LSVT LOUD clinicians will help you establish a daily routine of "homework" from day one, in which you continue to complete a short 10-15 minute set of the LSVT LOUD exercises, on your own.

The goal is for individuals to "rev up" their stronger voice with daily practice so they can use it comfortably in daily communication. Further, this will become a life-long habit of practice, even after the 16 sessions of treatment are completed.

This concentrated approach is critical for the positive changes LSVT LOUD achieves, consistent with what studies on motor learning and neuroplasticity (the ability for your brain and nervous system to adapt and evolve) show is most effective.

The care and skill of a speech-language pathologist is of the utmost importance when working on vocal loudness to ensure healthy voice quality. Although the concept of “speak LOUD” may appear simple on the surface, your LSVT LOUD Certified clinician is essential to help you learn how to improve vocal loudness in a way that does not harm your voice.

LSVT LOUD is typically delivered via in-person sessions, but there is the option for LSVT eLOUD where treatment is delivered using real-time videoconferencing. The LSVT LOUD clinician would be in his or her clinic and the person with PD would be at his or her home. Some or all of the 16 sessions can be delivered in this manner. Research has shown it to be as effective as doing all 16 sessions in-person at a clinic. To locate LSVT eLOUD Clinicians click here.

Another technology supported approach for LSVT LOUD involves using the LSVT Companion Client Edition for a portion of the treatment sessions. A research study has documented that when 7 of the 16 total sessions were completed using the LSVT Companion, outcomes were comparable at 6 months to all sessions being in-person. Click here to learn more about the LSVT Companion Client Edition.

Note that LSVT LOUD is not offered in fewer, shorter or more spaced-out sessions which would not give you the results that correct LSVT LOUD treatment achieves. Only alterations that are documented with research, such as the LSVT eLOUD or the LSVT Companion, are acceptable.

Traditional medical treatments, such as pharmacological and surgical approaches, do not consistently or sufficiently improve speech for people with PD or atypical parkinsonisms, but many published research studies and countless clinical cases show that LSVT LOUD speech treatment works!

To understand how LSVT LOUD can help, it's good to first know how Parkinson disease (PD) affects communication. The most commonly reported voice and speech issues are: soft voice, hoarseness, monotone, mumbled speech, and rapid speech.

• Creating a mismatch between how you think you're talking and how you actually sound:
  • your voice may feel normal to you, when you may actually be speaking quietly,
  • when you are speaking louder as taught in treatment, it may feel too loud to you while friends and family may say you sound normal;
• Interfering with thinking skills and coming up with the words you want to say.

Combined, all of these issues can make it difficult to feel confident in your communication. The good news is that something can be done! LSVT LOUD directly addresses these symptoms for proven communication improvements.

LSVT LOUD was created to address issues from Parkinson’s disease but also can help people with other conditions. Outcomes for various conditions and circumstances are explained in more detail below. The research evidence for LSVT LOUD for people with PD is very strong with three randomized clinical trials. In relation to other neurological conditions, evidence is emerging with single-subject and small group research. Ultimately, the LSVT LOUD Certified Clinician is the best person to determine if treatment could help.

People with more advanced PD (for example, Hoehn & Yahr stages 4 – 5) may also see improvements in loudness and clarity of speech, though possibly to a lesser degree. They may also need periodic reminders from friends and families to “speak louder” and may need more frequent "tune up" treatment sessions. These outcomes are supported by research and our extensive clinical work.

People with dementia or other cognitive impairments may face the challenge of difficulty remembering to use the tools learned in treatment, but improvements are still very possible! A single cue (speak LOUD), repetition and intensity in practice, and using shorter sentences in treatment all help people with cognitive impairments learn. Many improve their loudness and clarity but may need friends and family to remind them to “speak louder.”

People with atypical parkinsonism may see outcomes ranging from improved functional conversation to improvement in key functional phrases (like “good morning” or “thank you”) with loudness cueing from caretakers and family members, which can still offer enormous benefit:

• Giving someone with advanced-stage disease some access to spoken communication can be a great gift at that stage of progression;
• The single, redundant cue of “loud” can greatly help patients with cognitive impairment;
• Even if relying on external cueing, many people with atypical parkinsonism can improve voice and speech after treatment.

Children with cerebral palsy or Down syndrome can also benefit from LSVT LOUD treatment according to recent research. Clinicians gave the treatment to 25 children with cerebral palsy and nine children with Down syndrome and most parents reported immediate improvements, noting their children spoke more clearly and confidently and were more willing to talk with peers and teachers. Learn more about LSVT LOUD for KIDS here.

Listen to some audio samples of a child with cerebral palsy and a child with Down syndrome before and after LSVT LOUD.

Speech challenges related to other neurological conditions may also benefit from LSVT LOUD. While most studies have examined outcomes for people with PD, early research shows that LSVT LOUD can help adults with speech issues arising from multiple sclerosis, stroke and ataxia, for example.

In summary, LSVT LOUD is the global standard for speech treatment for people with PD. Beyond PD, it has potential application to speech disorders in a range of other neurological conditions in adults and children. Ultimately, an LSVT LOUD Certified Clinician is the best person to determine if treatment could help you and to determine the best course of action.

It's important to recognize that people with Parkinson's disease may not be overly aware of initial changes in their voice, speech and communication. This is likely due to real sensory changes in people with PD that cause the brain to not accurately register how softly they are actually speaking. If you've been diagnosed with PD, in addition to your perception of your voice, it's a good idea to also ask family and friends if they've noticed changes in your vocal loudness, voice quality or everyday communication.

That said, even if your speech is fine or does not feel impaired, it's never too early to begin LSVT LOUD treatment! When PD or other neurological conditions are first diagnosed, significant changes in the brain have already happened. Treatment with LSVT LOUD before noticing changes in communication may help you pre-empt problems and keep your voice and speech strong for years to come.