Tech & PD: Apps to Overcome Communication Challenges

Technology comes in many forms. There are apps for everything from buying books and airplane tickets to date managers that keep track of who you're seeing on what nights. The younger you are the more commonly apps are integrated with everyday life. They can tell you when the bus will arrive, how many steps you've taken or make a reservation for dinner.

Apps also have a role in health care. There are apps for record keeping and research that are used by doctors and nurses, hospitals, and pharmacies. There are wellness and health education programs, symptom trackers; disease support groups and training tools used by patients and families.

Vocal challenges for people with PD

Parkinson's disease (PD), a neurodegenerative brain disorder has motor symptoms that include difficulties with speech. Some people have trouble with enunciation, muttering, and slurring of words. These changes can make communication more difficult causing people often to become isolated. That is not helpful for managing any aspect of disease progression.

For people with PD, technology can help to overcome communication challenges. Most people with Parkinson's will, at some point, experience speech and vocal changes. The impact can affect volume, articulation, breathiness, a lack of inflection and rapid speech.1 Apps can now play a role in speech therapy, and with regular use can improve communication outcomes for people with PD.

Many apps are aimed at helping people with speech problems. They can teach people to speak louder and more clearly. Some promote practice, rehearsal and reinforcement of learned techniques. They can have interactive features that let you respond to program features, record your voice and some even have games.

Many of the apps have teaching components to help you practice vocal technique. Some allow you to record vocal exercises so you can play them back to hear and monitor your progress with volume, intonation, and pronunciation. Others allow for video review. Feedback can let people know and understand how voices sound compared to other noise. The apps serve to train individuals to speak louder and more clearly. They also help to build confidence and allow privacy for practice.

All of these techniques promote improved communication skills, and can lead to a better quality of life. They can also be an integral part of a treatment plan. Changes in vocal qualities and conversation patterns can motivate people to work on their voices.2

Some apps measure sound (amplitude), some show decibel levels. Some help to associate sound levels with appropriate activities: indoor voice (library, quiet, and dinner table) or outdoor voice (picnic, ballgame, on the street). Speech pacing can also be measured by technology.

In Queensland, Australia, researchers have developed an app called Harlie that is designed to engage in small talk. It was designed to assist the user and their medical teams to understand the impact of neurological conditions on patient communication and well being.2

When people with neurological conditions such as Parkinson's disease have trouble finding the right words it could mean a change in disease progression. General changes in having or following conversation could indicate a change in cognition and language comprehension. It could also indicate the impact that medications have on symptoms. Real-time feedback from patient apps could provide scientists and doctors with useful data to help monitor and treat the disease.

Conversation for many is more motivating than straight vocal exercises and allows people to practice in context. Changes in conversation, such as increased difficulty with finding the right word or following the conversation, could indicate important cognitive changes.

Other apps for other symptoms

Smartphone apps designed for PD patients are now available to address many different aspects of patients' needs. These apps are mainly designed to consolidate data gathered by sensors already common on most smartphones, including memory games, finger tapping, speaking, and walking steps counters. And researchers continue to assess the needs of the PD population, looking to create and update technologies to address their specific needs.

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