Adam gave up his long battle with Parkinson’s Disease and passed away last week. His wife called me Saturday to let me know, so I stopped by to pay my respects before the service to be held that evening. Adam was my patient through several home health certifications, and I think he taught me as many lessons as I taught him! It would take a lot of words to describe Adam, but for this Blog I want to reminisce about the highlight of my work with him: his Quarter Board.
When I first met Adam, he presented with hypokinetic dysarthria typical of patients with Parkinson’s. His voice was soft, and his speech rate was rapid. A round of Lee Silverman Voice Treatment (LSVT)* successfully established a louder voice, but that fast speech rate was stubborn and it was very difficult to understand him! We tried several different pacing strategies, to no avail. One day, I decided to have Adam touch objects instead of tapping his fingers. I pulled five quarters out of my wallet and taught him to touch and say one word for every quarter. His speech rate slowed to within normal limits and was immediately more intelligible! He was thrilled. I was thrilled. His wife was ecstatic! There were teary-eyes all around! I left them that day with instructions to glue or tape the coins on a piece of cardboard and practice, and I planned to provide a more conventional, “official” pacing board at our next appointment.
When I returned for the next session, Adam proudly showed me his fancy new Quarter Board! His friend had been so impressed by his improvement with the pacing strategy that he took the quarters to his workshop and embedded them in a board that he painted red. Adam took to that board right away. His son came home from work and was able to carry on a conversation with his dad for the first time in months. When I next saw him he said, A piece of wood with quarters in it! Who knew it could be that simple?! A piece of wood!!!!
Adam’s friend made two more Quarter Boards, one white and one blue, so Adam would have spares. He kept one with his walker, one in the car, and one beside his chair at home. Adam took his Quarter Board everywhere, using it proudly and unselfconsciously to tell jokes, participate in conversations, and engage more fully with friends and family at home and at church. When someone complimented him on the board and his improved speech, he would grin and say Yeah, and it only cost me a buck 25!
Sadly, Adam’s disease progressed to the point that he was no longer able to use his Quarter Board, but for a time it helped him convey what he wanted and needed to say. I am told that his family treasures and kept Adam’s Quarter Boards along with the sweet memories they hold. At the viewing on Saturday, his granddaughter thanked me for giving me back my grandfather’s voice. I have to say that this proud “speechie” was lost for words … then of course I said way too many! I doubt that I fully conveyed how much her spontaneous, unexpected statement meant to me. It was my privilege to work with Adam! He taught me lessons that I will use to help others, and I will always remember him, his enthusiastic response to the Quarter Board, and the priceless, intangible rewards of my work with him and his lovely family.
*Lee Silverman Voice Therapy (LSVT) is a trademark of LSVT Global, Inc., registered in the U.S. and other countries. Cyndee Bowen, SLP has been certified by LSVT Global, Inc. to provide treatment for individuals with speech disorders related to Parkinson’s disease and other neurological disorders using the LSVT modalities.
NOTE: Patient’s first name and circumstances have been used in this article with permission of his wife and family.
Cyndee Williams Bowen, SLP is Owner and Founder of Bowen Speech-Language Therapy, LLC in Clearwater, Florida. Her practice specializes in the assessment, diagnosis, and treatment of adults and adolescents with speech, language, voice, swallowing, cognitive, and related disorders. She has a special interest in working with patients with Parkinson’s Disease and is a certified provider of Lee Silverman Voice Treatment (LSVT) LOUD and eLOUD. You can learn more about the services provided at Bowen Speech-Language Therapy, LLC by visiting the company website, Facebook page, and following the @BowenSpeech handle on Twitter!