Question
I have a client with Parkinson’s Disease who I just evaluated. He is on Medicare so each visit is crucial and limited. He exhibits a slight voice warble with sustained production of the /z/ phoneme, and I did not recommend therapy at this time. Any thoughts?
Answer
I always think about therapy candidacy from the perspective of how the patient is functioning in everyday life. If they are not noticing that their speech is changing, they are not saying, for example, that they are withdrawing from social situations, or they do not feel that their daily life is impacted, and when you listen to them, you and the patient's family are not hearing big changes, it is okay to not recommend therapy. You want to save therapy, especially with Medicare where visits are so highly controlled, for people who are really having significant problems and who are reporting changes to their everyday life. I think you made a great decision about therapy efficacy and who should be getting therapy.
Jessica Huber Ph.D., CCC-SLP, is an Associate Professor at Purdue University in the Speech, Language, and Hearing Sciences Department. Her research emphasis is on the effects of aging and motor disorders on speech production. Her current research focus is the treatment speech, balance, and cognitive changes as a result of Parkinson's disease and aging.
