Belting out favorite movie tunes while tooling around town in the car is fun for most, but for Wayne Case, it’s homework.

Wayne’s “homework” was assigned by Kelly Smith, MA, CCC-LP, Speech Language Pathologist at Yavapai Regional Medical Center (YRMC), as part of a Parkinson’s speech therapy initiative called the Lee Silverman Voice Treatment (LSVT) program. Designed for people whose voices have been affected by Parkinson’s disease and related disorders, LSVT has allowed Wayne to re-gain his voice.

Speech Language Pathologists: Giving Voices Back

What does LSVT do? It teaches people with Parkinson’s disease how to:

  • Raise their voices to audible levels
  • Speak clearly
  • Vary the pitch of their voices


“We had noticed Wayne’s voice was becoming much quieter and monotone,” said Kathy Jensen, Wayne’s spouse. “It was definitely getting more difficult to hear him.”

Since LSVT training, Wayne and Kathy are singing from a playlist that includes music from “The King and I” and “The Sound of Music.”

“My favorite song to sing is ‘The Hills are Alive,’ from the ‘Sound of Music,’” said Wayne.

LSVT was inspired by its namesake, Lee Silverman, a woman living with Parkinson’s disease. It was developed by a team of speech language pathologists and a physician in the 1980s. LSVT is “evidence-based medicine” as it has been scientifically proven to be effective by the National Institutes of Health.

LSVT involves training people with Parkinson’s disease to use their voices at a more normal loudness level while speaking at home, work or in the community. Key to the treatment is helping people adjust their perceptions so they know how loud or soft they sound to others. This helps people with Parkinson’s disease feel comfortable using a stronger voice at a normal loudness level.

“People with Parkinson’s disease cannot always perceive if their voices are loud or soft,” said Lorrie Nebrig, MA, CCC-LP, Speech Language Pathologist at YRMC. “We help them re-calibrate their listening so they learn how to use their new loud voices.”

Combining Therapy and Technology

Parkinson’s patients work with one of YRMC’s three LSVT accredited speech language pathologists. During the intense program, the patient and speech language pathologist meet four days a week for a month. The 45-minute sessions include “high effort” vocal function exercises – sustaining a strong “ahh” for approximately 15 seconds over and over – to strengthen the muscles involved in vocal loudness. They also use vocal exercises focused on pitch. These exercises help people with Parkinson’s disease learn how to alternate the pitch of their voices so they don’t sound monotone.

“There was lots of practicing of ‘ahhs,’” said Wayne. “You have to work to get it louder and more forceful.”

“And lots of repetition,” added Kathy.

YRMC uses a software program that gives patients visual feedback as they practice their vocals and pitch.

Learning to Speak with Confidence

“We also focus on functional speaking,” said Jill Wingard, MA, CCC-LP, Speech Language Pathologist at YRMC. “This helps build confidence about speaking at home, in social situations outside of the home and at work.”

Kathy recalls that Wayne’s LSVT also included answering questions about his favorite topics – growing up on a Kansas farm, studying business and law at the University of Kansas, and vacationing in Italy – to measure the level of his speaking voice.

At home today, Wayne reads out loud from books and measures his volume with an app on his tablet. He uses the same app to check his “ahhs” and vocal variations.

In fact, LSVT has given Wayne the confidence to meet friends for coffee and conversation.

Think you could benefit from the help of a YRMC speech language pathologist? Talk to your physician or contact YRMC’s Physical Rehabilitation Services at:

YRMC Wellness Center
Prescott, Arizona 
(928) 771-5131

YRMC Del E. Webb Outpatient Center
Prescott Valley, Arizona 
(928) 759-5940