Monique Stukey, M.A., CCC-SLP, speech-language pathologist, Parkview Therapy Services.
The LSVT LOUD (Lee Silverman Voice Treatment LOUD) program is an evidence-based speech therapy program designed to improve vocal loudness and speech intelligibility through a series of hierarchical exercises. The program was originally designed for individuals with Parkinson’s disease (PD); however, research has shown it can be used with other neurological conditions such as multiple sclerosis, stroke and ataxia. It has also shown to be beneficial in pediatric populations as well with individuals with Down syndrome or cerebral palsy.
How LSVT LOUD can help
With PD, there is usually a "feedback mismatch" meaning individuals with PD often feel that they are speaking at a normal volume, when they are actually speaking in hushed tones, making it difficult to be heard or understood. LSVT LOUD retrains the patient's voice to speak at a louder volume, without shouting, to overcome this feedback mismatch and feel more confident in their voice.
Research has also shown that in addition to increasing vocal intensity, LSVT LOUD can also help improve other areas of communication including articulation, intonation and facial expression.
Components of LSVT LOUD
The LSVT LOUD program involves attending speech therapy for 1-hour long sessions 4 days a week for 4 weeks in a row, with daily homework assigned to help promote carryover at home. A patient will work one-on-one with an LSVT certified speech-language pathologist either in person, or via telehealth, to improve vocal intensity while maintaining a healthy vocal quality. The components include:
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Calibration exercises through sustained phonation (holding a single vocal sound) and pitch glides (moving from low to high pitch).
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List of functional phrases to repeat at an appropriate loudness level
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A hierarchy of speaking tasks including words, phrases, sentences, paragraphs and conversation level tasks.
Outcomes
Patients have reported excellent outcomes following treatment, with improved vocal quality and decreased need to repeat themselves to friends and family. However, even once the program is completed, it is important to continue to complete a maintenance program to help preserve the new LOUD voice. It is also recommended that patients complete a check-in with their clinician every 3-6 months to keep their voice strong.
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