Hypophonia (low volume of speech) is a common motor speech symptom of persons with Parkinson’s and has been attributed to a perceptual deficit or the lack of awareness of their own reduced speech loudness co-occurring with dysarthria ( a motor speech problem).

Changes and reduction in vocal intensity can also be attributed to age-related changes in the vocal folds and muscles of breathing, and without strengthening these muscles muscles it will be unlikely the person will be able to transfer the energy and effort of the loud “ah” produced in speech therapy to everyday conversational speech.

Interestingly, many individuals with Parkinson’s disease who have been diagnosed with hypophonia are often able to speak louder when their attention is deliberately directed to an external or explicit cue.

External cues can be verbal and provided by a spouse or therapist such as “speak twice as loud, or, an external cue might be visual such as the use of a sound level meter or Hi-VOLT® light for calibrated feedback during voice use.

Most speech therapy programs  designed for individuals with Parkinson’s attempt to teach or train the PWP to shift from an external cue to an internal cue such as “think loud,” or “speak with intent,” and while self-cueing has been shown to be beneficial for improving both speech and motor performance, it may be difficult for some patients to incorporate or sustain or incorporate outside of the therapy setting.

So, while many PWP CAN generate an increase in vocal intensity in response to cueing (external or internal) it is challenging for many individuals to maintain an appropriate level of loudness when outside of therapy where the constant demand to focus on speech production will compete with environmental noise and the cognitive attention and mental flexibility required for conversation which involves listening, processing,and formulating thoughts.

I often hear a spouse express frustration when they hear their husband/wife speaking louder in speech therapy only to get in the car or get home and revert to their low volume. And, while this can be perceived as “not trying,” it is more likely just the challenge for some people to be able to be able to maintain a level of consistent self-monitoring and focus on speech production when their own motor speech mechanism and self-perception of speech is faltering.

Hi-VOLT® Voice-activated Calibrated Feedback Helps During Therapy and Home Practice 

The Voice Aerobics Hi VOLT® Voice-on-Light Bracelet is a voice activated, calibrated light, housed within a bracelet, providing augmented feedback during daily speech practice. It was designed for use by individuals with Parkinson’s or related disease diagnosis. It is activated when the user’s voice is loud enough, helping them attain therapy targets for loudness and stay loud enough for everyday conversation.

The Hi-VOLT® is convenient for speech therapists to use during initial assessments to quickly assess stimulability for loudness or during Physical and Occupational therapy when carryover of loudness can be incorporated into counting exercise reps.

When used by patients at home, Hi-VOLT® can provide the simple cue they need to gain an exercise effect when performing vocal function exercise.

Acoustic data for 98 patients with Parkinson’s collected at the time of the initial evaluation was analyzed, and result indicated that the increase in loudness that occurred when the patients used the Hi-VOLT is greater than would be expected by chance, and is therefore, statistically significant. https://voiceaerobicsdvd.com/parkinsons-advocacy/hi-volt-yield-statistical-and-perceptual-improvement-in-vocal-intensity-for-parkinsons-patients/

It’s FUN, It’s Easy, Just SPEAK UP AND SEE THE LIGHT!

My Mission: To 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