Device May Offer Persons With Parkinson's Realtime Feedback Regarding Voice Use

I am currently trialing several new devices which may offer benefit to persons with voice and speech impairments associated with a medical diagnosis of Parkinson's Disease.

The VocaLog (TM), developed by Griffin Laboratories in California, uses a neck accelerometer to collect data, and it can also be set to beep or vibrate, serving as an external "cue" or reminder to patients that their vocal intensity has fallen below normal loudness levels, or a loudness level set by the therapist.

The monitor collects data for up to three weeks to assist clinicians in identifying vocal patterns, and also assists patients in adhering to their voice and speech therapy program. For persons with Parkinson's, it may help to encourage appropriate voice levels. For others, it may help to maintain voice rest or reduce inappropriate voice use such as excessive loudness.

The device may help researchers and clinicians  identify reasons why  some patients fail to retain voice improvements achieved in the therapy setting once they are at home. For persons with Parkinson's, analyzing several weeks of voice use data may also help physicians and clinicians understand ways medication, stress, and fatigue affect voice use, as well as provide information about the benefits of ongoing external cueing strategies as therapy tools for maintaining healthy voice use.

A "beep" or vibration which reminds a person to speak louder may be a helpful training tool for some or it may be perceived as "annoying" as one of my patients described it.
Additional information about this relatively new device can be found at:
http://www.vocalog.com/

Patient relaxing at home with VocaLog collecting data and providing feedback via vibration.

VocaLog in home station displays data on laptop.

In an upcoming blog, read about a new iPod application for Parkinson's speech.

Voice Problem Creates Case of Mistaken Identity

When speaking on the phone, a 45 year old woman sounds like an old lady in her 90's due to her scratchy and weak voice. A 56 year old preacher sounds timid and uncertain of his words due to reduced volume and mild tremor from Parkinson's disease. A 70 year old, also with voice changes from Parkinson's disease, leaves a phone message, but due to her breathy and soft voice, I struggle to understand, and after reviewing the message 3 and 4 times, the call goes unanswered as I fail to understand her name and phone number.

The voices characterized above, represent patient's voices that I heard for the first time on the  phone last week. Like many people with a voice problem, their voice impression is misleading and easily leads to a case of mistaken identity.

Before most of us meets a stranger face to face for the first time, their voice on the phone, creates our initital image of them. From their voice we often draw conclusions ( right or wrong) about their age, emotional or physical health and their physical persona.

When providing a seminar on voice, I often play a game with the audience, which involves matching voice types with  famous people.Try it for yourself. Look at the list of famous people and match their voice with one of the descriptive words below:

Kathryn Hepburn                                     

George W. Bush                                      

Jacqueline Kennedy                                 

Bill Clinton                                              

Fran Dreschler 

James Earl Jones                                         

sarcastic   authoritative   smooth and friendly   shaky   nasal   breathy/feminine

Does your voice convey the image you want others to hear and see, or do you suffer from a case of mistaken identity?

I often remind my patients: "you are not your disease", but rather a person with: Parkinson's, MS, aphasia, etc. But when any of the symptoms of a disease, such as a weak or impaired voice or slurred speech, become the predominant thing people notice about you, the disease may have begun to steal your identity.

A tape recording of your voice, even a recording on your home answering machine may be a good first step to judging how others hear you. Better yet, have someone video tape you. If your first thought in seeing the video is: "that doesn't even sound/look like me," it's time to take action. It's not too late to do something about it. A visit with a speech-language pathologist or voice therapist may help you identify methods to strengthen your voice and improve the way you sound to others. You might also want to tape the following affirmation on your bathroom mirror:

            "I sound GREAT!"
Say it every time you see it. Say it like you mean it. Say it with a smile. Fake it till you make it!

           

My Mother's Unexpected Stroke Has Brought Unexpected Blessings

On Thursday, February 2, 2012, while in the midst of a tumultuous hospital stay, my mother suffered a stroke. By Sunday, February 5, she was already regaining movement in her right arm and leg, and this quick motor recovery had put most of my family in a celebratory mood. In contrast, however, I stood at her bedside anxious and saddened by the knowledge that her quick motor recovery was a likely indication that the location of her stroke was in the language centers of her brain. My fears were born out in the next few days, as my mom became more awake and aware of her surrounding, but was unable to speak.

As my mother regained normal function in her right arm and leg and had some resolution of her other medical problems, it was evident now to everyone, that  expressive aphasia ( the inability to speak and formulate  language) was to be her most disabling condition. And, while some thought it a blessing that I was a speech-language pathologist, I thought it a cruel irony that my mother should have to suffer an impairment in communication, and put my therapy skills to the test. Although providing speech and language therapy has been the focus of my career for over  30 years, I was not sure I was up for this very personal challenge.

On March 17, 2012, my mother flew with me to my home in Florida to begin several months of further rehabilitation, including speech therapy, with me as her daily therapist. Little did either of us know how special these few months would be.

I have laughed more with my mother over the last two months than I think I have in a life time. Although usually prompted by some misstep in her speech, a funny twist on my dog's name or in the re-telling of a story, it seems to always bring tears of laughter to our eyes.

Post stroke, a gentleness and ease in my mother's personality has emerged which has allowed us to more easily meld into each other's lives. Much in the way I imagine a new mother must incorporate a growing child into her womb, my mother has become embedded into my day to day life. And the subtle accommodations I have had to make in my life's routines somehow seem to be for the better.

My mother's  speech and language has continued to recover, and this recovery is at least in part a testimony to the result of daily drills and speech practice. She practices with audio tapes I have created, the Lingraphica (R),  a speech generating device, and the CHAT (R),  program, a computer assisted home aphasia program. Even she wonders, if the outcome would have been different had she been home alone or in a nursing facility with minimal interaction from others. She is able to make her own phone calls now, and I hear the exclamation of joy on the other end of the phone when her friends, who have not seen her for months, hear her voice again. I have witnessed first hand, what I have always preached to  my patients, and that is the need for daily, at home programs to support the work that is done in speech therapy. While not every person with aphasia has a child who is a speech therapist, most individuals can take advantage of some of the tools and technology that are available for independent, daily practice at home.

My Mom and franki ( therapy dog) practicing speech drills

Happy Mother's Day!