Written evidence submitted by Auditory Verbal UK

(SFC0035)

1. About Us             

1.1 Auditory Verbal UK is an award-winning charity that wants all deaf children to have the same opportunities in life as their hearing peers. It supports deaf babies and children to learn to listen and speak through an approach to developing language and communication called Auditory Verbal therapy and provides internationally accredited training in Auditory Verbal practice for health and education professionals. AVUK is working to increase access to, as well as understanding of Auditory Verbal therapy, so that families of deaf children have the opportunity to access it through publicly funded services wherever they live in the UK. Along with other organisations in the sector, AVUK works to raise expectations and outcomes for deaf children and contributes to international evidence and best practice.

2. Summary

2.1 Auditory Verbal UK (AVUK) welcomes the call for evidence; Support for children and young people with special educational needs and the opportunity to submit evidence on the outcomes possible for deaf children and the importance of early and effective support to develop language and communication.

2.2 There are at least 50,000 deaf children in the UK, with around 7,000 under the age of 5. They are currently falling behind their hearing peers, facing the prospect of lower academic achievement and employment prospects, and are at higher risk of social exclusion, bullying and poor mental health. Deaf babies and children in the UK currently face a lifetime of disadvantage without access to early and effective support to develop language and communication so that they can achieve their potential in life. There has never been a more important time to invest to tackle the root cause of disadvantage.

2.3 Early and effective support is vital whether a family wish to use spoken language, sign language or both. For families wanting their children to communicate using spoken language, it is essential to provide intervention as early in the child’s development as possible following the child’s identification, while also considering the preferences of the family[1].

2.4 Deafness is not a learning disability. Most children with hearing loss have the potential to reach the same educational outcomes as hearing children if they have appropriate support. However, if there is a language delay, this can affect both children’s literacy and numeracy.

2.5 We know that when deaf children have access to early and effective support to develop language and communication, whether they wish to use spoken language, sign language or both, opportunities are transformed. Auditory Verbal therapy is a robust evidence-based, early intervention approach to developing spoken language through listening for deaf children. By increasing access to Auditory Verbal therapy for deaf children we can improve outcomes and opportunities, now and in the future.

2.6 We have restricted our answers to this call for evidence to questions where we can offer expertise and insight.

Inquiry Questions:

3. The overall picture on the support available and outcomes achieved for those with SEN;

3.1. The current situation for deaf children in the UK

3.1.1               There are at least 50,000 deaf children in the UK, with around 7,000 under the age of 5.

3.1.2              A study in 2017 funded by the Nuffield Foundation reported that 48% of oral children aged between 10 and 11 years were reading below age level[2]. Analysis of 2022’s GCSE results by the National Deaf Children’s Society shows that deaf pupils in England have now achieved an entire GCSE grade less than hearing peers for at least seven years in a row. Just 37.7% of deaf children gained a grade 5 in key subjects English and Maths, compared to 49.8% of hearing children. Similar analysis for Key Stage 2 results showed that only 40% of deaf children achieved the expected standard for reading, writing and mathematics at Key Stage 2 compared to 59% of all children [3].

3.1.3              Research shows that language development before two years can predict educational outcomes[4],[5]. By the age of three and a half, the human brain has completed 85% of its physical growth, meaning the first three years of life are critical for developing spoken language through listening[6],[7].

3.1.4              In addition, a population study of the emergent literacy skills of pre-schoolers found that children enrolled in Early Intervention before age 6 months had consistently higher scores in emergent literacy components over time compared with children enrolled at or after age 6 months[8], highlighting the importance of effective early intervention.

3.1.5              Figures show that deaf children are not ‘catching up’ from their lower starting points as they move through secondary school[9]. Furthermore, an early language delay can continue to jeopardise future educational outcomes for deaf children.

3.1.6              Children who have hearing loss are also at greater risk of experiencing social isolation, loneliness and difficulty with peer relationships[10],[11]. This influences later adult relationships and social emotional development. Early access to language is the decisive factor that drives development forward and provides good social-emotional functioning21. With over 40% of children with permanent hearing loss estimated to have mental health difficulties in childhood/early adulthood[12], there is a vital place for effective, family centred, early intervention.

3.1.7              The UK has one of the best Newborn Hearing Screening Programmes in the world and state of the art hearing technology, such as hearing aids and cochlear implants, are available to babies and young children through the NHS and local services. However, deaf children are not currently achieving the outcomes that we know are possible. This current situation represents a failure to maximise the return on investment being made in screening and technology.

3.2 Auditory Verbal (AV) Therapy

3.2.1              Auditory Verbal therapy is an evidence-based, early intervention approach which supports deaf babies and children to learn to listen and speak and maximises early diagnosis and hearing technology. It is delivered by qualified Auditory Verbal Therapists (who are speech and language therapists, teachers of the deaf or audiologists who have undergone additional training) and has a strong peer-reviewed international evidence base, and consistently delivers excellent outcomes.

3.2.2               Other countries including Australia, New Zealand and Denmark already provide state funding of AV therapy and the UK should match this investment. An evaluation of AV therapy in Denmark found that 84%[13] of the children acquired age-equivalent spoken language after 3 years of AV therapy compared to 30% previously. It also found that the investment delivered significant individual and societal gain due to individual’s participation in the school system, labour market and the wider economy. The socio-economic analysis in Denmark clearly demonstrates the economic and societal gains from investment and the fact that it can pay to invest in children's future. In 2022, following this successful government-funded pilot programme, AV therapy became part of the standard healthcare system in Denmark.

3.2.3              In the UK, approximately 80% of all deaf children who spend at least two years on our programme at Auditory Verbal UK achieve age-appropriate language[14] and most attend mainstream school[15].

3.2.4               On average, deaf children with additional needs double their rate of language development whilst on the Auditory Verbal UK programme, and one in two children reach age-appropriate spoken language at the end of their programme13. This suggests that Auditory Verbal therapy continues to be an effective intervention even if a child has additional needs. For children both with and without additional needs, the earlier they start the programme, the better the prognosis for language development13,[16].

3.2.5              Evidence of the literacy outcomes attained by deaf children in the UK whose families had chosen a listening and spoken language approach and accessed Auditory Verbal therapy were collated by AVUK in 2022. The research shows that most deaf children following the Auditory Verbal therapy programme are attaining educational outcomes on a par with hearing children. The full return on government investment in diagnosis and hearing technology is being realised for these children. They are getting an equal start at school and the health and education benefits are lifelong.

3.2.6              Over 80% of deaf children who have followed an Auditory Verbal approach in this study, were reaching or exceeding nationally expected standards at Key Stage 1 for Reading, and Mathematics. Over 75% were attaining or exceeding these standards for Speaking and Listening and for Grammar, Punctuation and Spelling. At Key Stage 2, the percentages of children reaching or exceeding nationally expected standards were 81% and 78% for Reading and Mathematics, respectively. The percentages of children reaching or exceeding nationally expected standards for Grammar, Punctuation and Spelling was over 75% and 76% for Science[17].

 3.2.7              By considering these outcomes in light of the national attainment figures for, first, children with no special educational needs [figure 1] and, second, all deaf children [figure 2], we see that the percentage of graduates from AVUK achieving competency as measured by the national SATs is at a level at least equivalent to their hearing peers. This data includes data of children with additional needs.

 Figure. 1 Figure. 2

4. Government action to create a sustainable SEN system and restore confidence.

4.1 At present over 90% of deaf children in the UK that could benefit from AV therapy are unable to access it, as currently there are only 32 specialist Auditory Verbal Therapists in the UK. To increase access to this support and enable every family with a deaf child to have the opportunity to access an AV programme through publicly funded services, we need to train more specialist practitioners (speech and language therapists and teachers of the deaf) working with deaf children under the age of 5, in the Auditory Verbal approach.

4.1.1 Auditory Verbal UK’s recommendations for the Government

4.1.2              AVUK’s ‘Hear Us Now’ campaign is calling for support and investment from the Government to transform the landscape of Auditory Verbal provision, so that every family who wants their child to learn to listen and talk will be able to access an Auditory Verbal therapy programme through publicly funded services in their local area in the pre-school years.

4.1.3               Economic research has shown that with an investment of just over £2 million per year, for the next 10 years, it is possible to not only transform opportunities and outcomes for deaf children but deliver £152 million of economic benefit. This figure rises to £11.7 billion within the next 50 years – through improved quality of life, employment prospects, lower costs of schooling and avoided injuries.

4.1.4              AVUK has developed a robust strategy to train a small proportion of the current public sector workforce of speech and language therapists, teachers of the deaf and audiologists already working with deaf children and embed 300 specialist Auditory Verbal Therapists in the NHS and local services across the UK, whilst supporting some of the most vulnerable children directly. By expanding the number of certified Auditory Verbal Therapists, every family who wants their child to learn to listen and speak will be able to access an AV programme through publicly funded services in their local community.

4.1.5              By increasing access to Auditory Verbal therapy for deaf children we can improve outcomes and opportunities, now and in the future, and this is a clear example of how a small amount of public investment targeted in the early years of a deaf child’s life can also reduce demands on public services and the taxpayer for decades to come.

4.1.6              According to a recently commissioned AVUK poll with YouGov, 85% of the public support the provision of AVT through public services, such as the NHS.

4.1.7              We therefore recommend that the Government:

• Commits to investing the £2.1 Million over the next 10 years to train a small proportion of the current public sector workforce as Auditory Verbal Therapists so that all children, in the UK, under the age of 5 have equity of access to an Auditory Verbal therapy programme close to where they live, whilst supporting some of the most vulnerable children directly whilst the workforce is sufficiently trained.
• DHSC, DfE and the Devolved Governments should work to embed a protocol and clear guidance for ensuring all deaf children have the opportunity to access an Auditory Verbal Therapy programme, no matter where they live in the UK.

November 2024