The Informed Care Partner’s Guide to Speech Therapy

You don't have to navigate this alone. This guide covers: 

• Therapy options 

• Insurance & Medicare tips 

• Finding the right therapist 

• Your role as care partner 

If your loved one has Parkinson's disease, you've probably noticed changes in their voice and speech. They may speak more quietly than they used to. Their words may sound slurred, or they seem to mumble. You might find yourself asking them to repeat things more often. 

These changes can be frustrating for both of you. The good news? Speech therapy can help. But navigating the world of speech therapy can feel overwhelming, especially when you're already managing so much as a care partner. 

This guide will cover everything you need to know about speech therapy for Parkinson's disease. You'll learn what to expect, how to find the right therapist, and how to make the most of every session. 

Understanding Your Therapy Options 

Not all speech therapy is the same. For Parkinson's disease, several proven approaches work well: 

LSVT LOUD is probably the most well-known program. It focuses on helping people speak more loudly and clearly. The program is intense – four sessions per week for four weeks – but research shows it really works. Your loved one will practice speaking with more effort and volume daily. The idea is to retrain their brain to use a louder voice as their new "normal." 

SPEAK OUT! is another evidence-based program. It teaches people to speak with intention and effort. Like LSVT LOUD, it focuses on volume and speech clarity. The SPEAK OUT! program requires daily practice, but the treatment sessions are less intense at 2-3x/week. 

Traditional speech therapy takes a more individualized approach. The therapist will address the specific problems your loved one is experiencing. Therapy may include voice exercises,

breathing techniques, clear speech strategies, cognitive therapy, language therapy, and/or swallowing therapy. 

Group therapy can also be a great option. Your loved one gets to practice with others who understand what they're going through. Plus, it's often more affordable than individual sessions. 

What to Expect from Speech Therapy 

The First Visit 

The speech-language pathologist (SLP) will do a complete evaluation during your first visit. They'll test your loved one's voice strength, speech clarity, and swallowing (if needed). They'll also ask about daily communication challenges. Evaluations usually take about an hour. 

The SLP will also ask you questions. Since you see your loved one every day, you might notice things that might not show up in a one-hour test. 

The Treatment Plan 

After the evaluation, the SLP will create a treatment plan. The plan will include specific goals, like "speak loud enough to be heard across the room" or "use clear speech during phone calls." 

The plan should make sense to you. If something isn't clear, ask questions. You're part of the team. 

What Happens in Sessions 

Most sessions last 45 to 60 minutes. Your loved one may engage in voice exercises, practice speaking loudly, or work on breathing techniques. The SLP will likely assign homework exercises to practice at home. 

Tracking Progress 

Good clinicians will show you how your loved one is improving. They might record voice samples or use measurements to track progress. Don't expect overnight changes – speech therapy takes time and practice. 

Navigating Insurance and Coverage

Medicare Coverage 

Here's some good news: Medicare covers speech therapy when it's medically necessary. There's no cap on the number of sessions, but your clinician will outline specific requirements that you can discuss with them. 

You'll need a doctor's referral for speech therapy billed to Medicare. Medicare Part B covers 80% of the cost after you meet your deductible. 

Private Insurance 

Most private insurance plans cover speech therapy, but the details vary. Some plans require pre-authorization. Others have limits on the number of sessions per year. 

Call your insurance company before starting therapy. Ask these questions: 

● Do I need a referral from my doctor? 

● How many sessions are covered per year? 

● What's my copay for each session? 

● Does the SLP need to be in-network? 

Advocating for Coverage 

If insurance denies coverage, don't give up. Ask your doctor and speech-language pathologist to write a letter explaining why speech therapy is medically necessary. Include research about how speech therapy helps people with Parkinson's disease. 

You can also appeal the decision. Many denials get overturned on appeal, especially when you have good documentation. 

Finding the Right Therapist 

What to Look For 

Not all speech pathologists have experience working with individuals with Parkinson's disease. Look for these qualifications: 

● Certification in LSVT LOUD or SPEAK OUT! 

● Experience working with neurological conditions 

● Knowledge about Parkinson's disease specifically 

● Good communication skills (they should explain things clearly)

Where to Search 

Start with your neurologist – they often have good referrals. You can also search online directories: 

● ASHA (American Speech-Language-Hearing Association) website 

● LSVT Global directory for certified speech-language pathologists 

● Parkinson Voice Project directory for certified speech-language pathologists ● Your insurance company's provider directory 

Questions to Ask 

When you call potential SLPs, ask: 

● How much experience do you have with Parkinson's disease? 

● What approach do you typically use? 

● Do you involve family members in therapy? 

● What are your fees, and do you accept our insurance? 

● How do you measure progress? 

Trust your instincts. The right clinician should make both you and your loved one feel comfortable and confident. 

Maximizing Therapy Benefits 

Before You Start 

Write down your biggest communication concerns. What situations are most frustrating? When is it hardest to understand your loved one? Share this information with the therapist. 

During Therapy 

Encourage your loved one to practice at home. Most programs include daily exercises, and your support and encouragement can make a huge difference in their success. 

If you're allowed in sessions, take notes and ask questions about how you can help at home. Your Role as Care Partner 

You're not just along for the ride – you're an essential part of the team. Here's how you can help: 

As an Advocate: Speak up if something isn't working. If your loved one isn't making progress, ask why. If they're frustrated with exercises, discuss modifications with the therapist.

As a Supporter: Encourage daily practice, even when motivation is low. Celebrate small improvements. Remember that progress in Parkinson's disease can be slow but meaningful. 

As a Communication Partner: Learn the strategies the therapist teaches. Practice good listening skills. Give your loved one time to speak without jumping in to help. 

Making It Work Long-Term 

Speech therapy isn't a one-time fix. Parkinson's disease is progressive, which means symptoms can change over time. Your loved one might need tune-up sessions or different approaches as the disease progresses. 

Stay in touch with your speech pathologist even after formal therapy ends. Many clinicians are happy to do periodic check-ins or refresher sessions (with a physician order). 

Remember, the goal isn't to get back to exactly how things were before Parkinson's. The goal is to communicate as effectively as possible right now, with the tools and strategies that work best for your loved one. 

You're Not Alone 

Navigating speech therapy can feel overwhelming, but you don't have to figure it out alone. Good clinicians will guide you through the process and answer any questions you may have. 

Your advocacy and support make a real difference in your loved one's success. Understanding your options, asking the right questions, and staying involved in the process give your loved one the best chance to maintain clear, confident communication. 

Remember: every person with Parkinson's disease is different. What works for one person might not work for another. The key is finding the right approach for your loved one, with a clinician who understands both the disease and your family's unique needs. 

At Lasting Language Therapy, we work with Parkinson's families every day, and we understand how overwhelming this journey can feel. That's why we’re passionate about helping care partners like you confidently navigate these decisions. Whether you're just starting to notice speech changes or you've been dealing with communication challenges for a while, having the right information and support makes all the difference.

Communication is about connection. With the proper support and strategies, that connection can stay strong, even as Parkinson's disease brings changes to your lives. 

Ready to Take the Next Step? 

If you're in North Georgia and looking for a speech therapist who truly understands Parkinson's disease, I'd love to help. At Lasting Language, I specialize in neurological speech therapy and work closely with families to develop communication strategies that fit your unique situation.

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