Innovative technology for the assisted delivery of intensive voice treatment (LSVT®LOUD) for Parkinson disease.

PURPOSE: To assess the feasibility and effectiveness of a newly developed assistive technology system, Lee Silverman Voice Treatment Companion (LSVT(®) Companion™, hereafter referred to as "Companion"), to support the delivery of LSVT(®)LOUD, an efficacious speech intervention for individuals with Parkinson disease (PD). METHOD: Sixteen individuals with PD were randomized to an immediate (n = 8) or a delayed (n = 8) treatment group. They participated in 9 LSVT LOUD sessions and 7 Companion sessions, independently administered at home. Acoustic, listener perception, and voice and speech rating data were obtained immediately before (pre), immediately after (post), and at 6 months post treatment (follow-up). System usability ratings were collected immediately post treatment. Changes in vocal sound pressure level were compared to data from a historical treatment group of individuals with PD treated with standard, in-person LSVT LOUD. RESULTS: All 16 participants were able to independently use the Companion. These individuals had therapeutic gains in sound pressure level, pre to post and pre to follow-up, similar to those of the historical treatment group. CONCLUSIONS: This study supports the use of the Companion as an aid in treatment of hypokinetic dysarthria in individuals with PD. Advantages and disadvantages of the Companion, as well as limitations of the present study and directions for future studies, are discussed.

Impact of four nonclinical speaking environments on a child's fundamental frequency and voice level: a preliminary case study.

PURPOSE: The aim of this study was to investigate how a child's fundamental frequency (F(0)) and estimated voice level (dB SPL) change in distinct speaking environments. METHOD: A child age 5;7 (years;months) wore a National Center for Voice and Speech voice dosimeter for 4 days. The 2 parameters measured were F(0) and dB SPL. During analysis, the F(0) and dB SPL data were segmented to represent 4 typical speaking environments of school-age children: (a) free-play (2.5 hr), (b) preschool (3 hr), (c) home (10.7 hr), and (d) adult (5.6 hr). Unique to this study, the child's voice data were presented as voice use profiles. RESULTS: The child's F(0) and dB SPL patterns within an adult environment were similar to that found in the literature but showed much greater variation in the free-play environment. The preschool environment elicited speech of a lower modal F(0) than did the home, but a higher median and mean F(0), as well as a somewhat elevated mean dB SPL. CONCLUSION: The child produced significantly different F(0) and dB SPL patterns across 4 different speaking environments. If future studies substantiate this pattern, clinicians and researchers must be aware of this difference when working with children.

The inability to produce soft voice (IPSV): a tool to detect vocal change in school-teachers.

PURPOSE: This study investigated whether clinicians could detect voice changes reported by teachers, from self-ratings teachers conducted of their inability to produce soft voice (IPSV). METHODS: Ten teachers wore a vocal dosimeter and completed daily IPSV ratings approximately every 2 hours for 14 days. Following the 2 weeks of dosimetry, two speech clinicians specialized in voice rated the teachers' IPSV from dosimeter recordings. Teacher and clinician ratings were compared for each participant. RESULTS: Although agreement between teacher and clinician ratings was not significant, descriptive analyses demonstrated an average difference score of 1.7 (SD 1.4) between teacher and clinician ratings. CONCLUSIONS: This study supports the potential usefulness of the IPSV as a simple tool to detect voice changes in oneself or others.