Frustrated by his difficulty in being understood, Lakeland resident Doug Fulton began isolating himself as he dealt with Parkinson’s disease. Carole Shamblin of Dover had the same problem. Their solution came through the Speak Out! speech therapy program developed by the non-profit Parkinson Voice Project.

Frustrated by his difficulty in being understood, Lakeland resident Doug Fulton began isolating himself as he dealt with Parkinson’s disease.


Carole Shamblin of Dover had the same problem.


"I didn’t realize how low my voice was," Shamblin said. "People would constantly say ‘What did you say?’ "


Her daughter noticed changes in her walking and movement, which led to the Parkinson’s diagnosis, but the vocal change was more subtle.


She and Fulton tried speaking louder, but came to realize that wasn’t enough on its own.


Their solution came through the Speak Out! speech therapy program developed by the non-profit Parkinson Voice Project, www.parkinsonvoiceproject.org.


At its heart is training people with Parkinson’s to convert speaking to being an intentional act instead of an automatic function. It combines education, individual therapy and group sessions.


"The hardest part is making it a habit to speak with intent," said Jennifer Ackett, speech-language pathologist with South Florida Baptist Hospital in Plant City.


A grant let SFBH add that speech therapy program last fall.


Shamblin was finishing Speak Out! there in February and looking forward to its follow-up group component, Loud Crowd.


"This helps everything, especially your breathing," said Shamblin, 76. "I tend not to use my mouth but, with this, I use my mouth more."


Speaking with intent involves more facial expressions and motor movements, Ackett said, which helps fight the mask-like expression that’s a typical characteristic as Parkinson’s advances.


Nine in 10 people with Parkinson’s are at risk of developing a weak voice, according to Parkinson Voice Project. That can lead to speech and swallowing problems.


Mike Schwartz, who with his wife, Kathy, comes to a support group in Lakeland, said he’s "always asking her to repeat herself."


South Florida Baptist and a few speech language pathologists in Polk County began offering Speak Out! within the past few months as an alternative to other speech therapy they provide.


Fulton, 70, completed Speak Out! with Julie Barrientes, a speech-language pathologist, at her Grow the Vine Speech and Wellness Gym in Lakeland. He gets follow-up therapy there.


"It makes me more relaxed," he said. "I will join into a conversation. I used to isolate myself."


He said he had been very articulate, but that he has a hard time making sentences.


"It was frustrating," he said. "I thought I was losing my mind."


Speak Out! is a way of living, said Barrientes, who also treats patients part time at Watson Clinic.


"It’s not just speech exercises, not just voice," she said. "It’s also cognitive actions."


Speech-language pathologists Allyson Waters and Emily Thomas, at Astoria Health and Rehab/Villages at Vienna in Winter Haven, had one patient on Speak Out! who drove from Avon Park.


"It’s a great program," Waters said, adding that scheduling for Speak Out! is more flexible than another program she uses.


Each person who completes the program gets a workbook and therapy kit to continue practice at home.


All three speech therapists interviewed like the cognitive aspects of the training, which works participants’ memory and thinking abilities as well as their speech.


All want to increase awareness to be able to have enough Speak Out! graduates for the Loud Crowd component, which is free voice maintenance in a group setting.


"You can do things like ask each other questions or play games," Ackett said."


"We may do singing," Shamblin said.


It offers socialization, reducing the isolation people with Parkinson’s may have, along with reinforcement for speaking with intent.


Without a Loud Crowd established, therapists and patients look for creative ways to provide continuing interaction.


Those include continuing to see their patients for follow up, recommending support groups and physical activity like Rock Steady Boxing or other tailored exercise programs. Rock Steady Boxing is in Lakeland at Florida Presbyterian Homes.


Barrientes, also a Parkinson’s Wellness Recovery instructor, has Fulton exercise with patients who have other disorders in Functional Fitness, whose foundation is Parkinson’s recovery.


They call out the number of exercises they’ve done and she quizzed Fulton during a recent session.


"This includes cognitive so the cognitive aspect is in both programs (he gets)," Barrientes said.


Robin Williams Adams is at robinwadams99@yahoo.com .