As we know, Parkinson’s Disease is a degenerative disease of the brain, which affects motor movements and coordination. Progression of symptoms usually occurs slowly over time, but the type of symptoms and severity can vary greatly from person to person. Many people who are first diagnosed with PD notice a tremor and/or other changes in physical movements, such as slowness, increased rigidity/stiffness, and difficulty starting movements. These same motor changes can also negatively affect the muscle movements needed for communication.
Current research indicates that 70-90% percent of people with PD will experience changes in speech and voice at some time during the course of the disease. Changes can include reduced volume, hoarse vocal quality, flat/monotone voice, imprecise articulation with slurred/mumbled speech, and vocal tremor. For example, changes in movement and coordination of your respiratory muscles may negatively affect the breath support you need for speech. During ENT (Ear, Nose, and Throat) exams, it is also very common for people with PD to present with bowed vocal folds, meaning their vocal folds are not closing all the way. This will result in a breathy voice that is lower in volume. Your articulation may be affected by changes in the way you move your tongue, lips, and jaw, either because of weakness, deceased range of movement, or coordination.
In addition, there are sensory changes that can negatively affect the way a person with PD hears their own voice. For this reason, it is very common for friends and family to first notice these symptoms, while the person with PD may not be aware. It is actually very common for those with PD to report that they think that everyone else around them is losing their hearing! At first the changes are usually subtle, but with time, if you are an individual with PD, you may notice that people are asking you to repeat yourself more frequently, you may have a hard time being heard in noisy environments, and may eventually start feeling left out of conversations.
Don’t worry, there is good news! Treatment methods for these speech disturbances include: speech therapy, pharmacological intervention, and surgical procedures. Studies have proven that speech therapy is the most effective treatment method for improving voice and speech function. Currently, there are two main treatment options: LSVT LOUD and Speak Out!
Next week we will dive into the similarities and differences of these two speech therapies.