Dear Elizabeth,

Lately, my wife is telling me to “talk louder” or having me repeat myself. She said that it is harder to understand me and is concerned this may be happening at work. Can this be due to Parkinson’s or is my wife overreacting?

Daniel C.

Hi Daniel,

Your wife may be noticing a very common symptom of Parkinson’s disease.   In fact, voice and speech challenges occur in almost all patients with PD. Many people notice the following:

    • Lower voice volume
    • A “breathy” and/or “strained” voice quality
    • Increased effort in speaking
    • Running out of breath when speaking

It is important to note that there are many factors that can be causing vocal difficulties including overall vocal hygiene (i.e. drinking enough water), a history of Gastro Esophageal Reflux Disease (GERD) and medications that may impact your voice. Fortunately, a speech-language pathologist who specializes in voice therapy may be able to help you address these and other concerns related to your voice.

Specifically, Lee Silverman Voice Therapy (LSVT) is an intensive voice program designed specifically for Parkinson’s patients. It is a clinically research-based method proven to increase vocal volume in Parkinson’s patients. In addition, some preliminary studies show that exercises that help with your voice may help improve swallowing function, which is another common problem that Parkinson’s patients often encounter.

Meeting with your doctor and speech-language pathologist is the first step in determining a program that is safe and specifically tailored to your needs.

Elizabeth Oakley, M.S., CCC-SLP
Speech-Language Pathologist
Co-Founder, Toluca Speech and Language

About Elizabeth

unanamedElizabeth currently dedicates her time to providing Alternative and Assistive Communication (AAC) to people who have limited verbal skills. With experience in schools across Southern California, Elizabeth has worked providing services to students with diverse and medically complex caseloads including the 0-3 population, Autism Spectrum Disorders (ASD), Down Syndrome, cleft-palates and stuttering disorders.

She is on staff at a local hospital, treating adults with cognitive, swallowing, and voice disorders. As a trained actor and singer, she is passionate about vocal rehabilitation and teaching healthy voice habits. Elizabeth is certified in Lee Silverman Voice Therapy (LSVT),which is voice therapy for individuals with Parkinson’s disease.

She has worked in-home, private clinics and outpatient hospitals with pediatric and adult clients. Elizabeth holds a M.S. from California State University, Northridge where she graduated with distinction. She received a bachelor’s degree from New York University with honors in theater and a double minor in Spanish and Sociology.

She speaks conversational Spanish and is a member of ASHA’s Special Interest Group 3, Voice and Voice disorders. She has a 2-year old daughter, 3 cats a dog and a husband who keep her busy when she is not working.


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