Reclaiming the voice by speaking with intent

The sounds of “may-me-my-mo-moo” thunder through a room in UB’s Biomedical Education Building on a recent Wednesday afternoon. Following that comes the fierce projection of a piercing “ah” sound.

Luckily, no one is hurt; these roaring shouts are coming from individuals with Parkinson’s disease who are patients of the UB Speech-Language and Hearing Clinic’s newest program, The LOUD Crowd®. These vocal warmups are helping these men from losing their voice to the degenerative condition.

Headed by Dona Hue Ritter-Schmidt, speech-language pathologist and clinical associate professor in the Department of Communicative Disorders and Sciences, The LOUD Crowd® is the second part of a speech therapy program offered by the clinic that helps Parkinson’s patients regain and maintain effective communication. The purpose of The LOUD Crowd® is to maintain the progress patients make through the SPEAK OUT!® program, which focuses on regaining the strength of the patient’s voice.

The programs are made possible through the teachings of the late Daniel Boone, a world-renowned speech-language pathologist and voice expert, and through a grant from the Parkinson Voice Project, a non-profit organization founded by CEO Samantha Elendary that is dedicated to preserving the voices of individuals with Parkinson’s and other neurological disorders through speech therapy. Boone found that restoring and maintaining the voices of Parkinson’s patients was most effective when emphasis was placed on converting speech from an automatic, extrapyramidal function to an intentional, pyramidal function.

“With Parkinson’s patients, they have a lack of, or a significant reduction in dopamine — which helps neurons to send messages to other neurons for movement,” says Ritter-Schmidt. “When somebody speaks purposefully, they use the pyramidal system. That system uses a more direct route and bypasses a lot of the areas that depend on dopamine. (These patients are now able) to execute movements stronger and more powerfully.

“We used to work with patients in slowing the rate of speech, being more precise and improving the loudness, but what we also know in Parkinson’s is that patients can concentrate better on one thing. By speaking with intent, the message travels directly down to the areas that are producing the movement, and they get a better bang for their buck in terms of speaking.”

The SPEAK OUT!® & LOUD Crowd® grant from Parkinson Voice Project was awarded to nearly 100 universities, clinics and hospitals throughout the country. The UB Speech-Language and Hearing Clinic is the only provider of The LOUD Crowd® program in Western New York.

The grant funded Ritter-Schmidt’s travel to a training symposium organized by the Parkinson Voice Project, as well as provided 12 LOUD Crowd® workbooks so she could administer the programs.

Ritter-Schmidt explains that one of the most significant aspects of the grant is that UB will now be a vital resource in expanding the program, with the clinic helping to train and establish SPEAK OUT!® and LOUD Crowd® programs in other area hospitals and clinics. Graduate students in the Department of Communicative Disorders and Sciences are also getting firsthand training in the program, further expanding its reach for the future.

Most importantly, The LOUD Crowd® is producing results that weren’t being achieved in the past.

“I can’t say enough about this program,” Ritter-Schmidt says. “For me professionally — and I’ve been at the university for 45 years — this is really, really great to see.

“I used to provide ‘LSVT’(Lee Silverman Voice Therapy) therapy, but the focus of that is to speak loudly. The focus of this is speak with intent and the volume comes from that. We found that people could hit the target and go through the program, but then there was very little carry over,” she notes. “It’s amazing where they have come from, where their voices are low and trailing off, to what they’re doing now (with The LOUD Crowd®).”

Many of the patients of The LOUD Crowd® have been with the Speech-Language and Hearing Clinic for more than five years and can attest to that improvement.

“This program is so much more successful than the last one,” says Chris Hipp, a patient in the program. “You can see it in the behavior in people and their body language; it just works.”

“I’ve noticed from people who’ve been here that their voice gets stronger and that’s pretty neat,” says Paul Markwart.

“It’s ultimately good for us, but great for UB. It’s a neat symbiosis and the objective has always been to speak loudly and to project. This class has been a further defining of speaking with intent,” Markwart says. “If you are reading a story and just reading it loudly, it wouldn’t have any life to it, but if you are doing it with intent, the sounds of the story vary in texture and what you hear.”

Not only have the patients seen a significant change in their lives because of the way they communicate, but they’re establishing friendships with people who are going through similar challenges. Bill Marx and Jim Eagan talk about the camaraderie they feel in the group, as everyone is doing things together outside of the clinic. Marx says that he’s proudly become “the group’s Uber driver,” while Eagan says he’s so much more outgoing because of the program.

“Sometimes people with Parkinson’s tend to withdraw a little bit,” says Eagan. “For me, I was always a little quiet and shy, but this has allowed me to come out of my shell a little bit. Now I’m more outgoing.”

“This group of guys is so terrific because they’re kind of like a little fraternity,” says Ritter-Schmidt. “A lot of them are involved in boxing, dance and yoga. They take advantage of a lot of what’s out there for Parkinson’s patients.”

For these patients, The LOUD Crowd® has been a rousing success, and for people like Marx, the enjoyment he’s getting from the program is giving him a much more positive outlook.

“Parkinson’s is a debilitating disease, but I don’t look at it as a disease; I have an inconvenience,” he says.

For more information about the SPEAK OUT!® and LOUD Crowd® programs, visit the programs’ UB website.