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August 28, 2023

Improving Monotone Speech in Parkinson’s Disease

flat monotone robotic speech Parkinson's disease, flat affect, theater and improvisation benefits for Parkinson's disease

Monotone Speech in Parkinson’s Disease

In this blog post, we’ll delve into how and why monotone speech happens in Parkinson’s disease and explore ways to regain your vocal melody.

Picture this: You’re at a family gathering, eager to catch up and share stories with your loved ones. You’ve got much to say but when you start speaking, others note that your voice sounds monotone and robotic. It’s not because you’re disinterested or lacking enthusiasm; it’s a common challenge faced by many living with Parkinson’s disease.

What Causes Monotone Speech in Parkinson’s Disease?

To understand why speech becomes altered in Parkinson’s disease, let’s first explore the underlying mechanisms. Parkinson’s is characterized by a deficiency in dopamine, a neurotransmitter responsible for regulating various bodily functions, including movement. This deficiency leads to a perceptual issue – individuals with Parkinson’s become less aware that their movements are smaller than normal. This lack of awareness extends to their speech.

Parkinson’s: The Disease of Low Amplitude

When we think about Parkinson’s, we often associate it with smaller steps or reduced arm swing. However, the “low amplitude” feature of this condition also affects communication in multiple ways:

Smaller Articulation Movements: People with Parkinson’s may find it challenging to articulate words clearly, resulting in less clear speech.

Smaller Vocal Projection: A quieter voice can make communication difficult, especially in noisy environments or when talking to someone at a distance.

Smaller Prosody and Melody: Parkinson’s can lead to a reduction in the natural ups and downs of speech, resulting in a flat, robotic monotone speech pattern.

Smaller Facial Expression: Referred to as facial masking, this symptom of Parkinson’s can result in the reduced ability to show animation in the face.

The Communication Challenge:

These changes in speech can lead to communication breakdowns. Others may mistakenly assume that someone with monotone speech is disinterested in the conversation or lacking emotional engagement, which couldn’t be further from the truth. The issue lies in both the physical challenges of producing speech as well as the reduced awareness of speech and voice changes, not in the person’s desire to communicate.

Correcting Monotone Speech: Go Big!

As with any aspect of Parkinson’s management, the key to addressing communication challenges like monotone speech is to make every movement and effort bigger and more exaggerated. Parkinson-specific speech therapy offers valuable strategies:

Be Louder: While it may feel uncomfortable or even unnatural, intentionally speaking slightly louder than feels necessary can enhance your communication. This not only helps others hear you better but also conveys your enthusiasm and engagement.

Be More Intentional: Focus on each word and syllable, articulating them with precision. This deliberate effort engages the non-automatic pathway in the brain (which does NOT pass through the dopamine deficient basal ganglia) and can improve both the clarity and loudness of your speech.

Embrace Exaggerated Melody: Instead of suppressing your natural prosody and melody, let them shine. Speak with exaggerated enthusiasm and variation, infusing your voice with emotion and expression.

TIP: Theater and improv themed activities are excellent for those with Parkinson’s disease as they encourage dramatic and exaggerated voicing, speech patterns, facial expressions and gestures. Try one of our signature ROLE PLAY classes taught by the talented speech pathologist and stage actor Olivia.

The Science Behind the Change:

Remarkably, research suggests that regular and intense Parkinson-specific voicing exercises can induce changes in the motor cortex of the brain. These changes have a cascading effect, leading to improvements in other aspects of speech, such as intonation and facial expression. By engaging in these exercises, you can actively work toward regaining the musicality in your voice.

While Parkinson’s disease may present challenges to your speech, it’s important to remember that these changes don’t reflect your true emotions or engagement in conversations. By embracing Parkinson-specific speech exercises and making your efforts bigger and more exaggerated, you can break free from the constraints of a flat and robotic voice. Rediscover the music in your voice and continue to share your stories, thoughts, and emotions with the world – louder, clearer, and more melodious than ever before.

Get LOUD! Stay LOUD!
Let our expert team of speech therapists guide you EVERY DAY through your Parkinson's speech exercises. Our diverse and comprehensive approach ensures that you not only stay motivated and diligent but that you HAVE FUN!

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