Speech Therapy and Parkinson’s Disease

What is Parkinson's

Parkinson's disease is the fastest growing neurological disease in the world and can cause a variety of symptoms, including tremors, muscle rigidity, and slowness of movement. The automatic processes that allow for us to walk, talk, and swallow can be affected by Parkinson's. One of the less-discussed automatic symptoms of Parkinson's includes voice and speech problems.

People with Parkinson's may experience a variety of speaking problems, including:

• Soft or breathy voice
• Either a slow or rapid rate of speech
• Slurred speech - "marbles in the mouth"
• Flat pitch and an impaired expression of emotion
• Loss of breath at the end of the sentence
• Worsening voice at the end of the day
• Difficulty projecting the voice in a noisy room or across the house
• Loss of the ability to sing

These voice problems can make it difficult for people with Parkinson's to communicate effectively. The way others hear the message tends to not match the person with Parkinson's intention. This can cause others to ask the person with Parkinson's to repeat themselves, shy away from continuing the conversation, and can lead to social isolation and depression.

How Speech Therapy can Improve Your Voice

There are a number of things that people with Parkinson's can do to improve their voice. These include:

Speech therapy: Speech Therapy can help people with Parkinson's learn how to improve their speaking ability. Speech Pathologists can teach people with Parkinson's how to breathe properly, project their voice, and speak clearly.

Specialty trained Speech Pathologists can help strengthen the speech muscles and help those with Parkinson's learn how to regulate their loudness and clarity in a variety of communication settings.

Specialty trained Speech Pathologists have additional training and certifications for helping those with Parkinson's. These include LSVT-LOUD ® or SPEAK OUT! ®. Learn more here: https://myvoicetherapy.com/parkinsons-voice or see below.

Voice exercises: With a Speech Pathologist, you can safely improve your vocal loudness to the "just-right" level of speech. During voice exercises, your body may need to practice louder speech than what is initially comfortable. Usually this gets better with time, practice, and guidance from a Speech Pathologist.

For most, Parkinson's disease impacts their own personal "feedback loop" for making sure their speech is clear enough depending on the situation. Clients start with the specialty trained Speech Pathologists at My Voice Speech Therapy with the notion that they are speaking loud enough for the situation. With guidance, and some audio/video replay, the person with Parkinson's can be guided to reconfigure the "feedback loop" to more appropriately use the speech muscles in order to be heard and understood.

Overtime, with skilled Speech Therapy, the focus will include learning what it feels like to be loud enough while also strengthening your speech muscles.

In the rare situation that there are abnormalities with the sound of your voice, outside of Parkinson's, the Speech Pathologist can counsel you through further assessments that may be needed to ensure overall health and safety.

If you have Parkinson's and are asked to repeat yourself, noticing unpredictability in your voice, mumbling, or other voice problems, talk to your doctor about treatment options with a Speech Pathologist. With the right treatment, you could improve your voice and communicate effectively for years.

Speech Therapy Programs

There are a number of speech therapy programs available for people with Parkinson's disease. Some of the most popular programs include:

• SPEAK OUT! ® is a Speech Therapy program developed by the non profit Parkinson Voice Project ® based in Texas. The program is designed to help people with Parkinson's disease improve their vocal volume and clarity. There are online classes and free workbooks to help support those with Parkinson's.
• LSVT-LOUD ® is a well-known Speech Therapy program developed by the Lee Silverman Voice Treatment Center. The program is designed to help people with Parkinson's disease increase their vocal loudness with amplitude.

If you and your Speech Pathologist has chosen to complete the SPEAK OUT! ® program, you can expect to work on the new exercises every day and several times with the Speech Pathologist through specialized Speech Therapy. The non profit Parkinson Voice Project ® runs the certifications for the Speech Pathologists and offers a free self-guided voice workbook. This workbook supplements Speech Therapy and each 24 lessons progress in difficulty, helping you become confident with your voice.

Once you are through the Speech Therapy coursework, you will need to keep practicing the loud enough and clear enough speech throughout all areas of your life. When talking to your loved ones, the louder, confident speech should be used at all times. In order to help your loved ones support you, and not "fill in the answer for you," they can watch an informational video produced by Parkinson Voice Project ® to better explain the program and the expectations from the communication partners here: myvoicetherapy.com/video

After Speech Therapy

Once you are completed with the program, maintenance work is needed. The automatic muscles used in clear and loud-enough speech aren't typically engaged by the Parkinson's brain and therefore can decrease in function. Constant work is needed to keep the strong muscles that were created through Speech Therapy strong and utilized every time someone with Parkinson’s speaks.

In addition to working on speaking clearly with your loved ones, with people in the community, on the phone, and in the doctor's offices, after completing SPEAK OUT! ® Speech Therapy, you are able to join a LOUD Crowd ® social group that works on the exercises and encourages appropriate initiation of the Speech muscles. At My Voice Speech Therapy, we offer two virtual LOUD Crowds that are based on the SPEAK OUT! ® model that are free and are held on Tuesdays. Please learn more and join here: myvoicetherapy.com/weekly

By following these tips, you can improve your voice and communicate effectively, hitting the right intention every time.