Speech Disorders in Parkinson’s Disease

 

Approximately 80 million people across the world have Parkinson’s disease. The number of people with PD is expected to double by 2040. When we ask patients newly diagnosed with Parkinson’s disease (PD) about their goals for therapy, one of the most common things we hear is, “I just want to stay the same even though I have PD.”

 

There is a strong desire to maintain movement, energy, balance, communication, and more. Parkinson’s disease impacts function in everything a person does at home, at work, and in social situations. The LSVT program can help a person with PD restore and maintain their voice, allowing them to maintain normal function in everyday life beyond medication. 89% of individuals with PD have a speech or voice disorder.

​

Communication challenges may include:

 

• Reduced loudness

• Hoarseness

• Monotone voice

• Imprecise speech

​

How do you treat speech and voice changes in individuals with PD?

​

There are several methods that speech pathologists use to treat speech and voice changes in individuals PD. Speech pathologists may recommend using a single approach or a combination of different approaches when treating a person with PD. Not all approaches are universally the best method for each person.

​

LSVT LOUD is an effective speech treatment for individuals with PD and other neurological conditions. LSVT LOUD is the first speech treatment with level 1 evidence and established efficacy for treating voice and speech disorders in people with PD. LSVT LOUD improves vocal loudness by stimulating muscles of the voice box through a hierarchy of exercises. Focused on a single goal, “speak LOUD!” – the treatment improves breath support, loudness, and clarity of speech to maximize speech intelligibility. The treatment does not train people for shouting or yelling; rather, LSVT LOUD uses loudness training to bring the voice to an improved, healthy vocal loudness with no strain. Some “unexpected” positive outcomes of LSVT LOUD include improvements in articulation, swallow, rate of speech, facial expression, and speech motor stability.

​

How does LSVT work?

 

LSVT LOUD is delivered over 16 sessions during 4 weeks (four individual 60-minute sessions per week). The program emphasizes intensive vocal and physical effort to maximize changes. This focus on effort is thought to override the altered and slow muscle movement and recalibrate new vocal effort and loudness, particularly as the disease progresses.

​

LSVT LOUD must be delivered by a clinician who is certified in the program.  

​

How does SPEAK OUT! work?

 

SPEAK OUT! focuses on the concept of intent and strengthens the muscles used for speaking to train clients to move from automatic voice use to an intentional act. In therapy, we work through a series of speech, voice, and cognitive exercises outlined in the free SPEAK OUT! Workbook.

​

Both programs (LSVT LOUD and SPEAK OUT!) are widely used and tested and shown to have positive outcomes for people with Parkinson’s disease.

​

SPEAK OUT! must be delivered by a speech pathologist who is certified in the program.

 

Some “unexpected”, positive outcomes of these voice programs for Parkinson’s disease include improvements in intelligibility, cognition and swallowing.

​