LSVT LOUD (Lee Silverman Voice
Treatment) is a treatment approach that was originally developed for people
with Parkinson’s disease to raise their voice and be heard more clearly. Cynthia
Fox and Carol Boliek took this intensive voice treatment approach as a starting
point to work on the breathing and phonation patterns in children with CP. Improving
breathing for speech is important as is lays the foundation to work on other
speech subsystems such as articulation.
Four children with dysarthria due
to spastic CP were recruited for the therapy study. The children had 16 therapy
sessions overall (4 sessions a week for 4 consecutive days), and were given
exercises to practice at home. Improvement in vocal functioning was measured
using a combination of perceptual evaluation and acoustic measures. Seven
speech and language therapists were asked to listen to speech samples recorded
prior to therapy, directly after therapy and six weeks after the end of the
treatment, and to judge which one they preferred.
Results were somewhat mixed.
Although the therapists judged that the speech of the children - for features
such as loudness and voice quality - improved directly after the intensive
treatment, the improvement could not be maintained. In addition, acoustic measures
taken prior to and after therapy did not suggest significant improvement in the
children’s voices.
At the same time though, parents reported
that after the treatment their children spoke with less effort and their voices
sounded less strangled. This raises the question whether the perceptual and acoustic
measures employed in this study were simply not suited to capture the actual improvements
in the children’s voices. This observation leaves us with two questions: 1.)
How can we best measure decreased effort? And 2.) What exactly is the basis of
listener perception?
Any ideas?
Fox, C. M. & Boliek, C. A. (2012). Intensive Voice Treatment (LSVT LOUD) for
Children with Spastic Cerebral Palsy and dysarthria. Journal of Speech, Language, and Hearing Research, 55, 930-945.
