Speech Therapy and Parkinson's

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Research shows that 89 percent of people with Parkinson’s disease (PD) experience speech and voice disorders, including soft, monotone, breathy and hoarse voice and uncertain articulation. As a result, people with PD report they are less likely to participate in conversation, or have confidence in social settings than healthy individuals in their age group.

Speech disorders can progressively diminish quality of life for a person with PD. The earlier a person receives a baseline speech evaluation and speech therapy, the more likely he or she will be able to maintain communication skills as the disease progresses. Communication is a key element in quality of life and positive self-concept and confidence for people with PD.

Speech and Voice Disorders in Parkinson’s

There are several reasons people with PD have reduced loudness and a monotone, breathy voice. One reason is directly related to the disordered motor system that accompanies PD, including rigidity, slowness of movement and tremor. For example, the poor muscle activation that leads to bradykinesia (slow movement) and hypokinesia (small movements) in the limbs can translate to the muscles involved in speech. These problems with muscle activation can result in reduced movements of the respiratory system (reduced breath support), larynx (reduced vocal loudness) and articulation (reduced clarity of speech).

Another cause of speech and voice impairment in PD is a change in sensory processing that is related to speech. It is believed that people with PD may not be aware that their speech is getting softer and more difficult to understand. When people in this situation are asked to bring their voice to normal loudness, they often feel as though they are shouting, even though they are perceived by listeners to be speaking normally

Another cause of this condition is that people with PD may have a problem with “cueing” themselves to produce speech with adequate loudness. Individuals with PD can respond to an external cue (e.g., an instruction from someone else to “speak loudly”), but their ability to cue themselves internally to use a louder voice is impaired. These problems can be frustrating both for the person and for the family.

How to Find a Speech Therapist

Tell your doctor If you are experiencing any changes in your speech or voice. Ask for a referral and a prescription for a speech evaluation and treatment. If you have not noticed changes in your speech, but a spouse, care partner or friend has: pay attention to their comments. The sooner you get a speech evaluation and start speech therapy, the better.

Speech therapists work in many settings, including hospitals, outpatient rehabilitation centers and private practice offices. To locate one in your area, contact the American Speech-Language-Hearing Association (ASHA) at www.asha.org, or find a therapist certified in the Lee Silverman Voice Treatment (LSVT) by visiting www.lsvtglobal.com.

Ideally, you should see a speech therapist face-toface for a complete voice and speech evaluation and treatment. However, if a speech therapist is not available in your area, LSVT LOUD — the most researched voice treatment for people with PD — is virtually offered in select states. The speech therapist interacts with you in your home or office live through your computer screen.

Learn more about speech and Parkinson’s by reading our free book Speech and Swallowing. Order online at Parkinson.org/Books or by calling our Helpline at 1-800-4PD-INFO (473-4636).

Tip: Do I Have a Speech or Voice Problem?

These are statements many people have used to describe their voices and the effects of their voices on their lives. Choose the response that indicates how frequently you have the same experience. (0 = never, 1 = almost never, 2 = sometimes, 3 = almost always, 4 = always).

  • It is difficult for people to hear me
    0 1 2 3 4
  • People have difficulty understanding me in a noisy room
    0 1 2 3 4
  • My voice difficulties restrict personal and social life
    0 1 2 3 4 
  • I feel left out of conversations because of my voice
    0 1 2 3 4
  • My voice problem causes me to lose income
    0 1 2 3 4
  • I feel as though I have to strain to produce voice
    0 1 2 3 4
  • The clarity of my voice is unpredictable
    0 1 2 3 4
  • My voice problem upsets me
    0 1 2 3 4
  • My voice problem makes me feel handicapped
    0 1 2 3 4
  • People ask, “What’s wrong with your voice?”
    0 1 2 3 4

To find your score, add up your answers. A score of 10 or higher indicates you might have a speech or voice problem that is affecting your quality of life and you should ask for a referral to a speech pathologist.


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