Speech and Swallow Therapy

Parkinson's Disease affects the coordination, timing and force characteristics of the muscles used for speech and voice. It is estimated that 75% of individuals with PD experience changes in speech and voice at some point throughout the disease progression. The same physical symptoms that occur in the limbs, such as reduced movement, rigidity and tremor, affect speech.

Symptoms

• Tremor or unsteadiness in the voice
• Hoarse/raspy voice
• Reduced vocal loudness/ Soft Voice
• Pitch variability
• Monotone voice
• Difficulty forming words
• Articulation
  • Slurred Speech/mumbled Speech
  • Imprecise Consonants
• Rapid Rate
  • Short Rushes of Speech
  • Increased speech at the end of a phrase

Effects of Drugs on Voice and Speech

A few studies have shown that with PD meds, voice and speech characteristics improve but most individuals report very little improvement. Systematic studies with tight experimental controls are needed. Peak medication periods as well as typical on/off patterns need to be studied.

Evaluation Process

• Examine all the muscles and structures that contribute to your voice and speech production
• Visual exam of the larynx
• Assess your speech patterns, quality, preciseness of articulation
• Assess your vocal quality and respiratory support

Importance of Voice and Speech Therapy

Speech-language pathologists have an essential role in the management of individuals with Parkinson’s Disease. Proper treatment of voice and breathing may play a key role in restoring and preserving the individual’s quality of life and possibly economic situation.

Two Therapy Options

One therapy for UFMDC patients is Respiratory Muscle Strength Training. It is a 4 week program developed by Drs Sapienza, Davenport and Martin that specifically works to increase the strength of the expiratory or inspiratory muscles using an experimental treatment device. The treatment involves assessment of baseline function that examines the patient's abilities in breathing, swallowing, speech and coughing. The treatment is done in the patient's home with weekly visits to the clinician. Outcomes have ranged from an 30-150% improvement in respiratory strength following the program and have positively influenced the functions of speech, swallow and cough after treatment.

The Lee Silverman Voice Treatment Program is a voice treatment program for individuals with Parkinson disease developed by Dr. Lorraine Ramig and colleagues. This innovative treatment program, now known as LSVT, was named for one of the first patients to receive treatment. LSVT is an intensive, behavioral treatment given over sixteen sessions in one month. The techniques are intended to help the individual with Parkinson disease increase speech intelligibility and vocal loudness. LSVT must be administered by a certified LSVT therapist, which are available through Dr. Okun's team.