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Regain & Maintain Speech in Parkinson's Disease

Updated: Apr 1, 2020

Typical symptoms of speech and voice changes in Parkinson's Disease include a low volume, a faster rate of speech and slurred speech.

90% of people with Parkinson's Disease will have speech and voice changes. Typical symptoms include low speech volume, a faster speech rate and slurred speech. These changes can worsen over time making it hard for others to understand them. This can be very frustrating and socially isolating.

Fortunately, there are evidence-based treatments for speech and voice changes in Parkinson's Disease. With intensive therapy, people with Parkinson's can regain clear speech and a good-quality voice of adequate volume.

However, there are challenges. While patients can make great progress, they need to continue to practice in order to maintain gains from therapy. Otherwise, their speech will revert back to how it was pre-therapy.

In this post, we take a look at the intensive treatments that can improve speech in Parkinson's Disease as well as ways to help maintain therapy gains.

Intensive Therapy/Behavioural Treatments

LSVT LOUD (Lee Silverman Voice Therapy)

LSVT® LOUD is a behavioural treatment with strong clinical efficacy data with individuals with Parkinson’s disease. It is designed to address the soft voice and unclear speech of individuals with Parkinson's Disease. LSVT® LOUD is intensive: four one-hour training sessions per week over the course of one month, for a total of 16 sessions.

Group therapy is not an integral part of the LSVT LOUD program but it is encouraged following treatment in order to maintain therapy gains.

Watch Bob speak about his experience of LSVT and how he maintains his gains from therapy.


SPEAK OUT! combines speech, voice, and cognitive exercises. It places emphasis on speaking deliberately or with intent. It is a two-part training course that includes individual therapy sessions (SPEAK OUT!) and group therapy (The LOUD Crowd).

The individual therapy consists of twelve 40-45 minute sessions. When the patient has completed the individual SPEAK OUT! therapy sessions they then transition into the LOUD Crowd. The LOUD Crowd is a maintenance program which consists of weekly group sessions. Watch this video to learn more about SPEAK OUT!

Ways to Maintain Therapy Gains

The Ambulatory Phonation Monitor

The Ambulatory Phonation Monitor (APM) is a portable device worn by a client in order to monitor how they use their voice throughout the day. This helps the clinician find out whether or not the client is maintaining gains from intensive therapy.

The APM device can also help clients maintain an adequate volume/a louder voice outside of the clinic environment via the use of real-time vibro-tactile feedback.

Due to cost, this device is perhaps more suited to clinics undertaking research than individual home users at present.

Visual Feedback

LSVT Companion

The LSVT Companion (client edition) provides personalised LSVT LOUD home practice during and after treatment. It offers real-time feedback on goals and displays loudness, pitch and duration measures to motivate the client.

Vocal Loudness Apps

There are a range of vocal loudness apps that measure volume and provide visual feedback on loudness level. See previous blog post on apps for Parkinson's Disease for full list.