What I learned in a LOUD Class!

Girl screaming at boy

I attended a Lee Silverman Voice Therapy® (LSVT) LOUD workshop a few months ago. In case you don’t know, LSVT® is the “gold standard” treatment for speech and voice changes in people with Parkinson’s Disease. It’s been around for more than 20 years and is backed by Level I treatment efficacy data. I am a certified provider of LSVT® LOUD, and I must re-certify my license every two years to stay abreast of the latest developments in the program. I can choose to do this online or in a two-day live workshop conducted by LSVTGlobal, Inc. I really like to physically attend when the location and my therapy schedule permit. I always learn new tips and strategies that benefit me professionally and that I can utilize immediately with my clients/patients with PD and other neurological disorders.

I actually wrote this blog while the workshop was fresh in my mind and posted it as a Talking Tuesday post on the Parkinson’s Assistance, Network, Directory, and Alliance (P.A.N.D.A.) website. I’m revising and posting it on my own blog today as a summary for people who have recently asked me questions about the program. Like the original piece, today’s post contains bullet points regarding speech, voice, and swallowing disorders in people with Parkinson’s Disease (PwPD) and the benefits of LSVT® LOUD therapy to treat them.

A Few Statistics…
~ 89% of PwPD will develop speech and/or voice problems.
~ 4% of PwPD are referred for treatment of their speech and/or voice problems.
~ vocal loudness improves in 90% of LSVT® LOUD clients.
~ 80% of LSVT® LOUD clients retain improvements for 12 to 24 months after the treatment.

In Case You Didn’t Know…

PwPD also experience sensory perception problems along with the motor difficulties of PD.
~ This is a mismatch between the actual vs. the perceived effort required to speak at normal loudness.
~ This mismatch is not limited to speech and voice. Perception of amplitude (intensity; size) of movement also impacted. LSVT® BIG was developed in more recent years to address this area.

PwPD often think they are:
~ speaking loudly when their voice is actually soft;
~ taking large, wide steps, when gait is actually small and shuffling;
~ writing at a normal size when penmanship has become quite small (micrographia).

LSVT® LOUD teaches PwPD to Think LOUD, but shouting is not trained. Re-establishment of an average, healthy vocal loudness is the goal.

Preliminary data show that …
~ LSVT® LOUD may prove beneficial in the treatment of swallowing problems in PwPD.
~ a LSVT® LOUD Junior version may benefit children with voice and/or speech problems, particularly those with Cerebral Palsy and Down Syndrome.

LSVT® LOUD has been around for more than 20 years, and its strong evidence base supports its potential to benefit many PwPD. It is very rewarding for me to provide LOUD therapy and see my clients regain their voice and confidence. It is one of my favorite treatment programs!

Grey ribbon candle



Hartelius, L., & Svensson, P. (1994). Speech and swallowing symptoms associated with Parkinson’s
disease and multiple sclerosis: A survey. Folia Phoniatrica Logopedia, 46, 9–17.

Logemann, J. A., Fisher, H. B., Boshes, B., & Blonsky, E. R. (1978). Frequency and coocurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. Journal of Speech and Hearing Disorders, 43, 47–57.

Ramig, L, Sapir, S., Countryman, S., Pawlas, A., O’Brien, C., Hoehn, M., & Thompson, L. (2001). Intensive voice treatment (LSVT®) for individuals with Parkinson disease: A two-year follow-up. J. Neurology, Neurosurgery, and Psychiatry, 71, 493-498.

Ramig, L., Spair, S., Fox, C., & Countryman, S. (2001). Changes in vocal intensity following intensive voice treatment (LSVT®) in individuals with Parkinson disease: A comparison with untreated patients and normal age-matched controls. Movement Disorders, 16, 79-83.


Visit our website, Facebook page, and/or follow the @BowenSpeech handle on Twitter for further information about the services provided at Bowen Speech-Language Therapy, LLC.

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