9 Ways to Improve Speech in Parkinson’s Disease

Parkinson’s disease (PD) affects not only movement but also speech, making it difficult for many people to communicate clearly. Thankfully, there are several treatment options available that target these speech issues, ranging from voice therapy to the use of assistive technology. Here’s a guide to some of the most effective strategies for managing speech difficulties in PD. Remediation: Addressing the Core Issue LSVT LOUD® Lee Silverman Voice Treatment (LSVT LOUD®) is a well-established, evidence-based therapy designed to help individuals with PD speak more clearly and loudly. It involves 16 one-hour sessions over four weeks, where participants learn to "think LOUD" to project their voice at a normal volume. Clinicians providing LSVT LOUD® must be certified through LSVT Global, with certification courses available online or in-person for about $600. Certification must be renewed every two years. SPEAK OUT!® The SPEAK OUT!® program, developed by the Parkinson’s Voice Project, focuses on combining speech, voice, and cognitive exercises to encourage speaking with “intent.” It is a slightly less intensive alternative to LSVT LOUD®, consisting of 12 sessions of 45 minutes each, plus daily practice at home. Following the one-on-one therapy, participants can join group sessions called The LOUD Crowd® for continued support. Clinician training for this program costs around $300 and does not require certification. Expiratory Muscle Strength Training (EMST) EMST helps strengthen the muscles used for breathing and speaking, resulting in better breath control and a stronger voice. The therapy involves using a resistance device like the EMST150 or The Breather™, which costs around $50. Daily practice is essential, but the exercises are simple, making it a manageable option for most individuals with PD. Visual Feedback Becoming aware of speaking volume can be key to improving speech. Several apps offer visual feedback to help individuals monitor and adjust their loudness: Speak Up For Parkinson’s: Provides phrases for practice and a volume meter for feedback. Bla | Bla | Bla: Displays animated faces that react to changes in volume. Sound Level Meter Apps: Apps like NoiSEE (iOS) or Sound Meter (Google Play) measure sound in decibels, providing a numerical guide for speech volume. Compensation: Tools to Aid Speech Speech Vive Speech Vive is a device worn in the ear that plays background noise, naturally prompting the user to speak louder. It’s based on the "Lombard effect," where people raise their voice in noisy environments. There’s also a free iOS app to test how well this method works before committing to the device. Many users have reported significant improvements in speech volume. Voice Amplifiers Voice amplifiers can significantly boost volume for people with soft speech. These devices range from affordable options like the WinBridge, to more advanced models like the ChatterVox, which may even be covered by insurance. These tools are commonly used by teachers and tour guides but are also helpful for individuals with Parkinson’s. Augmentative and Alternative Communication (AAC) AAC encompasses tools designed to assist with speech. For milder issues, using a pacing board or apps like Conversation Paceboard can help slow down speech. For those with unclear speech, apps like AlphaTopics AAC improve intelligibility by allowing users to communicate via a letter board. In cases of more severe speech loss, text-to-speech apps such as Proloquo4Text, ClaroCom, or Predictable offer an effective communication method. As PD progresses, experimental technologies like brain-computer interfaces may become viable options. Participation: Staying Engaged in Life Despite Communication Issues Partner Training Effective communication isn’t just about the person with PD—it’s also about the listener. Speech-language pathologists (SLPs) can train caregivers, family members, and medical staff to help facilitate better communication. This training goes beyond tips; it includes feedback and coaching to ensure smoother interactions, which reduces frustration for everyone involved. Singing Joining a choir can be both therapeutic and social. Singing improves breath control and vocal strength, and many choirs are designed specifically for individuals with PD or other communication challenges. Music not only enhances vocal abilities but also lifts the spirits, providing an important outlet for expression. Conclusion Difficulty communicating can isolate individuals with Parkinson’s, affecting their ability to express themselves and diminishing their sense of identity. Addressing speech issues through therapy and technology can make a world of difference. If you or a loved one is struggling with speech due to Parkinson’s disease, consulting a speech-language pathologist can open the door to effective, life-changing treatments.