening.

The LSLSTM Core competencies identified by The Academy are:

  1. Hearing and Hearing Technology
  2. Auditory Functioning
  3. Spoken Language Communication
  4. Child Development
  5. Parent Guidance, Education and Support
  6. Strategies for Listening and Spoken Language Development
  7. History, Philosophy and Professionals issues
  8. Education
  9. Emergent Literacy

LSLSTM — a growing demand for this specialty: The Canadian perspective

As hearing technology evolves and early identification of hearing loss becomes accessible across Canada, more and more families are looking for the services of professionals who are certified LSLSTM AV specialists. There is a growing need for this specialty within the field of hearing health and education as the number of families who want a positive listening and spoken language outcome for their child far exceeds the number of certified professionals available to meet their needs.

There are currently 63 certified AV professionals in Canada, most of whom are concentrated in Ontario.

The shortage of skilled and certified AV professionals concerns to VOICE for Hearing Impaired Children (Bernstein, 2009), a parent association focused on supporting families that have chosen a spoken language outcome for their children with hearing loss. VOICE, through its network of fourteen chapters in Ontario and three others across Canada, has advocated tirelessly for access to funded AV intervention for infants, preschoolers and in the school system. In an effort to improve this situation, VOICE developed the AV Training and Mentoring Program. In the early 90’s, supported by a Trillium Grant, VOICE focused on ensuring that every VOICE chapter in Ontario had access to local AV therapy delivered by a certified professional. In 2008, the Ministry of Education, recognizing the outstanding outcomes of children who have learned to listen and speak through an AV approach as well as VOICE’s expertise in training such professionals, provided VOICE with funding to train professionals in 26 school boards. Thirty professionals voluntarily participated in the program, three speech-language pathologists and 27 teachers of the deaf. Currently 12 have successfully attained their LSLSTM certification while the remaining professionals are in the process of completing their eligibility requirements.

VOICE has worked closely with Ontario universities, the College of Teachers and The Academy to ensure that Canadian professionals have the skills needed to support this growing population of students.

A couple of recent developments have addressed the need for specialized professionals:

  • The Ontario College of Teachers approved a specialization program for teachers of the deaf that will enhance their skills in supporting student with hearing loss that listen and speak.
  • The University of Ottawa launched a Diploma in Auditory-Verbal Studies in the spring of 2010 for S-LPs, audiologists and educators.


Angelina Cook (S-LP) recognized her need to develop additional skills to provide improved service to her families who had infants and preschoolers with hearing loss. She shares her experience in pursuing LSLSTM certification:

Auditory-Verbal Mentoring — Cultivating a change in professional perspective:
“As a speech-language pathologist with 6 years of practice under my belt, I enrolled in my first auditory-verbal (AV) course at York University in 1999. There are so many facets to the AV approach: from ensuring the child’s hearing technology is providing the best access to sound, to developing methods for evaluating listening, language, speech and cognition in infants, toddlers and preschoolers, to developing creative approaches to therapy to maintain the attention of young learners, to coaching and supporting parents as they continue the therapy at home, to team building with schools, audiologists and other professionals who work with the child. Having a mentor to provide feedback and guidance through all of the above is invaluable. Through the practice of AV therapy and the mentoring process, I have grown and continue to grow. I strive to include parents in the therapy sessions, improve goal setting and to promote advocacy.
I am truly thankful for all the opportunities I have had to develop these skills under the guidance of the VOICE Mentoring Program and for the opportunity to work with families, children and professionals in achieving the best outcomes in listening and spoken language for children with hearing loss.”


Where can someone find out more about LSLSTM and the auditory-verbal option?

The following links and resources provide current information on LSLSTM certification and auditory-verbal practice:

1. AGBell Academy 2013, retrieved June 27, 2013 from
2. Bernstein, A. (2009). The Growth of AV in Ontario. Sound Matters, pg. 22
3. Cook, A. (2011) Auditory-Verbal Mentoring – Cultivating a Change in Professional Perspective. Sound Matters, pg. 14
4. Fitzpatrick, E, Rhoades, E, Dornan, D, Thomas, E, Goldberg, D. (2012) FAQ 89: What Are Some of the Evidence-Based Outcomes of Auditory-Verbal Practice? In 101 frequently asked questions about auditory-verbal practice. Eastabrooks, W (Ed), Washington, DC.
AGBell Association.


Anita Bernstein_Portrait

Anita Bernstein
M.Sc.(A), LSLS Cert. AVTTM
Director of Therapy and Training Programs, VOICE for Hearing Impaired Children

About the author:

Anita Bernstein, M.Sc.A, Spec. Ed. Dip., LSLS Cert. AVTTM, is the Director of Therapy and Training programs at VOICE for Hearing Impaired Children. She oversees the VOICE Auditory Verbal Program which provides direct intervention in the listening and spoken language approach as well as a professional training and mentoring program for listening and spoken language practitioners. She has lectured at McGill University, York University and University of Toronto, presents at North American conferences, provides in-services on the listening and spoken language approach and publishes in the field of deafness. Bernstein received the AG Bell Professional of the Year award in 2000 and is currently a board member of the AG Bell Academy for Listening and Spoken Language.

Back to Top ↑