Congratulations! You completed an intensive voice program, such as LSVT LOUD or SPEAK OUT! Your hard work has paid off, and friends and family have noticed improvements in the way you sound, and you find that you don’t have to repeat yourself as frequently. But now what? Are you cured for forever? Unfortunately, the answer is no. It is just like getting into good shape. If you get a personal trainer, learn how to exercise and eat right, you need to continue to do so, even after you stop paying that personal trainer. Otherwise, the pounds will pile back on. Similarly, continued voice practice post-treatment is required for maintenance of skills.
It is crucial that you develop a lifelong habit of continuous practice. The good news is that with continued home exercise, as recommended, research has shown that the positive treatment effects can remain for one to two years. However, in the same way that you check up with your dentist regularly (despite still knowing how to brush your teeth), it is just as important to check in with your speech therapist.
Both the LSVT and SPEAK OUT! programs now recommend following an optimal wellness model (such as the dental model), with recommended check ups at least every 6 months. When you check in with your speech therapist, you may both agree that you are doing well, so give yourself a pat on the back, and no further action is needed. However, sometimes this check-in gives you that extra motivation to keep exercising on your own, or it is decided that you would benefit from some tune-up sessions.
Unfortunately, PD is a degenerative condition, so you will likely need another round of speech therapy at some point, but it is best to get ahead of things and seek intervention before a significant decline is noted. By checking in more frequently, your speech therapist can help you determine when more therapy is indicated. Also note that “tune-ups” are reimbursable by your insurance, so this should not be a barrier to getting the appropriate level and frequency of care. Keep working hard, you got this and we are here to help!
Körner Gustafsson J, Södersten M, Ternström S, Schalling E. Long-term effects of Lee Silverman Voice Treatment on daily voice use in Parkinson's disease as measured with a portable voice accumulator. Logoped Phoniatr Vocol. 2019 Oct;44(3):124-133. doi: 10.1080/14015439.2018.1435718. Epub 2018 Feb 15. PMID: 29447488.
Sapir, S., Ramig, L., Hoyt, P, Countryman, S., O’Brien, C., & Hoehn, M. (2002). Speech loudness and quality 12 months after intensive voice treatment (LSVT) for Parkinson’s disease: A comparison with an alternative speech treatment. Folia Phoniatrica et Logopaedica, 54(6), 296-303. https://doi.org/10.1159/000066148
Watts, C.R. (2016). A Retrospective Study of Long-term Treatment Outcomes for Reduced Vocal Intensity in Hypokinetic Dysarthria. BMC Ear, Nose and Throat Disorders, 16(2). doi:10.1186/s12901-016-0022-8
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