Lee Silverman Voice Treatment LSVT An intensive treatment

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 Lee Silverman Voice Treatment (LSVT) An intensive treatment program for individuals with Parkinson’s

Lee Silverman Voice Treatment (LSVT) An intensive treatment program for individuals with Parkinson’s Disease Presented by: Laura Dinges

Characteristics of Parkinson’s Disease w w w w Affects both speech and voice Exhibits

Characteristics of Parkinson’s Disease w w w w Affects both speech and voice Exhibits common form of hypokinetic dysarthria Decreased loudness Monotone Vocal tremor Hoarseness Rapid rate of speech 2

LSVT background w 1 st effective treatment for voice and speech disorders of people

LSVT background w 1 st effective treatment for voice and speech disorders of people with Parkinson’s Disease (PD) w Developed in 1987 by Dr. Lorraine Ramig and Carolyn Mead, both speech-language pathologists w Named after one of the 1 st patients to receive treatment 3

LSVT background (cont. ) w Began as a treatment program for PD, now includes

LSVT background (cont. ) w Began as a treatment program for PD, now includes other neurological disorders w Intensive behavioral treatment is 4 days a week for 4 weeks (16 sessions) w Patients also asked to practice at home 4

LSVT techniques w Techniques intended to help patients with PD increase intelligibility and vocal

LSVT techniques w Techniques intended to help patients with PD increase intelligibility and vocal loudness w Program emphasizes ‘loud’ speech w 5 basic concepts of program: n n n Think loud; Think shout Speech effort has to be high Must be intensive treatment Must be able to recalibrate loudness level Quantifiable improvements over time 5

Additional Information on LSVT w Program targets immediate improvement following treatment and also on

Additional Information on LSVT w Program targets immediate improvement following treatment and also on developing skills for longterm maintenance. w Must be trained and certified s-lp to administer treatment w 400+individuals with PD have been successfully treated in efficacy research studies w Approx. 90% of patients with PD improve from treatment 6

PET brain images and LSVT w Study from Neurology journal by Liotti and colleagues

PET brain images and LSVT w Study from Neurology journal by Liotti and colleagues (2003) w Looked at brain activity before and after voice treatment with LSVT using PET images w 5 patients with mild to moderate PD and speech disorders; 5 healthy subjects w PET images produced in 5 patients with PD during phonation and reading exercises before and after a cycle of LSVT 7

PET brain images and LSVT (cont. ) w 5 healthy subjects-images generated during same

PET brain images and LSVT (cont. ) w 5 healthy subjects-images generated during same activities w Before treatment: In patients with PD, motor and pre-motor cortex activated (voluntary effort) w In healthy subjects, automatic circuits activated, especially basal ganglia w After treatment, patients’ images appeared more similar to healthy individuals’ images 8

 Summary w 1. 5 million people are diagnosed with PD in the US

Summary w 1. 5 million people are diagnosed with PD in the US w Individuals with PD often exhibit certain speech and voice characteristics w LSVT-1 st effective treatment w Techniques: increase loudness and improve intelligibility w Many people with PD have been successfully treated with this program 9

References Cleveland Hearing & Speech Center (2003). Fact sheet: Parkinson Disease and the Lee

References Cleveland Hearing & Speech Center (2003). Fact sheet: Parkinson Disease and the Lee Silverman Voice Treatment. Received on March 27, 2003, from http: //www. chsc. org/Online_Press_Room/LSVT Fact Sheet. pdf Lee Silverman Voice Treatment Organization (n. d. ). Lee Silverman Voice Treatment facts. Retrieved on March 27, 2003, from http: //www. lsvt. org/main_site. htm Liotti, M. , Ramig, L. O. , Vogel, D. , New, P. , Cook, C. I. , Ingham, R. J. , Ingham, J. C. , & Fox, P. T. (2003). Hypophonia in Parkinson’s disease: neural correlates of voice treatment revealed by PET. Neurology, 60(3), 432 -440. Stemple, J. , Klaben, B. G. , & Glaze, L. E. , (2000). Clinical Voice Pathology: Theory and Management. (3 rd edition). Singular Publishing. 10