Although I have offered Online Coaching for over 10 years, the onset of the pandemic in 2020, ushered in a whole new world of telehealth, including the ability of patients to access speech therapy treatment from the comfort of their home.

Programs that I offer in person which are designed to address voice and motor speech symptoms associated with Parkinson’s include LSVT® LOUD and Speak OUT! ®

I also see patients with non-PD related voice symptoms including age related changes to voice and for those patients, I might offer PhoRTE® (phonation resistance training exercise).

Regardless the approach, my experience has been that these same programs can be delivered successfully via telehealth if the patient is motivated, reasonably familiar with ZOOM or other web platforms, and able to practice independently between treatment visits.

There has been one missing piece, however, in all our voice treatment, and that has been the ability to obtain reliable acoustic voice measurements remotely in the patient’s natural environment.

Acoustic measurements taken in the clinic at the onset and conclusion of voice treatment are important for documenting treatment outcomes. But, even when seeing patients in my office, their voice during treatment may not reflect their voice use at home during various times of the day and in various settings where demand for volume may be greater, like when in a noisy restaurant. Patients with Parkinson’s in particular, often report to me that voice use is affected by “off” times of medication, generalized fatigue and/or anxiety, non-motor symptoms which may not always be present during an out-patient voice treatment visit.


A novel, new app, VoiceEvalU8, developed by a speech-language pathologist and researcher, Elizabeth Grillo may be one answer to this treatment dilemma. One rationale for the development of the VoiceEvlU8 app, according to Ms. Grillo, was to provide speech-language pathologist a tool which would enable them to provide a more client-centered approach to voice assessment and treatment which considers the individual’s voice use in their everyday environment.

Much like OT and PT relate therapy to the patient’s activities of daily living, a more functional approach to voice assessment can enable us to assess a patient’s voice at different times of the day, and in the case of an individual with Parkinson’s this might include on/off medication, which is not often easily done in an out-patient clinic setting.

I have recently used the VoiceEvalU8 app with two patients of mine that have complex voice problems, and who, like many voice patients, report variability in voice use from day to day and within a day. Using a free app which they downloaded to their smart phone (android or apple), each day, they are sent two logs to complete with periodic push notifications until they have recorded their log. The acoustic and aerodynamic data collection takes about 5 minutes to complete and is available for me to view as soon as the next day. I can view the data over any time frame, which, in addition to acoustic data includes audio files which I can also download and share with the patient or the referring ENT.

Technology can seem overwhelming to all of us from time to time, and yet, it seems that the COVID pandemic ushered in a whole new world of opportunities for all of us to connect more easily using web-based platforms and for patients to access treatment from their home with the assurance that the quality of the assessment and treatment will be the same as in a face:face setting.

If you would like to learn more about VoiceEvalU8 visit:

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My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate  and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

             Voice Aerobics the heART and Science of Voice Practice