Individuals with hypophonia (low voice volume) and/or hypokinetic dysarthria (motor speech changes) resulting from Parkinson’s disease, may benefit from one:one speech therapy, employing a standardized protocol such as LSVT® Loud or SPEAK OUT!®.

30 days of progress made in speech therapy will be short-lived without a strategy for long-term maintenance.

In light of a neurodegenerative disease diagnosis, continued speech “practice” following speech therapy makes sense, and I often tell patients: “whether you do or don’t practice, Parkinson’s really doesn’t care, it will continue on it’s path.” So, as the saying goes: the best defense is an offense, with the idea being that proactivity instead of a passive attitude will lead to a strategic advantage.

Some patients tell me that they read aloud as a way of maintaining speech improvements after therapy, and while this is a good home practice strategy, I wonder, is it enough? After-all, without some feedback to measure vocal intensity, reading aloud at a speech volume below what is necessary for conversational speech will unlikely yield a strengthening effect or improvement that will generalize to conversational speech.

 Reading Aloud more effectively during home practice

Below are a few suggestions for how you can make reading aloud a more effective home-based practice activity:

  • Implement a feedback tool to maintain a target level of loudness. This can include: Hi-VOLT® , a voice-activated light bracelet, which, when positioned 8-12” from your mouth or body will provide feedback and a target for loudness. After reading aloud, continue to use the Hi-VOLT® as you re-tell 3 main points of what you read, or answer 3 questions.

Speak Up for Parkinson app  is a free app for ipad users. It  displays a sound level meter for feedback and allows you to video-record yourself while reading aloud short phrases embedded in the program, or anything of your own you would like to read. Video recording is such a great strategy for real-time feedback. It allows you to see and hear yourself the way others do. It also allows you to observe facial expression and other non-verbal gestures which may enhance or distract from what you have to say. is a website created by Sean Banville that lends itself nicely to home practice. It was developed for English as second language users, but, with over 450 1 minute reading passages on an array of topics, it can be a fun home practice tool. Each 1 minute reading displays as a pdf file, but after the initial reading, the passage appears again with some of the information missing, giving you an opportunity to “fill in the blanks,” and judge how well you were paying attention. There is also a word jumble.

• Read poems, limmericks, or Dr. Seuss out loud. The rhythm and rhyme of limmericks can be a fun way to practice pitch and inflectional changes that are important components of conversational speech and add meaning to what you say. Focusing on the rhythm of speech production can help to reduce the monotone speech that is frequently a by-product of Parkinson’s. Rythm also affects the rate of speech, and speech which is perceived as too fast by a listener can reduce understanding. Music based remediation of speech disorders is an interesting and evolving area of research and neuro imaging suggests  that rhythm-based therapy may help stimulate brain networks.(1)  

• If you have the opportunity to join a weekly speech class, this might be the best strategy for maintaining improvements attained in speech therapy. Group classes give you an opportunity for “speech practice” while engaging in activities that might include: reading aloud, choral reading, extemporaneous speaking on a variety of topics, and engaging in conversation with people who share your desire to maintain effective communication despite a diagnosis of Parkinson’s disease.

(1)Fujii, Shinya and Wan, Catherine Y.The role of rhythm in speech and language rehabilitation: the SEP hypothesis. Front. Hum. Neurosci., 13 October 2014 |

Enjoy the Benefits of Dancing NEW Weekly Dance in Charlotte County, Florida

English Folk and Country dancing is coming to Charlotte County staring Monday, February 3, 2020. The dances will be held from 6:30-8:30 at Universal Fitness which is located at 1544 Rio De Janeiro Ave, Punta Gorda, FL 33983.

These weekly dances are open to anyone in the community, including people with PD who feel stable on their feet. No partner is necessary.Gillian Beck is the Caller, and if you would like to be added to her mailing list, just use the email at the bottom of the flyer, or contact her by phone with questions. Come enjoy a fun evening of danicng that requires prior dance experience, just a desire for FUN!


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