ASHA provides a description of approaches, techniques, principles, ethics, and delivery of assessment for adults with dysarthria. This resource provides a broad stroke when it comes to assessment of people with Parkinson’s and can be used as a template to focus assessment of dysarthria. As clinicians we are required to use skilled language in documentation and this page can provide a model of appropriate verbiage.
According to the authors, the aim of the Voice Handicap Index (VHI) is to “quantify the psychosocial consequences of voice disorders”. The VHI is a 30-item questionnaire patients fill out before and after completing treatment. Each item is written as a statement about voice disorder’s impact on daily life and the patient identifies if the statements apply to them by using a scale from 0-4 representing a spectrum of responses from “never” to “always”. A printable version is linked below. If you have access to ASHA Wire publications, click the research link below to learn about the background of the VHI.
The Robertson Dysarthria Profile (Revised) provides eight areas of assessment, two of which are questionnaire-based. Use the 5-page scoring form to gather data on the characteristics of your patient’s dysarthria.
Side Note: There are criticisms related to the subjectivity of the scoring system on the RDP; however, taking notes on how you determined the 1-5 score can assist with inter-rater reliability.
Based on the International Classification of Functioning, Disability and Health (ICF), ASHA created a worksheet to guide goal development when assessing people with Parkinson’s disease. The ICF model is structured around four factors: health condition, body functions and structures, activities and participation, and environmental and personal factors. Person-centered goals are provided based on the outlined case study.
Although Parkinson’s disease has been linked with hypokinetic dysarthria, differential diagnosis is important in cases of non-idiopathic Parkinson’s or those who present with comorbidities impacting their speech pattern. The “Check It Out” button links to the presentation by Dr. Paul Blanchet, CCC-SLP, which provides descriptions and characteristics of each type of dysarthria using the ELMS model. The “Differential DX” button links to LocuTour’s differential diagnosis form, which can be completed during an assessment and/or sent to a physician requesting information on your findings.
The SpeechVive is a portable device worn in the ear by the person with Parkinson’s to improve speech and voice patterns using the Lombard Effect. This device was developed by a team out of Purdue University and can be purchased by the person with Parkinson’s or a trained SLP who wants to trial the device with patients. The website also outlines the associated research and provides forms for insurance coverage of the device in some cases. A notable benefit of the SpeechVive is that it requires no cognitive load to use but still yields great results for improving everyday communication.
LSVT LOUD® created by the Lee Silverman Voice Treatment program is designed as a “intensive and high-effort speech treatment for people with Parkinson’s and other neurological conditions”. The LSVT LOUD® protocol requires speech-language pathologist to become trained and certified to provide the 16-session approach that is based on research for improved speech. The primary motto for patients receiving treatment is “Think Loud” and the protocol guides therapists to instruct using increased modeling and decreased verbal instruction. When patients graduate from the program it is recommended they join a LOUD for LIFE® group, a community based class to continue practicing the skills learned in therapy.
Parkinson Voice Project developed a standardized, comprehensive program for individuals diagnosed with Parkinson’s and related movement disorders. SPEAK OUT! is based on principles of motor learning and places high emphasis on maintaining speech and communication skills, despite the progressive nature of Parkinson’s. SPEAK OUT! combines individual therapy with weekly speech and singing groups, daily home practice, and education for patients and their families. Patients complete eight individual treatment sessions where they are trained to “speak with intent,” converting speech from an automatic function to an intentional act. Patients join weekly speech/singing groups toward the end of individual treatment to continue improving their vocal intensity and quality, articulation, and intonation over time. SPEAK OUT! can be delivered in-person or via teletherapy.
