The Voice Aerobics Hi-VOLT® 4 PD voice-on-light is a calibrated feedback tool designed to help individuals with hypophonia (too low/soft a voice) increase their vocal intensity, through practice, to a more normal level of loudness.

How does it work? The calibrated, voice activated light is housed within a bracelet. When the switch is turned on, the light will be activated when the users’ voice reaches the appropriate level. The sensitivity has been set at the factory, and designed so that the bracelet won’t be triggered constantly by all of the ambient noise in a room. It is important to turn the bracelet OFF when not in use, or the battery will drain more quickly.

Do I have to wear it as a bracelet? The Hi-VOLT was designed as a bracelet for convenience, but frequently, in speech therapy with my own patients, I affix the device to whatever reading material a patient is using and position it near eye level. When used this way, I typically position the bracelet approximately 13” from the patient’s mouth/body. In therapy, I place a sound level meter at a similar distance in order to measure vocal intensity levels. When using the bracelet at home, I suggest patients cut a piece of ribbon 12-15”, depending on their distance, and attach it to the bracelet so they use the device at the distance best for them each time they practice.

How do I use the Hi-VOLT in speech therapy? Incorporating the Hi-VOLT into an initial speech and voice assessment of patients can help therapists and patients quickly identify stimulability for an improvement in loudness. Typically, I collect acoustic data (un-cued) using a standardized protocol, and then repeat the measures using the Hi-VOLT voice-on-light, with a single cue to the patient: “speak loud enough to activate the light.” Measured improvement on acoustic data, along with perceptual improvement on an audio-recording of the patient can be a great way to demonstrate to a patient that they have the ability to be louder, and with training, to use their voice at a more normal level of loudness. As with any voice therapy with a focus on loudness, the patient should never be straining to produce voice. If a patient is enrolled in a formal speech therapy protocol such as LSVT® LOUD or SPEAK OUT®, the Hi-VOLT can be used in treatment for feedback, and also at home for concurrent feedback during home practice. Eventually, a patient may begin to titrate use of the Hi-VOLT as their internal calibration to a normal loudness level improves. Other individuals may continue to need the feedback during speech practice. I usually recommend to patients that they use the device at least once a week to re-calibrate to the level of loudness necessary for effective practice and voice strengthening.

How do I use the Hi-VOLT in Physical and Occupational Therapy or during exercise? Physical and Occupational therapists and trainers working with individuals with Parkinson’s like to incorporate the Hi-VOLT into a patient’s physical exercise program, including LSVT BIG and Rock Steady Boxing. In this instance, using the Hi-VOLT as a bracelet provides patients with freedom of movement. The cue to the patient is exactly the same: “speak loud enough to activate the light.” Counting out loud while performing high amplitude movements provides patients the opportunity to kill two birds with one stone so to speak, providing voice practice during physical exercise.

Voice practice ALL DAY LONG: One of the greatest challenges for most patients with Parkinson’s hypophonia is finding the time or remembering to do some speech practice daily, so that the improvements attained in speech therapy are long-lasting. Once a patient is outside of a therapy setting and no longer being cued by the therapist for loudness, they may begin to detrain and revert back to their low voice. Participation in a weekly after-therapy class may be the best way to guard against de-training, but, when this is not an available option for a patient, use of the Hi-VOLT® at home may help them stay calibrated. The Hi-VOLT® 4 PD audio CD is a recording of guided practice approximately 22 minutes long. Patients are guided through hierarchical tasks, beginning with words and advancing to sentences, all the while being reminded to “speak loud enough to see the light.” Because the Hi-VOLT bracelet is portable, it can even be taken along and used while riding as a passenger in the car .  In this instance, I advise patients to read aloud street and business signs. Advertisements on  marquees. Repeat something heard on the radio. There’s NO RULES….no matter where you live, where you go, or what language you speak…just SPEAK UP and SEE the LIGHT!

How do I change the Hi-VOLT bracelet battery? This is probably the most frequent question I receive. At the present time, the battery CANNOT be changed. The battery life is 40 continuous hours, and if used daily 30-60 minutes a day, the bracelet will function for 7-8 weeks. It’s important to turn the device off when not in use to avoid unnecessary drain on the battery. If you have found the bracelet to be of benefit and are ready to re-order, you might consider taking advantage of some of the special pricing which includes 10% off when 2 are purchased, and if 3 are ordered, a 4th is provided for free bringing the cost to only $15 a unit. (Wholesale pricing options are also available for physical and speech therapy practices, and it is recommended you contact us for additional information).

So, What Are You Waiting For?

In Memoriam of my Patient and Friend, Dick Swetonic

Def friend: a person whom one knows and with whom one has a bond of mutual affection.

When working with patients over several years, there is no question that bonds form. We begin to know a lot about each other’s families, interests, and just as my patients cried with me after the loss of my mother last December, I cry when I learn of their passing.

Richard (Dick) was a special patient of mine, who recently passed away. Originally a native of Pittsburg, he relocated to Florida in 2000, and despite a 25 year history of Parkinson’s disease, he brought his upbeat spirit and energy to every class and interaction. He was an active member of the Doo Pointes, a 50’s type singing group, which he was so proud of, and I remember watching him in a performance a couple of years ago, seeing Parkinson’s retreat into the background as his passion for singing and entertaining moved into the foreground for all to enjoy.

Dick LOVED to talk, and when I first met him a few years ago at one of my Voice Aerobics classes, it saddened me to see that he had so much to say, and yet, speech was so difficult for him due to his dysarthria from Parkinson’s. Despite his difficulties, Dick, with the help of his loving and dedicated wife, Diane, drove over 30 miles to my office several times a week to engage in speech therapy treatment. Finally, a combination of therapy and a device, the Speech Vive, helped Dick to improve his speech clarity. And somehow, despite my taskmaster approach with him, he became fond of me, and I of him.

What I hate most about Parkinson’s disease is how it has taken away some of my patients and friends in the same insidious way it arrived in their lives, but I know, despite my sadness, that I am left a little better for having known each of them.

 

 

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

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