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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
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Main Components of Speech Therapy
Voice Swallowing Cognition
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Voice Dysarthria Soft/muffled voice Less precise articulation of words Difficulty with fluency or stuttering
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Treatment for Voice
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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
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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)
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LSVT Methods Used 1. Daily Tasks (in + outside of therapy)
Maximum duration of sustained vowel Maximum pitch changes Maximum functional speech loudness
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LSVT Methods (cont.) 2. Hierarchical Speech Loudness Tasks
Progressing from word/phrase to sentence to reading and eventually to conversation level
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LSVT Methods (cont.) 3. Carryover Activities
Provides the patient with the opportunity to implement their LOUD voice into daily life
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Treatment for Swallowing
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Dysphagia Definition: difficulty swallowing Signs
Food or medicine sticking in the throat Couching (when eat/drinking) Avoiding certain foods **Can lead to aspiration pneumonia!
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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…
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Swallowing Treatment/Tips
Try “easy grip utensils” Speech therapy exercises or modified swallow Electrical Stimulation May need Video Function Swallow Test
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Excess Saliva To combat drooling:
Form habit of consciously swallowing every few minutes Carry a bottle of water and sip every few minutes
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Treatment for Cognition
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Cognition Treatment Signs Forgetfulness Disoriented
Family seems to have to correct or help with words Testing Treatment Tips
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