Understanding LSVT Therapy: A Comprehensive Guide to Voice Treatment

The Lee Silverman Voice Treatment is a specialized program designed to address loudness and articulation in patients with Parkinson’s or other neurological conditions. Developed by Dr. Lorraine Raming, LSVT is an intensive treatment routine with structured exercises and activities. Research on the LSVT reported that the program is highly effective for its targeted audience: individuals with Parkinson’s and other neurological conditions in the area of their articulation and loudness.

What is LSVT LOUD Therapy?

The LSVT LOUD Program focuses on vocal loudness and speech intelligibility, targeting motor planning to improve communication and naturalness. It is typically conducted by a licensed speech-language pathologist.

What is LSVT BIG Therapy?

The LSVT BIG Program focuses on motor planning and amplitude of movements throughout daily activities. It is typically conducted by a licensed occupational therapist or physical therapist.

LSVT LOUD vs LSVT BIG

The differences between the LOUD and BIG programs are that they both target different deficits commonly found in neurological conditions like Parkinson’s. The LOUD Program addresses voice and intelligibility, while the BIG Program addresses whole body movement and amplitude. They are conducted separately by SLPs (for LOUD) and OT/PTs (for BIG.) The benefits of both programs have ample research, and the effectiveness of each program depends on your or your loved one’s personal needs with their condition. For today's post, we will focus primarily on LSVT LOUD.

How LSVT Therapy Works

LSVT LOUD requires a 4-week period of 16 one-on-one sessions. The sessions are considered intensive as they entail structured activities, homework, and daily practice with a care team.

Benefits of LSVT Therapy

LSVT LOUD shows improvements in vocal loudness, enhances speech clarity, provides better overall communication, and can lead to increased confidence in social situations.

Who Can Benefit from LSVT?

LSVT LOUD has been researched to be the most effective with patients with Parkinson’s disease. LSVT focuses on activities and skills that address specific symptoms or deficits found in PD. These can include dysarthria, a motor speech disorder that affects voice and articulation through muscle weakness or paralysis.

The LSVT Treatment Process

Here are the steps of the LSVT LOUD treatment program

• Initial assessment - An initial assessment is conducted to determine baselines (starting points) of the patient’s speech and voice capabilities. These include the use of standardized assessments, informal functional tasks, and case history/client interviews.
• Treatment planning - The purpose of LSVT is to increase vocal loudness and address intelligible speech. Goals are personalized and centered around exercises and techniques that address these specific areas.
• Therapy sessions -Session activities are structured, repetitive, and intensive to allow for data-driven results. It can include vocal function exercises, structured repetition, and feedback from the SLP.
• Progress monitoring - The SLP will work with you to provide you with an efficient and data-driven analysis of your progress. This can allow you to adjust your goals and provide feedback on homework assignments.
• Home practice - The SLP will work with you and your care team to set up successful generalization opportunities for you to practice your skills outside of therapy. This can include audio records of yourself, voice exercises at a specific time of day, and utilizing skills in everyday routines.
• Follow-up care - After the 16 sessions, follow-up can be anywhere from 3- 6 months to monitor progress or address newer concerns. It is vital to work with your SLP to find a long-term plan that you can adhere to for maximal results.

Finding the Right LSVT Provider

For the LSVT LOUD Program, you must work with a certified clinician. This means that the SLP has undergone additional rigorous training to specifically address your needs with this methodology. Look for clinicians who offer your preferred method of therapy: virtual, in-home, or office. Ask questions about the SLP’s method of treatment, what exercises they use, and what activities are utilized. This can help you and your family make an effective choice in partnering with the right SLP.

Supporting Your LSVT Journey

LSVT LOUD is a program that requires intensive commitment to improve your voice and speech. Open and honest communication is the key when needing to adjust goals or recommendations. Your SLP might recommend daily exercises in the bathroom mirror or may give you a visual to remind you of your loudness when picking up coffee. The journey you take when you start LSVT is one you do not have to take alone; your SLP is here to support you, your family, your friends, and your care team are all people who can help you achieve long-term success with this evidence-based approach.