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The Challenges of Speech Treatment in Parkinson's Disease

SPEAK OUT! is an intensive speech therapy program for Parkinson's Disease

90% of individuals with Parkinson's will have trouble speaking during the course of the disease. Typically, individuals speak too softly to be heard, or not clearly enough to be understood, even by close family members and friends. However, speech is an under-treated problem in Parkinson's Disease.

The treatment of physical problems such as slowness of movement, muscle stiffness and rigidity is often prioritised over problems with speech. The reason for this may be that physical problems affect walking and balance, leading to more immediate consequences; reduced independence and falls. Speech problems also have adverse consequences including social isolation and depression. However these negative consequences can happen over a longer period of time.

A big challenge in the treatment of speech problems in Parkinson's Disease is that intensive therapy is needed in order to make gains. In other words, attending a speech therapy session once or twice a week for a few weeks is usually not effective.

Many public sector services frequently report that they do not have the staffing or the resources to offer intensive speech therapy to individuals with Parkinson's. As a result, they may in fact offer therapy that is ineffective. This can have an adverse effect in that other professionals, individuals with Parkinson's and family members then believe that speech therapy in Parkinson's Disease does not work. This belief in turn leads to public sector adult speech therapy services not receiving the additional funding they need for more resources and more staffing. So the cycle of under-treatment continues.

In order to break this cycle, Speech and Language Therapists need to provide education on the benefits of proven intensive therapy approaches such as Lee Silverman Voice Therapy (LSVT LOUD) and Speak Out.

LSVT LOUD (Lee Silverman Voice Therapy)

LSVT LOUD is designed to address the soft voice and unclear speech of individuals with Parkinson's Disease. LSVT 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. This group therapy provides encouragement and motivation. It also makes group members accountable.

Watch this video to learn more about SPEAK OUT!

The Aptus Clinic

At the Aptus Clinic, we seek to break the cycle of under-treatment of speech problems in Parkinson's Disease in Ireland. We offer free educational talks on how Parkinson's affects speech and the benefits of intensive therapy.

We also provide the SPEAK OUT! and LSVT programs to individuals with Parkinson's in our clinic rooms in Clonee, Co. Meath. For individuals who wish to participate in intensive therapy but who cannot attend clinic, we provide LSVT e-LOUD (LSVT treatment delivered by tele-practice).

If you wish to have further information, please do not hesitate to contact us at the Aptus Clinic (​).

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