Speech Therapy for Parkinson’s Disease Presented by Andrea Peake, MS, CCC-SLP Supervisor, SIRH Outpatient Rehab Services Louisville Parkinson’s Symposium October 10, 2017

Main Components of Speech Therapy Voice Swallowing Cognition

Voice Dysarthria Soft/muffled voice Less precise articulation of words Difficulty with fluency or stuttering

Treatment for Voice

LSVT LOUD Intensive, behavioral treatment program specifically designed for patients with Parkinson’s disease. 16 sessions in one month Intent to help increase intelligibility and vocal loudness ~80% of patients with PD exhibit decreased loudness and unclear, rapid speech

5 Concepts of LSVT LOUD Focus on the Voice Focus on High Effort Focus on Intensive Treatment Focus on Calibration (to use louder voice automatically in daily life) Focus on Quantification (therapist provides feedback and uses objective methods to show improvement)

LSVT Methods Used 1. Daily Tasks (in + outside of therapy) Maximum duration of sustained vowel Maximum pitch changes Maximum functional speech loudness

LSVT Methods (cont.) 2. Hierarchical Speech Loudness Tasks Progressing from word/phrase to sentence to reading and eventually to conversation level

LSVT Methods (cont.) 3. Carryover Activities Provides the patient with the opportunity to implement their LOUD voice into daily life

Treatment for Swallowing

Dysphagia Definition: difficulty swallowing Signs Food or medicine sticking in the throat Couching (when eat/drinking) Avoiding certain foods **Can lead to aspiration pneumonia!

Swallowing Treatment/Tips Take medications 1 hour prior to meals Modify food consistencies Allow adequate time to eat Smaller pieces of food/pills Take meds in applesauce…

Swallowing Treatment/Tips Try “easy grip utensils” Speech therapy exercises or modified swallow Electrical Stimulation May need Video Function Swallow Test

Excess Saliva To combat drooling: Form habit of consciously swallowing every few minutes Carry a bottle of water and sip every few minutes

Treatment for Cognition

Cognition Treatment Signs Forgetfulness Disoriented Family seems to have to correct or help with words Testing Treatment Tips