LSVT LOUD FOR SPEECH, SPEECH AND SWALLOWING PROBLEMS
When I was diagnosed with idiopathic Parkinson's syndrome in November 2019, I occasionally stood in front of the camera as a supporting actor in cinema, television films, reports or commercials. When my voice failed on a scene for reference number X / Y, I had no idea that it was one of the harbingers of my illness. Neither the usual home remedies nor medication and speech therapy prescribed by the ENT were able to provide permanent relief. It was not until the diagnosis of “Parkinson's” that I clarified the cause. I got very uncomfortable swallowing difficulties relatively quickly and my level of suffering prompted me to make another attempt at a speech therapist, but now with a special therapy that has now become the standard worldwide and has helped me a lot: "LSVT Loud"
In an interview, LSVT therapist Dina Roos from Unterföhring near Munich explains to us what LSVT loud is, where it has its roots and how it works.
What exactly is LSVT loud?
LSVT® stands for Lee Silveman Voice Treatment. And Lee Silverman wasn't the doctor who developed the method. Lee Silverman was a woman with Parkinson's disease. At the end of the 80s, she and her family members presented to a speech therapist. The family's concern was very clearly formulated at the time: "If we could only hear and understand her" - If only we could hear and understand them.
In 1987 the Lee Silverman Center for Parkinson's was founded in Scottsdale, Arizona. Here, Parkinson's related communication disorders and their treatment options were specifically researched for the first time.
This began a journey that has now led to the so-called gold standard in the treatment of Parkinson's and atypical Parkinson's syndromes.
It quickly became clear that people diagnosed with Parkinson's can definitely speak at a healthy volume. Interestingly, they don't. A staggering percentage of people with Parkinson's will develop a communication disorder. This manifests itself either in voice problems, such as hoarseness, a monotonous voice, a very quiet voice, a busy voice, etc. Articulatory problems can also develop, which show up in unclear speaking or, for example, lisp or mumble. And just as often it is noticeable that those affected do not even notice the extent of their deficits.
Very often in the admission interview my patients are convinced that their spouse needs a hearing aid.
With that, I'm going back to the early days of Parkinson's research in Arizona: Very soon everything indicated that people with Parkinson's found their own voice way too loud the moment they speak at a healthy vocal volume. The logical consequence is that they speak with less vocal power, so that they themselves have the feeling that they are speaking with normal vocal volume.
Due to this existing shift in perception of one's own vocal volume, the voice that actually sounds is too quiet for the ear of the other person.
This is where LSVT® comes in. The Lee Silverman Voice Treatment is a behavioral approach in which this shift in perception is overwritten. The goal is for those affected to recognize and accept how loud their own voice has to feel in order to actually sound healthy.
LSVT LOUD® (German LSVT LOUD®) by no means trains a voice that is too loud. The goal is a healthy voice of good quality. However, due to the shift in perception caused by Parkinson's, those affected have the feeling that they are too loud. This is why the method is called LSVT LOUD®
As a therapist, how do you feel about LSVT loud?
I have been treating people with Parkinson's disease since 2008. In these years I have treated well over 100 people with the Lee Silverman Voice Treatment.
On the one hand, we are talking about an evidence-based therapy method - that is, in the context of large-scale “randomized controlled studies” it has been proven that the therapy will be successful if a fixed program that is specified but tailored to the patient is carried out correctly. On the other hand, I can confirm from my own experience that it works.
In my experience, the therapy method is actually the gold standard for Parkinson's disease.
First of all, a healthy vocal volume of good quality is developed and trained as part of the basic exercises. And this voice is then slowly but surely transferred into spontaneous speech according to the level of treatment.
The following is important for you as a patient:
- There is no such thing as 'LSVT-based' - if you want to be successful, you need the full program. You also don't take half of the antibiotics your doctor prescribed for you. This can be transferred to LSVT.
- Performing just a few of the exercises from the program will train your vocal muscles, but will not change the shift in perception of your own vocal volume. If you want your wife / husband to stop saying “speak louder” then do the full and correctly performed LSVT LOUD®
- A properly performed Lee Silverman Voice Treatment (applies to LOUD and BIG) includes.
- Implementation by certified LSVT LOUD® therapists
- 60min 4x / week on 4 consecutive days
- Implementation without interruption for 4 weeks (in exceptional cases 5-6 weeks)
- Daily homework - both training content and everyday use
- Contents suit you personally - include your areas of interest
Does LSVT Loud also help with swallowing difficulties?
Did you know that the muscles with which we speak and produce voices are exactly the same muscles with which we also swallow?
Did you know that a shockingly high percentage of people with Parkinson's will develop swallowing disorder?
When we keep in mind that almost everyone with Parkinson's has a more weak voice, it's not at all surprising that this leads to a swallowing disorder.
But why am I writing this when it is about voice / speech therapy? Quite simply: Almost all people with Parkinson's report to me in the admission situation that they 'have more saliva in their mouth' or 'swallow themselves on their own saliva', or 'have to cough more often when eating / drinking'.
If I see signs of a slight swallowing disorder, then I actually 'only' offer LSVT LOUD® at first. Lo and behold, these slight swallowing problems have improved again by week 3 of the treatment at the latest. Why? Because with healthier speaking in everyday life, not only the vocal / speaking muscles are continuously trained, but also the muscles with which we swallow.
What distinguishes LSVT Loud from other therapeutic approaches
In one sentence: With LSVT®, the success of the therapy is not lost on the way to the parking lot.
To properly understand the difference, we must first examine the objectives of speech therapy.
Sometimes muscle mass has to be built up in a specific area or incorrect tension has to be reduced. In this case, classic speech therapy 1-2x / week plus high-frequency training at home is definitely suitable for Parkinson's as well. An example of this would be severe swallowing disorders. In this case, the swallowing muscles must be specifically trained.
However, if we look at the typical Parkinson's voice, namely speaking more quietly and imprecisely, then we need an approach that focuses on the shift in perception and offers more than breathing, voice and articulation training. Because here people with Parkinson's show improvements in the therapy room and in the training situation, but as soon as the actual exercise is over, their speaking becomes quieter and less precise again.
And here is the difference: LSVT® is a behavioral approach and aims to correct the shift in perception.
This is what we mean when we speak of so-called calibration. We reset the internal measuring instrument. In these four weeks of treatment, we train and bomb the nervous system so intensely that our patients can not only get it right in the end - the goal is that they can no longer do it wrong. And if the corresponding exercises are then continued correctly, then the success is permanent and those affected can get by for years without regular therapy visits.
Who will prescribe LSVT loud for me?
LSVT LOUD is prescribed by neurologists, internists, ENT specialists or general practitioners. For people with statutory health insurance, as with other prescriptions for medicinal products, form 13 can be used. Privately insured people can get the prescription either on sample 13 or as a private prescription.
If the frequency is prescribed 4x / week and 'LSVT LOUD' is entered under therapy goals, then what has been prescribed can be understood by the insurance provider. I have never seen a person diagnosed with Parkinson's not getting paid for LSVT LOUD® treatment.
Scene from a video therapy session
Let's keep in touch and tell me what you think
If you have suggestions or want to get rid of criticism, this is the right place for it.
| Sometimes a simple star rating is enough
[yasr_visitor_votes size=“small”] |
You don't want to miss a thing. Then just subscribe to me.
[email-subscribers-form id = “2 ″] |
Could the post interest your friends? Then you can share it here.
|
Leave a comment
Participate in the discussion?Leave us your comment!