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Sensory Recalibration for Improving Speech in Parkinson’s Disease

presented by Cynthia M. Fox, PhD, CCC-SLP

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Disclosure Statement:

This course was developed in conjunction with LSVT Global, Inc. LSVT Global, Inc receives compensation from MedBridge for this course.

The LSVT LOUD was developed and patented as a licensed technology trademarked as the LSVT LOUD®. Because there are no other similar products available, this course will only cover information that pertains to the effective and safe use of the above-named product(s).

This presentation will focus exclusively on and will not include information other similar or related products.

Financial: Cynthia Fox is an employee and Cofounder of LSVT Global, Inc. She received a lecture honorarium from LSVT Global, Inc. and has financial interest in the company. There is no financial interest beyond the production of this course.

Non-Financial: Cynthia Fox has preference for the LSVT protocols as treatment techniques, which will be discussed as a part of this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 67 Minutes; Learning Assessment Time: 32 Minutes

The underlying mechanism of speech disorders in Parkinson's disease (PD) has traditionally been linked to the motor signs of rigidity and hypokinesia/bradykinesia. However, abnormalities of the sensory system, including difficulties self-monitoring normal vocal loudness, have come to light as important contributors to the voice and speech difficulties of people with PD. Understanding these central sensory processing deficits may facilitate improved understanding of successful speech treatment and improved functional communication for people with PD. This course will discuss motor and nonmotor disorders that impact voice, speech, and communication in people with PD, with a focus on sensory deficits. Barriers that make generalization of speech treatment improvements for people with PD outside of the treatment room challenging will be explored. The course will explain the four key components of the speech treatment Lee Silverman Voice Treatment (LSVT LOUD) that specifically address the sensory disorder in people with PD. Finally, the course will discuss behavioral and neural correlates (from PET and fMRI imaging studies) of treatment-related changes in sensory recalibration post LSVT LOUD.

Meet Your Instructor

Cynthia M. Fox, PhD, CCC-SLP

Cynthia Fox, PhD, CCC-SLP, received her doctorate degree in speech and hearing sciences from the University of Arizona, Tucson. Her training focused in the areas of neuroscience and motor control. She is an expert on rehabilitation, neuroplasticity, and the role of exercise in the improvement of function consequent to neural injury and disease. She has…

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Chapters & Learning Objectives

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1. Motor and Nonmotor Disorders in Parkinson’s Disease

This chapter will introduce Parkinson’s disease prevalence and the impact of PD on voice, speech, and communication. Motor and nonmotor symptoms that occur in people with PD will be defined. This will be followed by a description of how these motor and nonmotor disorders impact voice, speech, and communication.

2. Is the Speech Disorder in Parkinson’s Disease a Sensory Disorder?

Behavioral and neural evidence for the sensory disorder related to speech in PD will be summarized. The clinical manifestation of the sensory speech disorder in people with PD will be described. Finally, the hypothesized origins of the sensory speech disorder in people with PD will be explained.

3. How Can We Treat the Sensory Disorder for Speech in Parkinson’s Disease?

A brief overview of Lee Silverman Voice Treatment (LSVT LOUD) will be provided as an example treatment protocol that directly addresses the sensory disorder affecting speech in people with PD. The barriers to generalization of treatment effects outside of the speech treatment room will be discussed. The concept of calibration in LSVT LOUD will be defined.

4. How Can We Treat the Sensory Disorder for Speech in Parkinson’s Disease?: Expert Interview

This chapter gives examples of the four areas of LSVT LOUD treatment that address the sensory speech disorder in PD. The chapter explores the challenges sensory disorders related to speech pose for people with PD. This information will be presented through an expert interview with Angela Halpern, LSVT LOUD expert clinician and chief clinical officer of LSVT LOUD.

5. What Is the Evidence for Sensory Recalibration Following LSVT LOUD?

Today there is evidence from both behavioral and neural outcomes post LSVT LOUD that provides insights into the nature of the speech disorder in PD and how to successfully treat it. This chapter will highlight these data, including three imaging studies. The importance of recognizing and treating the sensory component of speech disorder in Parkinson’s will be summarized.

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