When we think about speech treatment for children with cerebral palsy (CP), familiar challenges often come to mind: reduced loudness, imprecise articulation, monotone pitch and communication breakdowns that limit their real-world participation. Many of us have also felt the frustration of seeing progress in the therapy room that doesn’t always carry over to daily life.
Traditional speech therapy approaches (i.e., articulation drills, compensatory strategies, pacing techniques) absolutely have value. But for some with CP, they don’t go far enough. Gains can be slow, effortful, and hard to generalize beyond the clinic.
That’s where LSVT LOUD® offers hope. Originally developed for individuals with Parkinson’s disease, this intensive, neuroplasticity-driven voice treatment is increasingly being applied with children with CP. And no, it’s not just about “talking louder.” LSVT LOUD targets the vocal system in a way that supports clearer, more functional communication, often leading to changes that extend well beyond volume alone.
Why Traditional Approaches May Fall Short
Traditional speech intervention for CP frequently targets individual subsystems in isolation, progressing hierarchically from sounds to words to connected speech. Therapy is often delivered infrequently with sessions lasting 30–45 minutes once or twice per week.
While this approach is systematic and has value, it may not provide the intensity or repetition required to drive meaningful neuroplastic change. Building new motor speech patterns takes more than occasional practice, it requires sustained, high-effort input over time.
This challenge is amplified for clients with co-occurring cognitive or language needs, where managing multiple goals and cues can increase cognitive load and limit learning. As a result, progress may plateau, and gains made in therapy may not generalize to everyday communication.
When treatment targets isolated speech components, it addresses only part of the puzzle, leaving families hoping for changes that truly impact everyday communication
Why LSVT LOUD Can Work for CP
Though CP and Parkinson disease are very different, many speech characteristics in CP (e.g. reduced loudness, imprecise articulation, monotone pitch, abnormal resonance) can benefit from increased motor drive and effort.
LSVT LOUD is especially suited when:
- Speech is too quiet to be understood: Many clients with CP struggle to project their voice, making participation in conversations, classrooms, or social interactions challenging. LSVT LOUD directly targets vocal intensity, helping clients speak louder in a safe, controlled, and consistent way. High-effort vocalization strengthens the voice, improves clarity, and boosts confidence in everyday communication.
- Cognitive demands should be minimal: The protocol relies on the single, consistent cue “LOUD,” which keeps therapy simple and focused. This is ideal for clients who may have cognitive, attentional, or language challenges, allowing them to concentrate on one primary goal without being overwhelmed by multiple instructions or techniques. The straightforward approach makes it easier to internalize the strategy and maintain effort throughout therapy sessions.
- Clients who struggle to generalize gains to home, school, or social settings: Some traditional approaches focus mainly on drills or isolated skills, which can make it hard for clients to apply improvements outside the clinic. LSVT LOUD emphasizes real-world carryover from the very first session, with exercises designed to transfer gains into everyday communication, whether talking with peers, participating in class, or engaging in family conversations. This focus ensures therapy has an immediate and meaningful impact on daily life.
For clients who haven’t responded to traditional approaches, LSVT LOUD provides a different and promising path.
Practical Advantages for Clinicians Working with CP
LSVT LOUD isn’t just effective for clients, it’s also designed to support clinicians. The program offers:
- Structured, standardized training and certification: Clinicians receive step-by-step guidance on implementing the protocol, ensuring consistency and confidence in treatment delivery.
- Access to online resources and mentoring: Ongoing support, instructional videos, and professional guidance make it easier to integrate LSVT LOUD into practice, even for new users.
- Intensive practice aligned with neuroplasticity principles: The therapy’s high-dose, repetitive approach leverages neuroplasticity, helping clients build stronger, more sustainable vocal and motor patterns.
- A practical, clinic-friendly delivery model: Therapy is provided in individual 60-minute sessions. Although the intensity requires scheduling flexibility, LSVT LOUD fits within most clinical environments without the need for specialized facilities or group-based programs.
- Clear focus on measurable outcomes: The protocol includes objective and functional measures, helping clinicians track progress, demonstrate results to families, and adjust therapy as needed.
Together, these features make LSVT LOUD a practical, evidence-informed option for SLPs looking to do things differently, and more effectively, with individuals with CP.
A Fresh Mindset for Clinicians
LSVT LOUD invites clinicians to think bigger about what speech therapy can achieve. It emphasizes maximizing a client’s own communication potential rather than relying solely on compensatory strategies.
Ask yourself: could your clients benefit from therapy that targets voice and vocal control intensively, not just articulation drills?
From Theory to Practice
So… does LSVT LOUD actually work outside the research lab? Yes, it does.
A recent clinical report by Fortin et al. (2023), published in the Canadian Journal of Speech-Language Pathology and Audiology, shows what LSVT LOUD can look like in real-life practice. Two very different clients with cerebral palsy, a preschool child and an adolescent, received treatment from certified clinicians in everyday clinical settings. And the results were hard to ignore. Both clients showed clear improvements in vocal loudness, speech intelligibility, and overall communicative participation.
👉 In Part 2, we’ll explore these cases in more detail, highlighting the observed changes and practical takeaways for SLPs working with individuals with CP.
Reference:
Fortin, A. J., Hamel, A., Asselin-Giguère, F., Poulin, S., & McFarland, D. H. (2023). Report on the impact of LSVT LOUD in improving communication of a preschool child and a young adult with cerebral palsy. Canadian Journal of Speech-LanguagePathology and Audiology, 47(2), 125–140. https://cjslpa.ca/detail.php?ID=1329&lang=en
AI (ChatGPT) was used to assist in the creation of this blog. All content was reviewed, edited, and approved by human author(s).