Speech & Voice Therapy
Speech and voice disorders in adults most often have a neurological cause. Parkinson's disease, stroke, traumatic brain injury, ALS, and other degenerative conditions can affect the muscles and neural pathways that control how a person speaks, how loud their voice is, and how clearly others can understand them. Clarity Rehabilitation provides in-home speech and voice evaluation and treatment for adults across the Denver metro area.
Changes to speech or voice can develop gradually or appear suddenly after a neurological event. Family members often notice the change before the person does, particularly with vocal volume, speech clarity, or rate. An evaluation determines what is present, what is driving it, and what treatment can address.
Speech disorders can present as dysarthria, a condition in which the muscles of the mouth, face, voice, and respiratory system may be weak or move slowly.
Speech disorders can present as apraxia, caused by injury to the parts of the brain associated with speech, resulting in inconsistent speech errors.
Causes of voice disorders can include damage to the vocal cords, respiratory disorders, vocal tension, neurological disorders, gastroesophageal reflux (GERD), and aging.
Here are common symptoms associated with speech and voice disorders:
Speech Symptoms
Speech that is difficult to understand
Inconsistent speech patterns
Slowed speech rate
Short rush or “bursts” of speech
Sounding like you have a stuffy nose or talking out of your nose
Problems moving your tongue, lips, or jaw
“Slurred” or “mumbled” speech
Speech sounding “robotic” or “choppy”
Voice Symptoms
Hoarse or rough-sounding voice
Strained vocal quality (harsh or tense)
Breathy vocal quality (vocal weakness)
Abnormal loudness/volume
Abnormal pitch (decreased vocal range)
Sore throat or pain after speaking
Voice breaks
Tremorous/shaky voice
Variable vocal quality throughout the day
We provide effective and functional speech & voice treatments such as:
Vocal function exercises
Manual circumlaryngeal techniques
Semi-occluded vocal tract exercises
Conversation training therapy
Resonant Voice Therapy (RVT)
Modified Lee Silverman Voice Treatment (LSVT) techniques
Respiratory Muscular Strength Training (RMST) & Expiratory Muscular Strength Training (EMST)
How We Approach Speech and Voice Treatment
Our approach to speech and voice treatment starts with a thorough evaluation that identifies the specific nature of the disorder before any treatment decisions are made. Dysarthria, apraxia, and voice disorders each have distinct presentations and require different treatment targets. A patient with hypophonia from Parkinson's disease needs a different approach than a patient with spastic dysarthria following stroke, even if both present with reduced intelligibility.
For patients with Parkinson's disease, a useful treatment technique involves SPEAK OUT!, an evidence-based treatment program that targets intentional speech production to improve vocal loudness, clarity, and confidence. SPEAK OUT! is designed to be maintained long-term through the LOUD Crowd group program, which provides community support and ongoing practice beyond individual therapy sessions.
For patients with dysarthria from stroke, TBI, ALS, or other neurological causes, treatment draws from techniques targeting breath support, articulation, rate, and prosody, selected based on the type and severity of dysarthria present. For voice disorders, we use vocal function exercises, resonant voice therapy, semi-occluded vocal tract exercises, and respiratory muscle strength training, among other approaches, depending on what the evaluation indicates.
Goals are written around what each patient wants to be able to do: hold a conversation at a family dinner, be understood on the phone, or speak clearly enough to participate in a group setting. That context shapes every treatment decision.
Who Is a Good Candidate for Speech and Voice Therapy
Adults with a neurological diagnosis who have noticed changes to speech clarity, vocal volume, speech rate, or voice quality are candidates for an evaluation. You do not need a confirmed motor speech or voice disorder diagnosis before scheduling. The evaluation identifies what is present and whether therapy is indicated.
Patients with Parkinson's disease are particularly strong candidates for early intervention. Speech and voice changes in Parkinson's respond well to treatment when addressed before significant decline has occurred. Waiting until communication difficulty is severe makes treatment harder and outcomes less predictable. If you or a family member has been diagnosed with Parkinson's disease and has not yet had a speech evaluation, scheduling one sooner rather than later is worth considering.
One of the most common diseases that Speech Therapists address is Parkinson’s disease, which can affect speech and voice. Research shows that 89% of people diagnosed with Parkinson’s disease (PD) experience speech and voice disorders. As a result of these symptoms, individuals with Parkinson’s disease report being less likely to participate in conversations or have confidence in social settings compared to healthy individuals in their age group.
Don’t let Parkinson’s disease keep you from participating in the things you love and communicating confidently. For additional support beyond therapy, visit our Parkinson's Disease Resources page, where we have compiled trusted organizations, Denver-area support groups, and educational materials for patients and families navigating a Parkinson's diagnosis.
Frequently Asked Questions
Does Medicare cover speech and voice therapy?
Medicare Part B covers outpatient speech-language pathology services, including motor speech and voice evaluation and treatment, when medical necessity is documented. Clarity Rehabilitation is a Medicare participating provider. Coverage depends on your specific plan and whether medical necessity criteria are met. Call us before scheduling if you have questions about your coverage.
Can speech therapy help with Parkinson's disease?
Yes. Research shows that 89% of people with Parkinson's disease develop speech or voice changes at some point. Evidence-based programs like SPEAK OUT! are designed for this population and have a strong track record for improving vocal loudness, speech clarity, and communication confidence. Early intervention produces better outcomes than waiting until communication difficulty is severe.
Do I need a physician referral to schedule an evaluation?
A referral is not required to contact us or schedule an evaluation. Medicare and most private insurers do require a signed plan of care from a physician before ongoing treatment begins, so we coordinate with your doctor early in the process.
What is the difference between dysarthria and apraxia?
Dysarthria results from weakness or reduced coordination of the muscles involved in speech, often causing slurred, slow, or strained-sounding speech. Apraxia of speech results from damage to the parts of the brain that plan and sequence speech movements, causing inconsistent errors that do not follow the pattern of muscle weakness. Both can follow stroke, brain injury, or other neurologic disorders and both are treated by speech-language pathologists, but they require different treatment approaches. An evaluation determines which is present and what treatment is appropriate.
Living with a speech or voice disorder affects more than the person diagnosed. Families and caregivers play a meaningful role in daily communication. Our Communication Strategies resource page offers practical tips for supporting a loved one with dysarthria, apraxia, or voice changes at home.
At Clarity Rehabilitation, we believe in the limitless potential for progress. The brain has the capacity to form new connections, even years following a stroke or brain injury. Our approach involves collaborating with you on your personal goals, ensuring they are not only achievable but also practical and relevant to your everyday life.
