July 23, 2024
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July 23, 2024
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The Role of Speech Therapy

Are you or a loved one struggling with Parkinson’s disease? Speech therapy can help!

I first heard from John in early 2019. He told me his dad, Eric, had recently been diagnosed with Parkinson’s disease and the family was very worried about his future. John was concerned with his dad’s speech, which was becoming quieter and quieter. He wanted to know if there was anything I could do, and I was determined to help!

The first step was a visit to an ENT to confirm there were no other causes for the changes in voice and speech. John later confirmed we were cleared by the ENT to start treatment.

Although Eric was initially opposed to therapy, he agreed to meet me. I visited Eric the following Tuesday and it was immediately clear how reluctant he felt about beginning therapy. I introduced myself with a bit of small talk and some jokes. Thankfully, Eric joined me in laughing. I then sat quietly to offer him the space to share or ask anything that was on his mind. I wanted him to take a liking to me and for us to establish a bond of trust instead of me “selling” the therapy. I waited for a minute, in what could be deemed an awkward silence, until he said “This is when you’re supposed to talk.”

Eric is a prominent man, respected by everyone in his community and workplace. His life had been turned upside down, and he began losing interest in speaking to people due to the frustration he experienced in being heard and understood. At the end of our meet and greet he said to me, “You seem really sweet and this is no offense to you, but I promised John I would meet you, and I have fulfilled my promise. Have a great day.” While I was with him he spoke very quietly, and his family constantly asked him to speak louder and more clearly.

Two days later John called to inform me that Eric had agreed to give one therapy session a chance. After the first session, he agreed to another, and another. Before long, we established a strong rapport. He gained trust in me due to the results he achieved in session after session. By utilizing the techniques gained during our time together, Eric began speaking more clearly and was more easily understood by those around him. This made him more confident and less frustrated.

Four weeks later John shared with me, “As a result of the therapy, my father has found his voice again, has regained his confidence and is joining conversations with enthusiasm!”

People diagnosed with Parkinson’s disease experience different symptoms throughout the course of the disease. Symptoms that are often not as noticeable at the outset are reduced volume, intonation and clarity of speech, and loss of facial expression.

Thankfully, there is an evidence-based treatment approach called LSVT LOUD. LSVT (Lee Silverman Voice Treatment) has been scientifically studied for over 25 years. Historically, speech treatments for people with Parkinson’s disease focused on articulation and speech rate at a low intensity; LSVT LOUD focuses on the singular target of increasing vocal loudness to normal levels and delivers the treatment in an intensive, high effort manner.

Because it is customized to each person’s specific needs and goals, this nonintrusive therapy can be used regardless of the stage or severity of disease. LSVT LOUD is most effective, however, for people in the early or middle stages of their conditions, so it is best to begin this treatment as soon as possible after diagnosis. The best part about this program is that it can be conducted virtually or right from the patient’s living room.

LSVT LOUD is an intensive treatment that requires one-hour treatment sessions four days a week for four weeks, along with daily homework exercises. Ultimately, 16 hours is a very small investment for the benefits of ongoing improved communication. A key focus of this treatment is helping people “recalibrate” their perceptions. This allows them to know how loud or soft they sound to other people and makes them feel comfortable using a stronger voice at a normal loudness level. LSVT LOUD has also helped people with atypical parkinsonisms (progressive supranuclear palsy). Recently, it has shown promise as a treatment option for adults with speech issues arising from strokes or multiple sclerosis and for children with cerebral palsy or Down syndrome.

As a speech therapist who completed extensive training in order to provide this treatment, I have been providing this therapy for the past six years and have seen first hand the success of this approach. Today, LSVT LOUD is considered the global “gold standard” for speech treatment for people with Parkinson’s disease. Research has shown that people with Parkinson’s exhibit improvements in loudness and more variation in pitch while speaking, and are able to maintain this for at least two years post treatment. Secondary improvements may include better articulation, changes in swallowing, improved facial expressions while talking and speech related brain changes.

LSVT LOUD has the potential to deliver significant improvements for people facing considerable communication difficulties. I would love to help you or your loved one who is struggling.

Ashley Small is a practicing speech language pathologist licensed in New Jersey and New York. She works for the Department of Education, where she treasures her role as a therapist helping children reach academic success and educating parents about the laws regarding special education. In addition, she has a private practice where she works with a variety of children with articulation disorders, apraxia, autism, language difficulties, reading disorders, stuttering and other health impairments, as well as adults with Parkinson’s disease. Information is available by calling (973) 486 4122, emailing [email protected],
or by visiting www.ashleysmallslp.com.

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