Frequently Asked Questions

Frequently Asked Questions Click on the questions for answers.

What are the early symptoms of a speech disorder associated with Parkinson’s?

Reduced volume
Hoarse-sounding vocal quality
Frequent throat clearing
Trailing off at the end of sentences
Some days the voice sounds normal; other days it doesn’t.

When is the best time to enroll in SPEAK OUT!^® therapy?

If someone with Parkinson’s is experiencing any of the speech difficulties listed above, an evaluation with a speech-language pathologist trained in the SPEAK OUT! therapy (a SPEAK OUT!Provider) is recommended. Since the muscles used for speaking are the same used for swallowing, early intervention is important to minimize future swallowing difficulties. Parkinson’s patients who complete SPEAK OUT! therapy typically experience improvement in a matter of days. Early intervention is essential.

What causes speech and swallowing issues in Parkinson’s?

Speaking and swallowing are highly-automatic behaviors. When we speak, we don’t think about taking air into our lungs, contracting our diaphragm, or moving our vocal folds, tongue or lips; it all happens automatically. It’s the same for swallowing; it’s an automatic behavior.

Dopamine facilitates automatic movements. However, in Parkinson's, there is a considerable loss of dopamine. With less dopamine, automatic movements are disrupted, which can contribute to speech and swallowing difficulties.

How does “INTENT” improve speech?

When we speak with intent or deliberation, we are using a system in the brain that is less dependent on dopamine. This is why people with Parkinson's can improve their speaking abilities. As patients complete SPEAK OUT! therapy, they not only learn to “speak with intent,” but they also learn to incorporate "intent" into everything they do, such as walking, writing, eating, swallowing, getting out of a chair, and putting on their seatbelt. In essence, they learn to “live with intent.”

SPEAK OUT!^® sounds too good to be true. What’s the “catch”?

The only “catch” is that regaining and maintaining speech and swallowing requires quality speech treatment with daily home practice and consistent follow-ups. Follow these guidelines:

• Find a speech-language pathologist who has completed formal SPEAK OUT! training through Parkinson Voice Project (called a "SPEAK OUT! Provider").
• At Parkinson Voice Project, patients typically receive two or three SPEAK OUT!^®sessions a week for four weeks.
• During SPEAK OUT!, complete the exercises twice a day. On therapy days, complete one lesson from the workbook at home. On non-therapy days, complete one lesson from the workbook at home and participate in one online SPEAK OUT! Home Practice Session.
• Upon completion of SPEAK OUT!, complete SPEAK OUT! exercises every day - either using your SPEAK OUT! Workbook or by participating in an online SPEAK OUT! Home Practice Session. In addition, participate in LOUD Crowd speech and singing groups to maintain the improvements made in therapy.

How can I get a SPEAK OUT!^® Workbook?

If you live in the United States and are working with a SPEAK OUT! Provider, call Parkinson Voice Project to order a SPEAK OUT! Workbook. You also have access to all of Parkinson Voice Project's therapy workbooks and flash cards through our eLibrary. Ask your SPEAK OUT! Provider for the link to access the eLibrary.

If you live outside of the U.S., ask your SPEAK OUT! Provider for the link to access the eLibrary. Unfortunately, we do not ship SPEAK OUT! Workbooks outside of the U.S. due to the shipping costs.

How do I find a SPEAK OUT!^®Provider?

Speech-language pathologists who have been trained by Parkinson Voice Project are listed on our website. Click here to locate a SPEAK OUT!^® provider.

Speech-language pathologists who also offer LOUD Crowd^® groups are designated by this symbol.

What if there isn’t a SPEAK OUT!^® Provider in my area?

Parkinson Voice Project awards grants to speech therapy clinics that want to bring our SPEAK OUT! and LOUD Crowd program to their area. Grant applications are available in mid-January. Email grants@ParkinsonVoiceProject.org.