Parkinson's Treatment - Robert
Date of Observation: 12/01/24
Setting: Speech Therapy Office.
I observed a therapy session between Dr. Brown and her 52-year-old male client, Robert, who was diagnosed with Parkinson's disease and presented with hypokinetic dysarthria. The session happened in a professional speech therapy office, where everything was clean and made a comfortable impression. There was a table, chairs, and a range of therapy equipment to create a functional and homely environment. Robert looked relaxed, and he and the SLP had a familiar relationship.
Visual Feedback Software (to monitor loudness and clarity)
Reading Passages and Word Lists
This session aimed mainly to teach Robert to speak louder and more clearly and improve his breathing control.
Specific focus areas included:
Strengthening of phonation with the help of exercises with vowels
Accurate realization of phonemes in connected speech
Learning ways to monitor and control speaking volume
Dr. Brown's approach was very systematic and positive. She began by explaining the rationale behind the tasks planned for the session. Robert understood what was expected of him and made a lot of progress. She kept Robert motivated by consistently encouraging him. I liked that the session alternated between planned activities and spontaneous conversation, which kept Robert engaged and focused on his functional communication skills.
This observation made me appreciate the LSVT LOUD techniques for patients with Parkinson's disease. To target loudness, Dr. Brown used structured tasks (sustained phonation and reading passages).
These are some examples of the techniques observed:
Phonation Practice
SLP: Take a deep breath and then loudly and clearly say, 'Ah.'
SLP: Hold that for 5 seconds. Pretend that you are projecting to the back of the room.
Articulation Excercise
The clinician used several word lists that included multisyllabic words to improve the articulation.
SLP: I want you to say the word' identification.' And exaggerate each syllable.
CLIENT: i-den-ti-fi-ca-tion
SLP: Fantastic! Let's try that in a sentence: 'I need identification.
Conversational Practice:
SLP: Describe your favorite pastime, but talk as if you are addressing a group of people.
CLIENT: I prefer fishing during the weekend, particularly in the morning."
SLP: Nice volume! Let's keep this volume for the next question.
Visual Feedback:
Robert used a real-time software program that showed how he spoke (loudness and frequency).
Breathing Exercises:
Dr. Brown incorporated controlled breathing activities to augment speech support.
SLP: Take a deep breath, hold it for four seconds, and blow out while saying Ah."
What types of assistive devices can patients with Parkinson's use in addition to speech therapy?
Vocal amplification devices increase vocal intensity, while communication applications and AAC systems are available as alternative forms of communication. Speech pacing tools such as metronomes or delayed auditory feedback help regulate speech rate, while respiratory training devices help to improve breath control needed for voice projection. There are also wearable sensors, writing aids, and personal alert systems that help clients communicate functionally and independently.
Reference: https://www.parkinson.org/living-with-parkinsons/management/activities-daily-living/assistive-tech-devices
