Definition of Practice: to perform or work at repeatedly so as to become proficient practice the act; to do repeated exercises for proficiency (source: Merriam Webster)

We have all experienced times in our life when we practiced performing or perfecting a skill. We may have practiced a skill associated with a sport such as hitting a golf or tennis ball or shooting baskets for basketball. We may have practiced playing an instrument. Or, we may have practiced delivering an important speech.

Experts who study such things suggest that: Practice makes perfect if it is deliberate, frequent, if you’ve got the right sequence, and if you’re paired up with a partner.

Some research related to learning suggests that reward and sensory feedback accelerates learning.  Ali A. Nikooyan and Alaa A. Ahmed[i], researchers who have studied the effect of feedback on motor learning, concluded that a combination of reward and sensory feedback considerably improved motor learning in terms of learning rate in healthy adults, and it is likely that both sensory and reward feedback drive learning when the two are combined.

So, what does that have to do with speech practice?

Individuals with Parkinson’s disease often exhibit motor speech symptoms that are characterized perceptually by decreased vocal intensity (hypophonia), articulatory imprecision, diminished prosodic modulation (monotone), and a sometimes breathy or harsh voice quality. Additionally, sensory-perceptual feedback and accurate self-monitoring are also impaired and may leave individuals unaware of the changes to their speech production. However, despite these motor speech symptoms, many people with Parkinson’s can improve some of these aspects of speech in response to external cueing.

Various cueing strategies are used as a component of speech therapy protocols and are often incorporated into daily practice as a method of improving speech. During one: one therapy, the therapists are often providing qualitative feedback (“good job,” “keep going,” “louder”). Some treatment protocols, such as LSVT® LOUD have been designed to train individuals with PD to pay attention to their speech output and to monitor the effort to produce this output.[i] And although this approach has been shown to be effective, generalization of the trained skills from this program or others to conversational speech and accurate self-monitoring of performance during independent home practice may not occur with all patients, particularly those with greater sensori-motor deficit or some degree of cognitive impairment.

 Feedback and Independent Speech Practice

Could sensory feedback accelerate and improve speech practice for persons with PD? The Hi-VOLT® voice-on-light is a voice activated, calibrated, feedback tool that provides a cue for loudness when patients are performing speech practice. A simple cue to the patient: “speak loud enough to activate the light,” typically elicits louder and clearer speech from most users. This type of simple, extrinsic feedback may help individuals with PD practice at a level of effort necessary to yield perceptual improvement and help to calibrate them to the effort required to speak loud enough for everyday conversational speech.

The Hi-VOLT® is not intended for all day use, but rather it’s recommended it be used during daily speech practice, during physical therapy, or perhaps even when riding as a passenger in the car, turning a 30 minute drive into an opportunity for speech practice with feedback.

[i] Sapir, Ramig, and Fox. Intensive Voice Treatment in Parkinson’s Disease Lee Silverman Voice Treatment. Expert Review Neurother. 11 (6),815-830 (2011).

[i] Ali A. Nikooyan and Alaa A. Ahmed J Neurophysiol 113: 633–646, 2015. First published October 29, 2014; doi:10.1152/jn.00032.2014.


Telemedicine Study Recruitment

The Purdue Motor Speech Lab is currently recruiting adults for a fully online Telemedicine Study. Participants must:

  • be adults aged 30-85,
  • either have Parkinson disease as diagnosed by a neurologist, ORhave no diagnosis of any neurological or pulmonary conditions,
  • have access to an internet- and web-camera-enabled device,
  • be fluent in English, and
  • have adequate hearing to process verbal instructions.

To enroll or learn more:


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