What is the Lee Silverman Voice Treatment (LSVT Loud)?
Most people are aware of the hallmark symptoms of Parkinson’s disease: tremors, stiffness, and trouble walking.
But did you know that up to 90% of people with Parkinson’s also have trouble speaking? Words can be slurred, mumbled, or stammered out in a pattern known as ‘tachyphemia’. Or sometimes a person will speak softly, or with a breathy quality.
All these changes in speech can make it hard for others to understand people with Parkinson’s, which hinders their ability to communicate with family, friends and caregivers.
This can feel incredibly isolating. After all, humans are social creatures, and we need to connect with each other!
Fortunately, there is a treatment available that has proven successful in helping Parkinson’s sufferers address speech problems. That treatment is called the Lee Silverman Voice Treatment (LSVT), and it’s part of our speech therapy treatments here at SpeechEase.
Let’s dive into what the treatment is, how it works, and how it can help Parkinson’s sufferers communicate better.
About Lee Silverman Voice Treatment (LSVT) Loud
LSVT Loud is a behavioural program designed to create sustained improvement in speech and voice function. It’s an evidence-based treatment that helps patients with speech problems increase their vocal loudness and ability to be understood.
The program trains people to use their voice at a more normal loudness level when speaking, whether they’re at home, at work, or in the wider community. It focuses on helping people adjust their perception of how loud or softly they’re speaking, so they can feel comfortable using a stronger voice at a louder level.
Who can benefit from LSVT Loud?
LSVT Loud was initially created to address speech issues related to Parkinson’s disease, but it can help others with a range of conditions that cause significant problems with voice, speech, and communication.
People with progressive neurological conditions such as multiple sclerosis and Huntington’s disease are all suited to undergo this therapy to help them control their voice and be heard.
Children with cerebral palsy or Down syndrome also show promise of improvement in speech with this treatment, which is great news for parents and children alike!
What can LSVT Loud improve?
The technique aims to improve volume, articulation, intonation and confidence when speaking. It doesn’t simply teach people to shout, it recalibrate the feedback mismatch between the muscles and the brain to help develop a voice that’s comfortable to use and easier to
understand.
Not only is LSVT Loud considered the ‘gold standard’ for improving audibility, it can also aid swallowing, improve facial expressions, and stimulate changes in how the brain processes speech.
How does LSVT Loud work?
Many people with Parkinson’s disease have a misperception of how loud they’re being, and put less effort into vocalising. As a result, their speech becomes quite difficult to understand.
LSVT Loud reframes motor learning (how they physically form speech) and recalibrate sensory feedback (how they perceive their speech), so people with Parkinson’s can feel that their ‘louder’ voice is actually in normal vocal range.
The treatment is built on exercises that strengthen the voice box and speech system and redefine neurological paths from the brain to the muscles in the throat.
This kind of learning is intensive, and requires continued practice, self-monitoring, and reinforcement from others to sustain lasting change.
It’s therefore conducted over 16 sessions that last about an hour each. To maintain good progress during the treatment, these sessions are delivered 4 times per week, for 4 weeks in a row. There are also 10-15 minute ‘homework’ exercises to do – high effort for high reward!
LSVT Loud is built using three key principles:
TARGET: Vocal loudness
Using evidence-based strategies that help the brain to learn, modify, adapt and change in both structure and function.
MODE: Intensive effort
Research strongly suggests 4 that short bursts of intensive cognitive and skills-based training is most helpful for bringing about lasting change. That’s why the LSVT Loud method is delivered rapidly and includes exercises to do at home too.
CALIBRATION: Generalisation
‘Recalibrating’ sensory feedback so people recognise that their new, louder voices are within normal limits. The aim is for people to feel comfortable with their voice, and more confident when speaking to others in different environments.
Where to get more information
If you’ve been diagnosed with Parkinson’s, or have a loved one with a neurological disorder that’s affecting their speech, explore your options with speech therapy. At SpeechEase, our speech therapists are trained to deliver the Lee Silverman Voice Treatment Loud program for people of all ages. It’s never too early or too late for treatment to improve communication.
If you’d like to find out more about how we can help using LSVT Loud, register for our services for a free consultation with one of our friendly speech pathologists.