Keys to Successful Speech Treatment in People with Parkinson’s Disease

Current Perspectives on the Lee Silverman Voice Treatment (LSVT) for Individuals With Idiopathic Parkinson Disease

Cynthia M. Fox, Chris E. Morrison, Lorraine Olson Ramig, Shimon Sapir

American Journal of Speech-Language Pathology, May 2002, American Speech-Language-Hearing Association (ASHA)

DOI: 10.1044/1058-0360(2002/012)

What is it about?

Speech treatment for people with Parkinson’s disease (PD) was previously unsuccessful. An approach, called LSVT LOUD, was developed in the late 1980s. At that time, LSVT LOUD was substantially different from traditional speech treatment in several ways. This article reviewed the novel concepts of this approach. These included a single focus on vocal loudness, intensive delivery, sensory retraining, and a simple and redundant treatment cue, “speak loud”.

Why is it important?

This article summarized, for the first time, novel and key concepts for why and how speech treatment could work and last for people with PD. At the time LSVT LOUD was developed, the outlook for improving speech in people with PD was very grim. One quote stated, “…voice treatment for disorders that are degenerative is controversial since there is no expectation for recovery of function or that any improvement secondary to speech language pathology intervention will be maintained in the long term” (Hillman et al., 1990; p. 308). LSVT LOUD proved this quote wrong. Research documented improved communication in people with PD and lasting improvements over time – out to 2 years (see LSVT two years article in resources). This has changed the perception of speech treatment for people with PD.


The concepts discussed in this article are now well accepted as key aspects of successful speech treatment for people with PD. It has been rewarding to see that our observations nearly 20 years ago are still true today. Speech treatment must target the underlying cause of a softer voice (hypokinesia).  Treatment must be delivered in an intensive and high effort manner.  The fact that patients think they are loud when they are not must be addressed. Finally, treatment that is simple in focus for people with PD (e.g., “Speak Louder”) may accommodate cognitive changes, such as slower processing and memory deficits. Our perspectives on key elements for successful speech treatment in people with PD continue to evolve with ongoing research – both from our research laboratory and others around the world.

Read the full article HERE.


Click here to watch Bob and Angela

Hear a conversation in which Bob, a person with PD, discusses elements of his journey with LSVT LOUD and how he works to maintain his voice improvements. His LSVT LOUD Certified Clinician, Angela Halpern, is interviewing him.

Visit our website for more LSVT LOUD information

Learn more about LSVT LOUD, who it can help and how it differs from other speech therapy programs.

Click here to view our webinar on The impact of Nonmotor Symptoms in the Successful Delivery of LSVT LOUD® and LSVT BIG®

View this 1 hour On Demand webinar. Webinar summary: People with Parkinson’s disease (PD) can experience non-motor symptoms. These may include changes in cognition, fatigue, and apathy. This webinar will discuss how LSVT LOUD and LSVT BIG address these symptoms during therapy.

Read our LSVT Two Years Later article

To assess long term (24 months) effects of the Lee Silverman voice treatment (LSVT®)