Over 10 million people worldwide live with Parkinson’s Disease, a neurodegenerative disorder that can cause problems with movement, speech, language, thinking skills, voice, and swallowing. When left unaddressed, these challenges can make it difficult to participate actively in social settings and day-to-day life. 

In honor of Parkinson’s Disease Awareness Month, this blog post explores three common concerns expressed by those with Parkinson’s and ways to support cognitive and communication skills for more fulfilling interactions with others. We’ve incorporated exercises from the Constant Therapy app and what Parkinson’s issues they can help address.

Common Parkinson’s Disease concerns: 3 Parkinson’s speech therapy exercises that address them

Concern #1: “Others say I mumble when I talk and it’s hard for them to understand me”

Unclear speech is a frustrating challenge experienced by many with Parkinson’s Disease. A speech-language pathologist can introduce strategies that will help improve speech skills and/or compensate for difficulties. Some strategies may include:

• Speaking slowly
• Exaggerating mouth movements
• Using short phrases
• Using a communication device
• Having conversations in a calm, quiet environment (e.g., turning off TV, radio) 

Additionally, Constant Therapy’s speech recognition software can provide a way to practice speech strategies with feedback on performance. Consider trying cognitive and speech activities that address Parkinson’s, such as Name Pictures, Describe the Picture, and Read Complex Sentences Aloud.

Concern #2: “People say I speak too quietly, but it sounds normal to me”

Individuals with Parkinson’s Disease often experience sensory changes that can influence perception and awareness of volume. For this reason, it is common for those with Parkinson’s to speak quietly and feel as though it is at a normal volume. This can also make it feel like you are shouting when speaking at a conversational volume.

Fortunately, there is an evidence-based therapy program known as Lee Silverman Voice Treatment (LSVT-LOUD) that has been shown to help re-train vocal loudness. Throughout the program, a certified speech-language pathologist will support you through exercises that help safely “re-calibrate” your perception of how loud you sound so that you can comfortably speak at a normal volume. LSVT-LOUD has also been proven to support clear speech, which provides another way to address the “mumbling” concern!

Additionally, when practicing using a louder voice, it can be helpful to use visual feedback. You can download sound level meters (such as NIOSH) on your smartphone to help increase awareness of when you are speaking at a reduced volume. Constant Therapy supports this ability by displaying sound level meters for all speaking tasks. Be sure to check with your doctor and speech-language pathologist to help you learn how to increase your speaking volume safely.

Example of Describe the Picture exercise with sound level meter

Concern #3: “It is hard for me to pay attention and remember information. I find it really difficult to organize myself”

Cognitive changes frequently accompany Parkinson’s Disease. This can involve feeling forgetful, distracted, and/or having trouble staying organized, planning, and making decisions. These same skills are also involved in communication (e.g., following a conversation, remembering what was said) and socializing (e.g., making and following through with plans), highlighting the importance of addressing cognitive difficulties. A speech-language pathologist can suggest ways to support your cognitive skills, such as:

• Creating routines so that it is easier to stay organized and remember tasks
• Using planners, calendars, and smartphone reminders to keep track of important information
• Eliminating distractions whenever possible (e.g., clutter, side conversations, TV)

There are also other ways to practice cognitive skills from home. Constant Therapy provides a range of therapy exercises that address skills such as:

• Memory (e.g., Remember Spoken Word Order, Understand Voicemail)
• Attention (e.g., Find the Same Symbols, Find Alternating Words), and
• Reasoning (e.g., Solve Word Problems, Put Steps in Order). 

Struggling to communicate can bring a range of emotions to the surface. It is frustrating to constantly have to repeat yourself in a conversation, and trouble with speech and cognition can lead to social isolation and loneliness. However, addressing cognitive-communication challenges as they arise can significantly improve independence and quality of life.  In addition to the above resources, consider asking your doctor if speech-language therapy would be a good fit for you. 

Further resources about Parkinson’s Disease:

• Living with Parkinson’s. Parkinson’s Foundation. https://www.parkinson.org/living-with-parkinsons
• Mayo Foundation for Medical Education and Research. (2022, March 24). Parkinson’s disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
• Patients & family. LSVT Global. https://www.lsvtglobal.com/Patients_Family