January 13, 2016 | Erin Bluvas, bluvase@sc.edu 

The Arnold School of Public Health’s USC Speech and Hearing Research Center provides treatment for both common (e.g., speech delay, articulation challenge) and low-incidence (e.g., selective mutism, stuttering) communication disorders. However many primary conditions can have an impact on speech as a side effect as well.

It is well known, for example, that Parkinson’s affects walking and writing. By causing neurons in the movement centers of the brain to die, this progressive neurological disease causes a decrease in all motor movements. When this happens, walking becomes a series of very small steps, and writing gets smaller and smaller.

“While many people are aware of walking and writing difficulties, problems with speech are another challenge affecting most people with Parkinson’s,” says Senior Clinical Instructor Sarah Scarborough. Speech symptoms can include decreased volume, monotone speech, stuttering, increased hoarseness, and mumbling toward the end of sentences. “There are improvements to speech from medication and some types of surgeries but just not as much as for walking,” she says.

But progressive treatment centers, such as the USC Speech and Hearing Research Center, which is located within the Department of Communication Sciences and Disorders (COMD), have had success with an approach known as Lee Silverman Voice Treatment. Developed in 1985, clinicians began using the series of exercises included in the treatment.

This intensive exercise program consists of four one-hour treatments on four consecutive days a week for four weeks. The goals of speech therapy are to increase intensity (i.e., loudness) of speech to recover a clear high quality voice. By concentrating on intensity, the patient will also increase the size of their breaths, improve their articulation and reduce the rate of their speech.

Scarborough has worked with patients who have Parkinson’s since before the program was developed and has seen the evolution of its integration into standard treatment protocols—at least at more innovative clinical sites. “Before Lee Silverman Voice Treatment, the medical community was skeptical of the benefits of speech therapy for people with Parkinson’s,” she says. And with good reason. “The traditional therapy addressing speech intelligibility was hampered by the various factors affecting speech in persons with Parkinson’s, such as rate of speech and loudness,” Scarborough explains. “But this therapy addresses these issues and has helped persons with Parkinson’s greatly increase their speech clarity.”

As a Lee Silverman Voice Therapy certified speech language pathologist, Scarborough and other Center clinicians have been providing this unique, but effective, therapy with great success at the USC Speech and Hearing Research Center since 2003. “The treatment has resulted in improved intelligibility for almost every person with Parkinson’s by the end of the four weeks of treatment,” she says. “This improvement has been maintained for each patient when we complete a re-evaluation six months following the end of therapy.” Scarborough also teaches the program to her students (COMD 772) so that they can apply their hands-on experience with this therapy from her class to their clinical practices after they graduate.

Because the Center is entrenched within the COMD department, it always benefits from being informed by the latest research in the field, with the researchers sharing office space and often seeing patients as well. For example, Roozbeh Behroozmand joined the department in 2014, and his research examines the neural basis of speech disorders, including persons with Parkinson’s.

In his Speech Neuroscience Lab, Behroozmand utilizes a variety of techniques to measure and track changes in brain activity that are associated with speech impairment with Parkinson’s disease. Together, Behroozmand and Scarborough are working to develop other treatments for Parkinson’s disease which could augment exercise programs like Lee Silverman Voice Therapy and perhaps assist with new medical treatments for this disorder.