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Rehabilitation Medicine




Rehabilitation Medicine - Parkinson's Program

Parkinson's Program at Sibley


Lee Silverman Voice Treatment (LSVT®) LOUD is a clinically proven method for treating speech and voice impairments in patients with Parkinson's disease (PD).  Often referred to simply as LOUD therapy, this 4 week intensive program helps individuals improve effectiveness as a communicator by focusing on one target, "Think LOUD!"  As changes with Parkinson's disease take a toll gradually over the course of years, its effect on volume and intelligibility often goes unnoticed until an individual is having significant difficulty in being heard and understood.  
Vocal Quality and Volume 
The most prominent vocal symptom related to PD is a reduction in volume.  Because this change occurs gradually over a period of years, the patient is often the last one to recognize it as a communication problem.   If family and friends are often asking for a repetition, it may indicate the need to have a voice evaluation.
PD can also affect one’s vocal quality. People often describe changes such as a raspy, hoarse, and breathy quality.  These symptoms often clear quickly after the first couple of weeks of LOUD therapy.  
PD is known to cause a stooped posture, thereby collapsing the chest and directing speech downward.  With such changes in posture it can become difficult to fully expand the lungs or to fit a single sentence on one breath.  This posture can direct already soft speech downward.  In speech therapy, we emphasize the importance of posture for eye contact and successful communication.  
Breath Support
Increasing breath support is another goal for improving communication.  With reduced breath support it is difficult to convey all of one’s thoughts and ideas. Often people compensate by speeding up to attempt to fit more words in on one breath, which results in reduced intelligibility.  Some individuals make no effort to compensate and the last few words of a sentence are uttered at a volume too soft to be understood.  Others find they are constantly taking a breath every few words.  Communication shouldn’t require so much effort.  With training and respiration exercises the breath can once again support speech.  
In Their Own Words
A few of Sibley’s LOUD participants described their experience in the program in this way: 
"In all the things I’ve done, [LOUD] has had the greatest impact."   AMC, Bethesda 
"Until I took the LOUD program, I thought the diminution of my voice volume since my 2000 diagnosis of Parkinson’s disease was inevitable and progressive. The speech therapist, Cecelia Pizano, showed me otherwise. In the four weeks of the program she showed me how to improve the quality and range and volume of my voice. (She also saved my husband from getting a hearing aid which he did not need.)  The program is long and intense. In someone else’s hands it might have been boring.  Cecelia actually made it fun. I hated to see the sessions end!"  LaVerne, Annandale  
"I have completed the LOUD program at Sibley Hospital. I can attest to its value. Before I joined the program, I had trouble making myself heard at a meeting. Since taking the program, I had no such problem. I recommend this program with enthusiasm."   Bob, Bethesda

Contact Us

Don't wait!  It is most beneficial to start the LSVT® programs early in the diagnosis period and before experiencing a communication problem.  

The Speech Language Pathologists of Washington Hearing and Speech are LSVT® trained and certified.  Call with questions or to be scheduled for a LOUD evaluation as soon as you are considering the program, as there is often a waiting list. 
Phone: 202-537-4010
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