Lee Silverman Voice Treatment (LSVT) Loud

LSVT Loud is a behavioral program designed to create sustained improvement in speech and voice function. It’s an evidence-based treatment that helps patients with speech problems increase their vocal loudness and ability to be understood.

The program trains people to use their voice at a more normal loudness level when speaking, whether they’re at home, at work, or in the community. It focuses on helping people adjust their perception of how loud or softly they’re speaking, so they can feel comfortable using a stronger voice at a louder level.

Who can benefit from LSVT Loud?

LSVT Loud was initially created to address speech issues related to Parkinson’s disease, but it can help others with a range of conditions that cause significant problems with voice, speech, and communication.

People with head injury, stroke, dementia, and neurological conditions such as multiple sclerosis and Huntington’s disease are also candidates for this therapy to help them control their voice.

What can LSVT Loud improve?

The technique aims to improve volume, articulation, intonation and confidence when speaking. It doesn’t simply teach people to shout, it recalibrates the feedback mismatch between the muscles and brain to help develop a voice that’s comfortable to use and easier to understand.

LSVT can also aid swallowing, improve facial expressions, and stimulate changes in how the brain processes speech.

How does LSVT Loud work?

Many people with low vocal volume have a misperception of how loud they’re being, and put less effort into vocalizing. As a result, their speech becomes quite difficult to understand.

LSVT Loud reframes motor learning (how they physically form speech) and recalibrate sensory feedback (how they perceive their speech), so patients can feel that their ‘louder’ voice is actually in normal vocal range.

The treatment is built on exercises that strengthen the voice box and speech system and redefine neurological paths from the brain to the muscles in the throat.

This kind of learning is intensive, and requires continued practice, self-monitoring, and reinforcement from others to sustain lasting change.

LSVT is conducted over 16 – one hour sessions. To maintain good progress during the treatment, these sessions are delivered 4 times per week, for 4 weeks in a row. There are also 10-15 minute carryover exercises, twice daily, to be done at home.

LSVT Loud is built using three key principles:

TARGET: Vocal loudness

Using evidence-based strategies that help the brain to learn, modify, adapt and change in both structure and function.

MODE: Intensive effort

Research strongly suggests 4 that short bursts of intensive cognitive and skills-based training is most helpful for bringing about lasting change. That’s why the LSVT Loud method is delivered rapidly and includes exercises to do at home too.

CALIBRATION: Generalization
‘Recalibrating’ sensory feedback so people recognize that their new, louder voices are within normal limits. The aim is for people to feel comfortable with their voice, and more confident when speaking to others in different environments.

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