Independent access to efficacious voice treatment (LSVT LOUD) through technology is an essential solution to improving quality of life in individuals with PD. It can alleviate the barrier of inadequate numbers of clinicians, enhance feasibility of the essential intensive dose requirements, while relieving the physical burden of traveling to and from the clinic. LSVT LOUD is ideal for independent software applications as it is a standardized 16 session protocol with well-defined outcome measures. Implementation of our LSVT LOUD treatment software program (the LSVTC) for independent use for approximately 50% (7) of the treatment sessions, has demonstrated treatment outcome data comparable to 16 face-to-face treatment sessions with a clinician. Our next step in overcoming the accessibility bottleneck of a clinician shortage is to move toward a more fully independent treatment delivery model. As we move toward this model, one potential concern is that in the process of learning to improve vocal loudness, clients may exhibit unacceptable voice characteristics that an LSVT expert clinician would """"""""not allow to persist"""""""" in face-to-face treatment. This Phase 1 proposal begins to address this issue by delineating the acoustic and electroglottographic characteristics of voices that LSVT LOUD expert clinicians would """"""""not allow to persist"""""""" in treatment. These Phase l outcome data will be used in Phase II work to develop an algorithm for integration into LSVTC software that will detect unacceptable voice characteristics during client independent use, stop the client from using that unacceptable voice, and subsequently improve voice characteristics through feedback and modeling during independent practice. These Phase I and Phase II advances would be major technological milestones towards a continuum of technology-supported solutions that increase accessibility to efficacious speech treatment for individuals with PD.

Public Health Relevance

Nearly 90% of people with Parkinson disease have speech disorders that negatively affect quality of life as expressed by this patient: """"""""If I have no voice, I have no life."""""""" Today, the first effective speech treatment (LSVT LOUD) is not accessible to the vast majority of patients because there are not enough speech clinicians to deliver it. This proposal will begin to advance a software version of that treatment (LSVT C) that ultimately will allow patients direct access to effective speech treatment and improved quality of life.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
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Special Emphasis Panel (ZRG1-BBBP-T (10))
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Shekim, Lana O
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Lsvt Global, Inc.
United States
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Tsanas, Athanasios; Zañartu, Matías; Little, Max A et al. (2014) Robust fundamental frequency estimation in sustained vowels: detailed algorithmic comparisons and information fusion with adaptive Kalman filtering. J Acoust Soc Am 135:2885-901
Tsanas, Athanasios; Little, Max A; Fox, Cynthia et al. (2014) Objective Automatic Assessment of Rehabilitative Speech Treatment in Parkinson's Disease. IEEE Trans Neural Syst Rehabil Eng 22:181-90