Tools for speech therapists working with Parkinson’s disease & other neurological diseases

1. Technologies
for the clinic and beyond:
Tools for speech therapists working with Parkinson’s disease
& other neurological diseases
John M Dean | MA, CCC-SLP

2. NO validated apps for PD
Recent Search on Pubmed
Mobile OR app* AND Speech OR Voice OR Dysarthria
•57 hits
• AND Parkinson*
•0! hits
•Mobile OR app* AND Parkinson*
•100’s of results, none for speech…
What do we know so far?
Search returned 0 results

3. What can we learn from the FitBit?
Largely a motivational tool
•Commercially available since 2007
•“10,000 steps a day” is clever
marketing
•Limited scientific basis

4. Android
•Speak Up – An SPL Meter
• LiveWell RERC (Free)
What do we want to motivate?
Louder voicing

5. •iOS
Too Loud Pro
• (RGB Studios) $.99
Noise Down
Internetics Ltd
(Free/$.99)
What do we want to motivate?
Louder voicing

6. Speak Up for Parkinson’s
What do we want to motivate?
Practice at home
Nice early addition
to app landscape
Some limitations
iPad only
Not customizable
Cannot calibrate
No iPad?
Use the phone’s camera or
webcam on a computer
Northwest Parkinson’s
Foundation (NWPF)
Sandcastle (FREE)

7. Native speech recognition on a smartphone
VIDEO
Is there more functional carryover ?
•Immediate feedback
•Intro training for use
in other contexts
•Texting
•Searching via Siri and
other digital
assistants

8. SWALLOW Prompt
Speech Tools Limited ($.99)
Android and iOS
•Can be connected to
Bluetooth earpiece
for a discreet
solution in public
What about more practical tools?
Prompt for drooling

9. One: Reminder
Reminder App Ltd. (free)
iOS (android “coming soon”)
•Ability to program a
set number of trials at
specified intervals
•Cons – only break
down in minutes
What about more practical tools?
Prompt for drooling

10. •“Pacing board” apps
•For palilalia
• ”festination of speech”
•Not very functional in a
clinical environment
•What is a simpler and
more effective approach?
•Actual pacing board
•Simple ballpoint pen
Sometimes technology isn’t the answer
Just because you can doesn’t mean you should

11. •Nat’l Institute for Occupational Safety and
Health (NIOSH) studied SLM apps (Kardous, & Shaw, 2014)
•4/192 (iOS only) met criteria (+/- 2dB)
•Released their own free app (iOS only)
Any exceptions to the rule?
Sound Level Meter (SLM)

12. MicW i436 ~$130 VS Dayton Audio iMM-6 ~$24
(Kardous, & Shaw, 2016)
Addition of external mic helped significantly
Kardous and Shaw highlight 2 options

13. •Very dependent on
programming
• If you don't get immediate
results, start adjusting
parameters
DAF Pro
Speech Tools Limited $1.99
What are some other compelling examples?
Delayed Auditory Feedback (DAF )

14. SpeechVive ®
•Based upon NIH-funded
research
• Jessica Huber, PhD CCC SLP at
Purdue University
•Automatically detects
speech
• Plays “multispeaker babble”
in earpiece to induce
Lombard effect
•No desensitization to
“multispeaker babble” cue
(for at least three years)
Strong research support
SpeechVive

15. LSVT® Companion software
• Automatically measures
amplitude (in dB)
• Sustained phonation
• Glides
• Connected speech
• Benefits
• Improved data collection
• Automated
• Telemedicine?
• Via a home version
• NOTE –No pitch range
• Have to manually identify
Another well-known example

16. These slides are available online - LinkedIn “Slideshare”
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