LSVT LOUD Therapy
LSVT LOUD is an effective speech treatment for people with Parkinson’s disease (PD) and other neurological conditions. Named for Mrs. Lee Silverman (Lee Silverman Voice Treatment), a woman living with PD, it was developed by Dr. Lorraine Ramig and has been scientifically studied for over 25 years with support from the National Institute for Deafness and other Communication Disorders within the National Institutes of Health (NIH) and other funding organizations. LSVT LOUD trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people “recalibrate” their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.
Research on LSVT LOUD has documented improved impact on multiple levels of functioning in people with PD following treatment including:
Increased vocal loudness
Improved articulation and speech intelligibility
Improvements in facial expression
Changes in neural functioning related to voice and speech
What is LSVT LOUD?
Nearly 90% of individuals with PD have speech and voice disorders that negatively impact communication abilities. These disorders include reduced vocal loudness, monotone, hoarse, breathy voice quality, and imprecise articulation, perceived as mumbling, and other rate-related features, such as hesitations and short rushes of speech. In contrast to previous medical “chart review” literature suggesting a mid- or late-stage onset of speech and swallowing symptoms in PD, more recent investigations with sensitive and valid measures consistently report speech symptoms in early PD. Further, self-report data from individuals with PD have indicated that voice and speech changes are associated with inactivity, embarrassment, and withdrawal from social situations.
LSVT LOUD trains the target of vocal loudness in order to (1) enhance the voice source, consistent with improving the carrier in the classic engineering concept of signal transmission, (2) use vocal loudness as a trigger for distributed effects (e.g., improved articulation, vocal quality and intonation, and reduced rate) across the speech production system, (3) recalibrate sensorimotor perception of improved vocal loudness, and (4) train a single self-cue and attention to action to facilitate generalization of treatment effects into functional communication.