Guest Post: Study Looks at SPEAK OUT!® and The LOUD Crowd® Therapy Programs
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We are excited to share this guest post from our Parkinson’s partner, Parkinson Voice Project.

Speech difficulties common in Parkinson’s

While the cardinal symptoms of Parkinson’s focus on tremor, rigidity, postural instability, and slowness of movement, its disruption of speech can be very disabling. Speech difficulties affect nearly 90% of people with Parkinson’s disease. Parkinson’s causes a speech disorder called “hypokinetic dysarthria,” which commonly causes speech to be softer, breathier, unclear, and more monotone than normal. While other Parkinson’s symptoms, like tremor and rigidity, tend to respond well to medications and surgical treatment, speech disorders do not. Instead, speech is best improved through behavioral therapy. In order to improve oral communication, speech-language pathologists must help the person with Parkinson’s improve their breath support, voice clarity, and articulation through speech therapy. While there is research supporting the benefit of speech therapy for Parkinson’s, a new approach involving intensive one-on-one speech therapy followed by long-term group maintenance therapy has been developed.

Learning to take control of speech through “intent”

A recent study has evaluated the effectiveness of SPEAK OUT!®, a program designed to improve speech in people with Parkinson’s by teaching them to speak “with intent,” or rather, to be consciously aware of how they’re speaking. For people without Parkinson’s, speech is typically a highly automatic motor function that doesn’t require conscious awareness. However, people with Parkinson’s tend to have more difficulty with automatic movements. Learning how to speak intentionally helps people with Parkinson’s to activate a neurological motor pathway called the “pyramidal system,” which is typically less affected by Parkinson’s than the motor pathways responsible for automatic movement. To address the progressive and degenerative nature of Parkinson’s, the SPEAK OUT!® program includes a group therapy component, called The LOUD Crowd®. The LOUD Crowd® helps SPEAK OUT!® “graduates” to receive the ongoing support they need to practice speaking intentionally and provides additional opportunities to interact socially with others.

Promising findings support the benefit of individual and group therapy

The study followed 12 participants as they engaged in individual therapy, the SPEAK OUT!® program, for 4 weeks and then attended weekly LOUD Crowd® group sessions for eight weeks at Parkinson Voice Project’s clinic in Richardson, TX. The study evaluated the participants’ vocal intensity (loudness) and how their speech impacts their quality of life. Analysis showed that SPEAK OUT!® significantly improved the loudness of the participants voices. The study also found that the participants’ perception of their own ability to communicate also improved post-treatment. In addition, follow-up visits showed that by attending weekly group maintenance therapy, the participants had retained these improvements 8 weeks following treatment.1

Future directions for research

While these results are promising, further research with more participants would further validate the effectiveness of this treatment approach. Since there may be a connection between speech and swallowing, studies evaluating the indirect effect of SPEAK OUT!® and The LOUD Crowd® on swallowing function is a possible future direction for research. Finally, future studies are planned to study the long-term effect of participation in The LOUD Crowd® on participants. Future research will give a clearer picture of the full spectrum of benefits possible through speech therapy programs that combine individual therapy with ongoing group maintenance therapy.

About Parkinson Voice Project

Parkinson Voice Project is a non-profit organization based in Texas that focuses on restoring the voices of those with Parkinson’s disease. The organization treats patients in their clinic, hosts free lectures, conducts research, and trains speech-language pathologists in their SPEAK OUT!® and LOUD Crowd® therapy programs. The organization has a unique model in which patients are not charged for their therapy services – their program has been funded entirely through donations and a Pay It Forward concept.

view references
  1. Levitt J, Chitnis S,& Walker-Batson D. The Effects of the “SPEAK OUT! ®” and “LOUD Crowd®” Voice Programs for Parkinson Disease. International Journal of Health Sciences. 2015; 3(2):13-19. DOI: 10.15640/ijhs.v3n2a3
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