Areas of Practice

Parkinson’s Disease

Speech and Voice in Parkinson’s Disease

Parkinson’s disease produces changes throughout the body and the speech-producing system is no exception. In fact, one of the first things people with Parkinson’s often notice is that their voice has become quieter. They are frequently asked to repeat; listeners don’t catch what they said. It is embarrassing and frustrating and can result in misunderstandings and withdrawal from social activities.

Unfortunately in the past, the value of speech therapy has been dubious. People would frequently make good gains during the therapy sessions, then lose the benefit on their way to the parking lot. In response to this dilemma, Dr. Lorraine Ramig and her colleagues at the University of Colorado developed a treatment method based on new information about the disease and how best to combat its effects. Their approach, now about 15 years old, is called the Lee Silverman Voice Treatment program (LSVT©). The LSVT© has been extensively researched and the data confirm its effectiveness. At the present time it is the gold standard in treating speech and voice problems in Parkinson’s.

The LSVT© program runs over a 4 week period, 4 days a week, for 50 minutes per day. Only clinicians who have taken a training program are certified to administer it. Participants are taught an exercise program to follow daily, once therapy is completed. They also learn to gauge the right amount of effort necessary to speak well. The LSVT© is not a magic pill. It requires effort and its success depends upon regular practice and diligence in monitoring. But for people facing growing isolation because they can’t communicate effectively, its benefit is undeniable.

For more information, please go to: www.lsvt.org

Cost

The cost of the program is in accordance with the recommended fee schedule of the BC Association of Speech-Language Pathologists and Audiologists. Extended medical benefits may cover some or all of the cost—you should check your plan for specifics.

Sound Advice for People with Parkinson’s

These simple reminders can go a long way to make speaking and listening easier.

Speaking Well

  • Pay attention to your speech. Be aware, not only of what you are saying but how you are saying it.
  • Think loud—deliberately speak loudly. Chances are you won’t blow people out of the room; you will get back up to a level where others will hear you better.
  • Face your listeners. Make sure they are watching you before you begin to speak. And make sure you are in the same room. Long distance conversations are stressful and they really don’t work all that well.
  • Don’t compete with background noise. Turn off the TV; ask the waiter to turn down the music.
  • Sit/stand tall. All the opera singers do it. There has got to be a reason.
  • Ask for feedback. Say, “Did you get that?” This gives your listeners an opportunity to admit if they haven’t heard and gives you information about how well you are doing.

Listening Well – A Guide for Friends and Family

  • Give the speaker your full attention. We all get much more than we realize from watching as well as listening
  • Be a relaxed listener—don’t interrupt. People with Parkinson’s frequently have difficulty getting started or may speak more slowly than they did before. If you interrupt, you run the risk of hijacking the conversation—never pleasant for the other party. Being relaxed helps take the pressure off both of you.
  • Don’t be misled by a lack of facial expression. A reduction in facial expression is common in Parkinson’s and has nothing to do with how the person is feeling inside.
  • Give feedback about how well you are understanding. If you are not sure you got it, re-phrase what you thought you heard. This gives the speaker a chance to confirm or correct.