Speech and swallowing changes are common challenges for people with Parkinson’s. Research shows that up to 90 percent of people with Parkinson’s experience a softer voice, slurred speech, and/or swallowing difficulties. Despite how common these problems are, they are sometimes overlooked in the early stages of Parkinson’s. Families may focus first on tremors, balance changes, or slowed movement. Yet speech changes can appear just as early, and if left unaddressed, they may become more difficult to treat later. Early intervention is crucial.

The SPEAK OUT! Therapy Program, developed by Parkinson Voice Project, helps people with Parkinson’s and related disorders REGAIN and RETAIN their speech and swallowing. This highly effective, research-based therapy teaches patients to transition speech from an automatic function to an intentional act. Speaking with INTENT means using deliberate focus and purposeful effort instead of relying on the weakened automatic system. Swallowing with INTENT means making each swallow purposeful, which reduces the risk of coughing or choking.

Why INTENT Matters

Parkinson’s causes dopamine loss, which disrupts the brain’s automatic motor system. This system normally controls movements we do automatically, like speaking, managing saliva, and putting on a sweater. As dopamine decreases, automatic movements become less smooth and coordinated.

Fortunately, people also have an intentional motor system that does not rely as heavily on dopamine. By focusing attention and effort, people with Parkinson’s can bypass the impaired automatic pathway. Speaking with INTENT transforms automatic actions into deliberate ones.

The Circle of INTENT

People with Parkinson’s and their families need solutions that last a lifetime. At Parkinson Voice Project, our motto is, “We’re in it with you for the long haul.” The Circle of INTENT outlines the therapy components and emphasizes that this program is lifelong. Each element reinforces the others, creating a program that sustains progress over time.

1. SPEAK OUT! Evaluation

The journey begins with an evaluation by a Certified SPEAK OUT! Provider. The Care Partner is an integral part of SPEAK OUT! Therapy, so they are included in the evaluation and the following sessions.

2. What is Parkinson’s? Video

Education is a vital part of SPEAK OUT! Therapy. Parkinson Voice Project’s What is Parkinson’s? video explains how dopamine loss affects automatic movements, why speech is at risk, and how INTENT is the answer. Patients and families watch this video to gain insight on why SPEAK OUT! works.

3. Daily SPEAK OUT! Home Practice

Parkinson’s is a movement disorder, and as such, it responds very well to movement, that is, exercise! Daily exercise will strengthen the speech and swallowing muscles and facilitate the carryover of using INTENT to every day conversation. Establishing a new practice habit may seem daunting, but Certified SPEAK OUT! Providers have strategies to make it possible.

There are several options for daily practice. First, there are Parkinson Voice Project’s SPEAK OUT! Home Practice Sessions. They are available live and recorded. These sessions, led by Certified SPEAK OUT! Providers, are engaging, educational, and even a little fun! With a new topic every day, people with Parkinson’s eagerly return to learn something while completing their daily practice. Then they are able to take on the day, speaking with INTENT.

Other practice choices are found through the SPEAK OUT! eLibrary. There is the online SPEAK OUT! Booklet. There are also many sets of flashcards with different topics. These materials are created by Parkinson Voice Project’s Speech-Language Pathologists to ensure daily practice is interesting and challenging.

4. Individual SPEAK OUT! Therapy

Patients typically reach their goals in four hours (eight 30-minute sessions, delivered twice a week for four weeks) with a Certified SPEAK OUT! Provider. Patients learn to strengthen their muscles through SPEAK OUT! Exercises, to establish a daily practice routine and how to speak with INTENT. Care Partners learn what the “best cue” is to prompt their person to speak with INTENT.

5. Weekly SPEAK OUT! Classes 

During week three or four of individual therapy, graduates transition to weekly SPEAK OUT! Classes to maintain the progress they achieved. Led by a Certified SPEAK OUT! Provider, these 30-minute online sessions provide accountability, camaraderie, and encouragement. Speaking with INTENT with other SPEAK OUT! Graduates facilitates the carryover to every day conversation. 

6. SPEAK OUT! Refreshers

Patients and Care Partners meet with their Certified SPEAK OUT! Provider every 6-12 months for a re-evaluation. Several components of the program are assessed, including the home practice routine, how the exercises are completed, and the Care Partner’s use of the “best cue” to speak with INTENT. Additional individual sessions may be scheduled as needed to address any changes. 

The Role of Care Partners

Care Partners are essential in SPEAK OUT! Therapy. Their support ensures practice remains consistent and meaningful. Strategies include:

• Assist with the development of a daily SPEAK OUT! Home Practice routine.
• Attend all SPEAK OUT! Therapy sessions to learn how to use the “best cue” to elicit INTENT. 
• Celebrate progress to build confidence.
• Attend the monthly Virtual Parkinson’s Family Education Group. A Certified SPEAK OUT! Provider leads this group with the purpose to educate Care Partners and families about Parkinson’s and help them proactively navigate their journey with INTENT.  

When Care Partners are involved, therapy extends beyond the clinic and becomes part of daily life. That carryover strengthens outcomes and deepens connections between families.

What Makes SPEAK OUT! Therapy Unique?

SPEAK OUT! Therapy is unique for several reasons:

• We’re in it with our patients for the long haul. Once a patient begins SPEAK OUT! Therapy, they are not discharged. SPEAK OUT! Classes and SPEAK OUT! Refreshers ensure that patients maintain progress over time. 
• We recognize that daily practice is essential. Therefore, Parkinson Voice Project developed the SPEAK OUT! eLibrary to provide an abundance of adult therapy materials to use with daily practice to keep it engaging and interesting. The SPEAK OUT! Home Practice Sessions are available live or recorded. All of these resources are provided by Parkinson Voice Project, without charge.

Outcomes of SPEAK OUT! Therapy

People with Parkinson’s who follow the program consistently report:

• Stronger voices that are heard.
• Reduced drooling and improved swallowing.
• Improved facial expression.
• Confidence in social, family, and public settings.

Families notice that conversation returns at mealtimes, phone calls become more natural, and social outings feel less stressful. They feel more connected to their community. These successes align with Parkinson Voice Project’s research and outcomes that highlight the effectiveness of SPEAK OUT! Therapy.

Don’t Wait – Get Started TODAY!

SPEAK OUT! Therapy provides people with Parkinson’s the tools to REGAIN speech and swallowing and RETAIN those skills for the long haul. The Circle of INTENT, with its six components, demonstrates the components for lasting success.

With the right tools, education, individual SPEAK OUT! Therapy and weekly SPEAK OUT! Classes, and an abundance of practice resources, people with Parkinson’s are able to reclaim their voice and LIVE with INTENT.