App-licable Ideas for Parkinson’s Disease A growing number of apps aim to help clients with Parkinson’s disease tackle communication challenges. App-titude
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App-titude  |   September 01, 2016
App-licable Ideas for Parkinson’s Disease
Author Notes
  • Mandie Oslund, MS, CF-SLP, recently graduated from the University of North Carolina at Chapel Hill and is now a practicing clinician at the University of Tennessee Medical Center. mandieoslund@gmail.com
    Mandie Oslund, MS, CF-SLP, recently graduated from the University of North Carolina at Chapel Hill and is now a practicing clinician at the University of Tennessee Medical Center. mandieoslund@gmail.com×
Article Information
Special Populations / Older Adults & Aging / Telepractice & Computer-Based Approaches / App-titude
App-titude   |   September 01, 2016
App-licable Ideas for Parkinson’s Disease
The ASHA Leader, September 2016, Vol. 21, online only. doi:10.1044/leader.APP.21092016.np
The ASHA Leader, September 2016, Vol. 21, online only. doi:10.1044/leader.APP.21092016.np
Parkinson’s disease—a neurodegenerative disorder caused by a loss of dopamine-producing neurons in the basal ganglia—affects as many as one million Americans. An estimated 90 percent of those with Parkinson’s disease experience speech and voice changes that can significantly affect their quality of life. These changes can include reduced loudness, imprecise articulation, dysfluencies, hypernasality, harsh or breathy vocal quality, and prosodic abnormalities, such as rapid rate of speech, monopitch and monoloudness.
With their interactive features and easy accessibility, apps can play a major role in speech treatment to help people with this aspect of the disease. However, trying to navigate the vast sea of options can be overwhelming to many clinicians.
Here I share with you some of my favorite apps designed to improve communication outcomes for clients with Parkinson’s disease. With these key programs in your intervention toolbox, you can help these clients live more independent and connected lives.

Apps that target increased vocal loudness are an easy way to promote home practice and carryover of treatment techniques into daily communication.

Hear me now?
Apps that target increased vocal loudness are an easy way to promote home practice and carryover of treatment techniques into daily communication. My clients find that the convenience and simplicity of these apps help to build their confidence in using new techniques outside of therapy during everyday interactions. One of them is Sandcastle’s Speak Up for Parkinson’s app (free and available for iOS devices), created by the Northwest Parkinson’s Foundation. This app allows users to practice voice exercises daily.
The app aims to increase users’ vocal amplitude in variable speaking activities involving 1) words and phrases and 2) reading and conversation to promote carryover of vocal techniques for longer durations. Both activities provide biofeedback with real-time volume monitoring with a predefined “Target Zone.”
The app provides a video review to promote recalibration of vocal loudness and self-monitoring skills. It also lists speaking tips and compensatory techniques to help enhance functional communication in daily life.
Another app that targets hypophonia in Parkinson’s disease is Decibel 10th, free for iOS and for Android from Skypaw Co. Ltd. This app turns your iOS device into a professional sound meter that measures noise levels and displays the data in clear digital and analog layouts.
Two more apps, Voice Meter Pro ($3.99 for iOS) and Voice-o-Meter ($0.99 for iOS), allow users to monitor the volume of their voice using a visual sound level meter. Users can adjust the sensitivity to include an acceptable loudness range that best suits their current level of functioning and outcome goals.
What about Android users? They can measure their volume levels using Sound Meter Pro, a free app that displays measure data in decibels as related to common objects and situations (such as quiet library, alarm clocks or moderate rainfall).
Focus on fluency
Altered auditory feedback (AAF) can have long-term beneficial effects on intelligibility in a subset of people with Parkinson’s disease, according to a 2010 study by Anja Lowit, Corinne Dobinson, Claire Timmins, Peter Howell and Bernd Kröger. However, device usability and acceptability are significant limitations to AAF effectiveness. Fortunately, several apps address these concerns and allow clients to use AAF on a more familiar and accessible platform.
Parkinson’s Speech Aid (free for iOS) allows users to speak in unison with themselves with a slight delay and change in pitch, thereby reducing their rate of speech and number of repetitions. It has several user-friendly features, including a recording option for users to track their progress.
Speech Pacesetter Lite is another free app for iOS that allows users to read the text and pace their reading with the help of a visual cue and optional auditory metronome cue. It is designed to target imprecise articulation and fast speech rate in people with acquired neurological disorders.
Lastly, DAF Professional ($4.99 for iOS and $2.99 for Android) is an easy and convenient tool to help people speak more slowly when hearing their own speech in an altered manner. Although originally designed for people who stutter, the app has since become a well-established therapy tool for individuals with various communication disorders.
Try it
While there are wide-ranging apps available for clients with Parkinson’s disease, the apps listed here are unique in that they require little cognitive effort and can be customized to suit individual needs and intervention goals. With the right app, smartphones can enhance your treatment and improve intervention outcomes for people with Parkinson’s disease.
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September 2016
Volume 21, Issue 9