Voice and speech changes in Parkinson’s disease: “Speak up!” Or “Get your hearing checked!”
Parkinson’s disease (PD) is a progressive neurological disorder that affects the coordination and control of movement, and commonly has significant consequences on voice and speech. Speech and communication often get less attention than the other deficits, such as those affecting gait or tremors, however it is estimated that 89% of those diagnosed with PD have some degree of a speech and/or voice disorder, and a shockingly small percentage (3-4%) of this number seek the help of a speech language pathologist. How can we, and why should we, change this statistic?
Communication is a significant part of life. Not being able to communicate can have a huge impact on personal expression, individuality and overall quality of life. It can also be frustrating for both the person with PD and their communication partners when they are not able to effectively communicate together. Although the person PD often doesn’t notice the changes in their voice or speech, some common complaints of communication partners are, “I can’t hear you, speak up” or “can you repeat that?” A soft, hoarse voice with difficulty or inability to increase loudness is one of the hallmark features of speech changes with PD. Others include a fast rate of speech, with imprecise articulation.
There are therapy options available to this population that help combat these changes and improve communication and quality of life. Intelligible speech requires a combination of adequate airflow from the lungs, voicing from the voice box or larynx, and correct movement of the articulators that shape the sounds. Behavioral therapy for voice and speech changes in PD typically focuses on increasing loudness and vocal quality, and also decreasing the rate of speech in order to increase intelligibility. One well-studied therapy is the Lee Silverman Voice Therapy (LSVT) program that has a goal to “speak LOUD.” LSVT, or a modified “maximum performance” version, may help to improve each of these functions. Treatment can be effective during all stages of PD, but the sooner a person with PD receives treatment, the more effective it will be! If you or someone you know has PD, think about making an appointment to see a speech language pathologist in your area to see what options are available.
Ramig, L., Fox, C., Sapir, S. (2008). Speech treatment for Parkinson’s disease. Expert Rev. Neurotherapeutics, 8(2), 299-311.
Trail, M., Fox. C, Ramig, L.O., Sapir, S., Howard, J., & Lai, E.C. (2005) Speech treatment for Parkinson’s disease. NeuroRehabilitation, 20(3), 205-221.