Parkinson’s Disease Speech Therapy

How Do I Know If I Have A Speech Or Voice Problem

• My voice makes it difficult for people to hear me.
• People have difficulty understanding me in a noisy room.
• My voice issues limit my personal and social life.
• I feel left out of conversations because of my voice.
• I cannot participate in telephone calls because of my voice.
• My voice problem causes me to lose income.
• I have to strain to project my voice.
• My voice clarity is unpredictable.
• My voice problem upsets me.
• My voice makes me feel handicapped.
• People ask, “What’s wrong with your voice?”

Data Collection And Analysis

The review authors independently assessed the studies identified by the search strategy. We resolved disagreements about inclusions by discussion.

We contacted the authors of trials in the cases where further trial information was required for full analysis. We assessed full papers for methodological quality by recording the method of randomisation, concealment of allocation and blinding of assessors to treatment group, whether an intentiontotreat analysis was used and the number of patients lost to followup.

Two review authors independently abstracted eligible data onto standardised forms, checked for accuracy and amalgamated the information. We resolved disagreements about inclusions by discussion.

We combined the results of each trial using standard metaanalytic methods to estimate an overall effect for one type of speech and language therapy intervention versus another.

var diff = var pre + var post 2r

where var diff is the variance of the change score var pre is the variance of the baseline score var post is the variance of the final score and r is the correlation between the pre and post treatment scores. We assumed a correlation coefficient of 0.5, which is a conservative estimate, to reduce the chance of false positive results .

How Can A Speech And Language Therapist Help

If you are concerned about your speech, communication or swallowing you should first talk with your doctor. He or she will be able to refer you to a speech and language specialist if appropriate. By talking to you early on, the speech and language therapist will be able to put in place strategies to enhance your communication and therefore quality of life before difficulties have any significant impact. Early intervention may even be able to prevent or delay other problems so even if you are not experiencing problems or have doubts on whether you are or not, then speak to a speech therapist as finding out more will help with the management of current or future symptoms. You may also be provided with maintenance exercises used to retain your current skills.

Speech and language therapy will focus on maintaining adequate volume of speech by working on breathing and voice to produce clear pronunciation . It will work on the muscles in your mouth and throat and how you create words, phrases and sentences. It will also make you aware of your facial expression and other non-verbal skills. In short it will preserve your communication skills.

A speech and language therapist will also discuss other factors such as:

Note: ParkinsonNet provides evidence based guidelines in English for healthcare professionals.

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How Speechease Can Help

If youre living with Parkinsons disease and would like help to improve your speech, then were here for you.

Some of the SpeechEase staff are trained in the Lee Silverman Voice Treatment Loud approach, an evidence-based therapy that helps you increase your volume and ability to be understood.

Please contact us today. Wed love to help you express yourself.

Dual Task Training For Parkinson

Publisher: Triad Solutions, Inc.

Dual Task Training is combining speech therapy with physical movement and cognitive tasks. It has been shown to be the most comprehensive and fun type of speech therapy. This page has seven short dual task exercise videos plus one video of aquatic dual task training.

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How Does Speech And Language Therapy Help Parkinsons Disease

Speech and language therapy can be very helpful to someone who has Parkinsons disease. Speech and language therapists will investigate swallowing, facial expression, and body language as well as language and speech. It is thought that up to half of Parkinsons patients will at some point have difficulty with communication and speech.

Speech therapy may also improve patients confidence in communicating with others which may in turn increase social and work opportunities.

What problems caused by Parkinsons disease can speech and language therapy help with?

Speech and language therapy can help with a number of problems which are caused by Parkinsons. Each persons treatment will be different, however, generally people will have the same sort of difficulties relating to speech, language and swallowing. This is because as the condition gets worse the control of the muscles will deteriorate and can include the tongue, larynx, pharynx and vocal cords.

Our speech and language therapists can help individuals who have Parkinsons disease with attention and listening problems, communication problems, swallowing difficulties, voice and speech problems.

Benefits Of Speech Therapy For Parkinsons Disease

Posted on: April 8, 2021

After someone is diagnosed with , they are frequently referred to physical therapy to address the physical impairments associated with this disease. Parkinsons disease does not just impact physical impairments but can also affect speech, swallowing and cognition. A speech-language pathologist specializes in evaluation function and providing treatment in the areas of communication and swallowing across the lifespan .

As Parkinsons disease evolves, changes in speech production and swallow function are expected to occur. Speech changes associated with Parkinsons disease is called hypokinetic dysarthriacharacterized by decreased volume, hoarse vocal quality, monotone and short rushes of speech. Patients often state they feel frustrated because their spouses or family members can no longer hear them or frequently have to repeat themselves. who has a certification in Speak Out!® like the experts at Sheltering Arms. It is a program designed specifically for Parkinsons disease to target speech and cognition that provides a maintenance program to continue with skills learned during the course of treatment.

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Parkinsons Voice Project Practice Videos

Four Speak Out! practice videos, each with a different Parkinsons Voice Project speech language pathologist .

Cost: $34.99/month or $349.99/year, first month free

Online post speech therapy maintenance with a speech language pathologist trained in either LSVT LOUD or Speak OUT!

Includes 15+ voice practice sessions per week as well as facial exercises, articulation practice, and more.

Publisher: LSVT Global, Inc. Cost: $28 for DVD or download $15/year streaming

Speech exercises for people with Parkinsons Disease and other neurological conditions. Available in English and Cantonese.

Lee Silverman Voice Treatment

LSVT-LOUD is an intensive behavioral treatment program that requires sixteen therapy sessions in one month with a trained speech therapist. The primary goal is to help improve vocal loudness. As a result of therapy, improvements in speech clarity and breathing are often seen. DVDs are also sold for at-home treatment.

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How Parkinsons Affects Speech And Communications

Some people living with Parkinsons will not experience speech and communication difficulties. However, a large number of people do develop problems with speech and non-verbal communication. The stage when these problems might emerge is different for everyone. The symptoms will vary from person to person but may include:

• Reduced volume of speech
• Reduced body language, including hand gestures

How Are Speech Problems Treated

There are many options to help improve your speech. A speech-language pathologist can help you pick the right approaches for you. SLPs are trained health care professionals who specialize in evaluating and treating people with speech, swallowing, voice and language problems.Ask your doctor for a referral to a speech-language pathologist. It is also important to contact your health insurance company to find out what therapy and procedures are eligible for reimbursement and to find a list of SLPs covered by your plan.Finally, visit a SLP who has experience treating people with PD. Call the Parkinsons Foundation Helpline at 1-800-4PD-INFO for help locating a speech-language pathologist in your area. Lee Silverman Voice Treatment, discussed below, is a specific voice therapy for PD but it is not the only way to obtain high quality speech therapy for PD.

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Q: One Of The Most Important Aspects Of Lsvt Is The Training Of Speech

A: You are correct training is at the heart of our organization. Because LSVT LOUD and LSVT BIG are evidence-based treatments, the goal of clinical training is not only to transfer science to clinical practice, but to ensure the quality of treatment matches the research .

LSVT Certification is available to speech, physical and occupational therapists, assistants, clinical fellows, and students enrolled in speech, physical and occupational therapy programs. LSVT Training and Certification Courses are offered in either two-day live in-person courses around the world or a 14-hour online course available in English. Both formats offer the same content, training and culminate in identical certification.

COVID-19 brought our live in-person training courses to a screeching halt in March 2020. While the LSVT LOUD and LSVT BIG Online Training and Certification Courses remained fully operational, training was limited to therapists who were comfortable with a self-paced, pre-recorded course and the English language. We have since made modifications to enable training in other languages, as well as virtual live training options.

We will remain virtual in 2021 for our live courses and continue to offer our very popular online courses as well. LSVT Certified Clinicians can be located through our LSVT Certified Clinician Directory.

Can Anything Be Done To Treat Speech And Language Problems Seen In Parkinsons Disease

Yes. Sadly, although the majority of people with PD experience some type of speech problems, less than 5% get treatment for those speech problems.

This is unfortunate, as research shows that effective treatments are available for some of the speech, voice and language problems of PD.

Medication, speech and language therapy and brain surgery have all been evaluated as potential treatments for speech and language problems of PD.

The various types of brain surgery used in the treatment of PD over the last 30 years or so have generally not been shown to have a beneficial effect. In many cases surgery has caused deterioration in speech and language in PD.

Parkinsons medications by themselves are not effective in improving problems with speech. They can however help by improving the volume and clarity of speech and body language while the medication is working . The converse of this is that when the medication is not working the voice may be quiet and difficult to understand. This can be frustrating, but there are ways to adjust life around on/off periods. For further information regarding the on/off syndrome please see the Parkinsons Associations Information Sheet on the On/Off Motor Fluctuations in Parkinsons Disease.

Speech problems in PD do not respond well to speech and language therapy if the mobility problems and tremor of the person with PD are left untreated.

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Cognitive Therapy To Improve Communication

A speech language pathologist trained in cognitive therapy can help address the communication breakdown that can result from PD. The goal of treatment is to identify strengths and strategies that may improve functional performance. These may include:

• memory retraining strategies
• self-cueing strategies to increase speed and accuracy of word retrieval
• organization strategies

There are several communication deficits associated with PD. In addition to speaking issues, individuals with PD can also experience comprehension deficiencies. These may include:

• syntactic comprehension
• pragmatic comprehension

Therapy Programmes For People With Parkinsons

Your speech and language therapist may be trained in one of the following treatment programmes which are specifically designed for voice and speech therapy in people with Parkinson’s.

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What Are The Symptoms Of Parkinsons Disease

Parkinsons Disease has Four Primary Symptoms:

• Tremors in the Hands, Legs, Jaw, Arms, or Head
• Muscle Stiffness and Muscle Contractions that Persist for a Long time
• Slowness when Moving
• Impaired Balance and Reduced Coordination

Other symptoms include:

• Depression and other Changes in Emotions
• Difficulties related to Chewing, Swallowing and Speaking
• Elimination or Urinary Problems

In most cases, the early symptoms of Parkinsons disease are subtle and develop gradually. For instance, an individual in the early stages of the disease might experience a mild tremor in their hand or may struggle to get up out of a chair. Or they may notice that their speaking voice has become extremely soft, or that their handwriting is looking less neat or legible. Loved ones may also notice the early subtle signs of Parkinsons disease before the individual does. They may notice an absence of facial expressions or animation when they are speaking. They may also notice a difference in the individuals gait, or the movements of their hands, arms, and legs.

In many cases, the symptoms of Parkinsons disease begin to emerge on one side of the body or even one limb. As the disease progresses, both sides of the body are eventually affected. It is relatively common, however, for the symptoms to be more pronounced on one side of the body, even when both sides are affected.

How Are Cognitive Issues Diagnosed

Common ways to assess and diagnose cognitive disorders:

• Interview the person with PD.
• Ask family members or care partners about their observations.
• Administer cognitive screening tests such as the Mini-Mental State Examination or Montreal Cognitive Assessment . The neurologist will ask questions that evaluate the persons understanding of where and who they are, the date and year, attention, memory, language and problem-solving skills.
• A neurologist may suggest seeing a clinical neuropsychologist for a more detailed assessment.
• Neuropsychological assessment can be an important diagnostic tool for differentiating PD from other illnesses such as Alzheimer’s disease, stroke or dementia.

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Lets Talk About Talking With Parkinsons Disease

Communication issues can become a problem for people living with Parkinsons disease . Recently APDA published a new booklet entitled Make Your Voice Heard! Healthy Communication and Parkinsons Disease which can be downloaded from our website for free or ordered by mail at no cost to you. Lisa Sommers, MA, CCC-SLP Clinic Director and Clinical Assistant Professor, in the Department of Communication Disorders at University of Massachusetts Amherst, is a Speech-Language Pathologist and an expert in speech and communication issues for people with PD and was one of the authors of this extremely informative publication. She is also an advisor to our APDA Massachusetts Chapter. Recently, I was able to talk with Ms. Sommers about the value of speech therapy for people with PD at all stages of the condition and what someone with PD might expect from a visit with an SLP.

See A Speech Therapist

Speech and language therapists are trained to diagnose and treat speech, language and swallowing difficulties. If youre living with Parkinsons disease, a speechie can help you:

• Maintain your communication skills
• Help you use non-verbal techniques to aid communication
• Improve your muscle strength and coordination using certain exercises
• Use assistive communication devices and techniques to make communication easier.

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What Is Speak Out

Speak Out! is an evidence-based program that emphasizes speaking with intent and converts speech from an automatic function to an intentional act.

The program consists of 12 individual sessions across 4 weeks where the speech pathologist and client will work together to implement intentional speech. This is done by using the Speak Out! workbook that includes vocal exercises, readings, and cognitive tasks. For optimal results, the client is to complete a lesson each day .

After Speak Out! is complete, the client is recommended to join the Loud Crowd!, a group of Speak Out! graduates that meet weekly to practice their intentional voice

Treatment For Parkinson’s Disease

The symptoms of Parkinson’s disease can be managed effectively for a significant period of time. Although there is still no cure for PD, there are currently many medical and surgical treatments available for PD and other degenerative diseases of the central nervous system.

The treatment should be individualized, as many factors have to be taken into careful consideration, including the patient’s symptoms/signs, age, stage of disease, degree of functional disability, and level of physical activity and productivity. Therefore, the options and decisions may vary significantly from one patient to another.

Considering the ongoing research and clinical trials, as well as the recent advances in the understanding of PD, it is realistic to expect some breakthroughs in PD treatment in coming years.

For a better understanding, treatment can be divided in pharmacologic , nonpharmacologic, and surgical therapy.

Pharmacologic TreatmentThe pharmacologic treatment of PD can be divided into neuroprotective and symptomatic therapy . In reality, nearly all of the available medications are symptomatic in nature and do not appear to reverse the natural course of the disease.

Different types of medications available to treat the symptoms of Parkinson disease include:

• Inhibitors of enzymes that inactivate dopamine: MAO-B inhibitors and COMT inhibitors
• Anticholinergics

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