89% of people living with Parkinson's Disease experience speech and voice challenges, including soft, monotone, breathy and hoarse voices, as well as uncertain articulation. Speech disorders can progressively diminish the quality of life for a person with PD. However, speech therapy helps to maintain communication skills as the disease progresses. Exercises and therapy utilized to help with speech can also help with swallowing due to exercising the same muscle, the larynx.
Speech and Voice Disorders in Parkinson's
When it comes to having Parkinson's, people may experience softer and monotone or breathy voices. The reason is directly related to the motor symptoms that also produces rigidity, slowness of movement, and tremor. For example, the poor muscle activation that leads to bradykinesia (slow movement) also translates to the muscles involved in speech and swallowing. This can impact our respiratory system, breath support, vocal volume, and articulation or clarity of speech.
Many people with PD are not aware of the changes in their voices, and often even feel like they are shouting, even though they are perceived by listeners to be speaking normally. Just as we may struggle with cueing ourselves to walk, we may experience issues cueing ourselves to talk when we have PD. This can be very frustrating for the person living with Parkinson's and their family members.
Finding and working with a speech therapist can help you manage these speech and voice issues. If you notice changes in your voice, it may be time to locate a speech therapist. Speech therapists work in many settings, including hospitals, outpatient rehabilitation facilities, and private practice offices.
Ideally, you should see a speech therapist face-to-face for a complete voice and speech evaluation. Treatment recommendations can be better recommended unique to your needs from this assessment. Once you see a therapist, you may be able to plug into additional recommended programs that you can attend online from the comfort of your home, or in person with others on the journey with Parkinson's.
There are several programs available that speech therapists utilize specifically used to help Parkinson's patients. They include the LSVT BIG Program and the Speak Out and Loud Crowd.
LSVT BIG/LOUD
LSVT Loud is an effective speech treatment for people with Parkinson's disease (PD) and other neurological conditions. Named for Mrs. Lee Silverman (Lee Silverman Voice Treatment,) a woman living with PD, it was developed by Dr. Lorraine Ramig and has been specifically studied for over 25 years with support from the National Institute for Deafness and other Communication Disorders within the National Institutes of Health (NIGH,) as well as other funding organizations. LSVT LOUD trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people "recalibrate" their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.
While LSVT LOUD treatment has helped people in all stages of PD, most of the research has been on those in moderate stages of the disease. LSVT LOUD has also helped people with atypical parkinsonism's, such as progressive supranuclear palsy (PSP), and has recently shown promise for adults with speech issues arising from stroke or multiple sclerosis, and in children with cerebral palsy or down syndrome. Beginning your work with LSVT LOUD before you've noticed significant problems with voice, speech, and communication will often lead to the best results, but it's never too late to start. LSVT LOUD has the potential to produce significant improvements even for people facing considerable communication difficulties.
Your physician should be able to refer you to LSVT LOUD, and associated costs are generally covered by most insurance programs. To learn more about LSVT LOUD, CLICK HERE.
SPEAK OUT®
SPEAK OUT! is a two-part, evidence-based speech therapy program proven to help individuals with Parkinson's and related movement disorders to regain and retain their speech and communication. SPEAK OUT! combines patient and family education, individual speech therapy, daily home practice, speech and singing groups, and regular follow-ups.
Developed by Samantha Elandary, a Speech-Language Pathologist and Parkinson Voice Project's CEO and Founder, SPEAK OUT! is based on the principles of motor learning and teachings of the late Daniel R. Boone, Ph.D., CCC-SLP. In the 1950s, Dr. Boone recognized that individuals with Parkinson's could improve their communication by "speaking with intent."
A typical SPEAK OUT! individual therapy session is 40 minutes long. Patients are usually seen by a speech-language pathologist 2-3 times per week and reach their goals in 8-12 sessions. Patients then transition to a weekly speech group. Parkinson Voice Project provides SPEAK OUT! Workbooks and eLibrary access at no cost to all U.S. patients with Parkinson's or a related movement disorder if they are treated by a speech-language pathologist who is a trained SPEAK OUT! Provider.
To help support individuals with Parkinson's and related movement disorders, Parkinson Voice Project hosts live, daily SPEAK OUT! Online Home Practice exercises from 10:00 - 10:30 a.m. U.S. Central Time, and recordings are available 24/7 in the video practice library. They also offer a monthly Learn About Parkinson's Webinar. There is no charge for any of these events. You can learn more about Parkinson Voice Project and their SPEAK OUT! Therapy Program by CLICKING HERE.
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