VML method (Verbal Motor Learning)
The VML method is a treatment system targeting motor speech disorder and specifically Apraxia of speech in children and adults. The VML method was developed in Israel, by Dr Elad Vashdi, through clinical experiences with children with Apraxia of speech. The VML system is part of a bigger therapeutic system called MDT (Multi-dimensional therapy) and represents the interdisciplinary approach in therapy.
The VML method has two opposing aspects; structured, analytic side , versus the flexible, dynamic side. The structured aspect deals with what need to be done while the dynamic aspect deals how to implement the structured system.
The VML method structured aspect involves:
- A multi-dimensional speech evaluation using a specific evaluation form and protocol;
- A multi-dimensional analysis of the child’s condition using a specific analysis form;
- Identifying the key objectives for speech treatment and the formation of a treatment plan with a specific treatment plan form
- Use over a hundred Manual techniques in treatment
- Applying motor learning principles in different levels and aspects of the method.
- Applying unique teaching principles in the rehabilitation process.
The dynamic aspect of the system enables adaptation of the system to the specific needs of the child in terms of:
- Treatment objectives
- Type of therapist
- Place of therapy
- Amount of sessions during the week and their length
- Different weights for every objective based on dynamic needs
- Adaptation of the system to the cultural preferences of the child.
- Adaptation of the system to the cognitive, lingual and communication needs of the child
A VML treatment session is planned carefully up front. When being administrated it can take many shapes; for the outsider it might look like play therapy, art therapy, ABA session or sport therapy. The truth is none of the above. It is a speech interdisciplinary treatment using the VML structure, analysis and tools.
The method uses motor learning principles while considering Apraxia of speech as a motor planning oriented problem. Nevertheless, language and communication goals have a major weight in the evaluation, analysis and the treatment plan. In addition, each vowel, consonant, syllable and word has special techniques that assist the child in learning to imitate the desired sound. The VML strives to build a system to treat the speech problem rather than relying only on the professional treatment.
In the basis of the method stands the idea of questioning the treatment procedure and decision making on a regular basis. No technique or basic assumption is free of critic, and re-evaluation of the axiom is it’s the basic concept. That perception of questioning the treatment procedure enables the method to change rapidly based on new data and better understanding of the broad picture.
While originally based on the Hebrew language, over the last few years the VML is being practiced in several languages such as English, Romanian, Slovenian, Russian, Mandarin, Polish, Turkish, French and more. Training of therapists took place in Australia, Slovenia, Romania, Taiwan, USA and planned in many other countries in the next few years.
In the early years VML was used to treat children with autism and Apraxia of speech. In the last few years there has been more and more experience with a variety of syndromes as well as with pure Apraxia of speech at different severity levels; from children who have no verbal ability at all and who have severe oral motor apraxia, to children with minor deficits in speech. 62% of the children evaluated at Yael Center for speech were diagnosed with ASD, 13.5 % with Apraxia of speech only and 24.5% with other syndromes such as Cerebral Palsy, Down syndrome, Speech delay, severe developmental delay etc.
The treatment age ranges from 1.5 to 27 years of age. The Average age is 4:11 years. The treatment delivery and goals differ according to the child’s age. VML can also serve adults with Apraxia of Speech (AOS). AOS, unlike CAS, is an acquired syndrome due to trauma to the brain at an older age.
VML can help children with Apraxia of speech or other speech delays (mainly of motor origin). There is no age restriction in treatment using VML, although the treatment plan would vary according to the patient’s age.
Every treatment begins with a thorough evaluation that determines if the speech treatment is necessary and can be useful, what the causes for the current developmental status are, and what is the right way to perform the treatment (treatment details, place, intensity, therapists, attitude, techniques, etc).
Evaluation report and treatment plans are produced. The treatment procedure can vary between cases according to parameters such as hours per week (1-6 hours range), numbers of therapists and their professional status (SLP, tutor, parent, teacher, other specialist), amount of Topics addressed, etc.
Each treatment plan should be monitored on a weekly basis so adjustments (if needed) will take place as soon as possible.
Every few months a general evaluation takes place to examine the effectiveness of the treatment program.