Adult Services : Voice

Voice Disorders

The use of our voice is essential to speaking and communication. In our day-to-day lives we have to use our voice to communicate in professional, vocational, educational and social situations. As human beings we cannot avoid speaking to others. Life is full of social and professional interactions. If one’s voice becomes impaired then it may become difficult to interact with others. For example, a teacher has to use his/her voice to educate a classroom of students; a preacher needs to use his/her voice to communicate with members of a congregation and a salesperson needs his voice to sell his products.

Yet thousands of adults experience difficulty with voice production that may affect the quality, strength, loudness and endurance of their voice to the extent that it affects their ability to communicate effectively. The effects of voice problems will vary from person too person. Some professions are more susceptible to voice problems. These professions can include teachers, pastors, sales professionals, speakers, coaches, and radio and television announcers. However, voice problems can occur with any adult regardless of their profession. There are many different causes of voice disorders in adults.

    Some of the primary causes include:

  • Vocal abuse, misuse or overuse resulting in vocal nodules
  • Laryngitis
  • Psychological problems resulting in depression or anxiety
  • Weaknesses with respiratory support and control
  • Age related changes
  • Gastro Esophageal Reflux Disease (GERD)
  • Neurological conditions such as Parkinson Disease or Multiple Sclerosis
  • Spasmodic dysphonia
    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Individually scheduled therapy sessions
  • Collaboration with Ear, Nose and Throat physicians as needed



“His words are scarcely intelligible…”

James Parkinson, 1817

At least 89% of people with Parkinson’s are at risk of losing their ability to speak and swallow.

Lee Silverman Voice Training (LSVT)— A scientifically documented efficacious program for treating voice and speech disorders in patients with Parkinson’s Disease and other neurological disorders.

Lee Silverman Voice Treatment is the only speech treatment clinically proven to effectively treat the speech and swallowing deficits associated with Parkinson disease. In sixteen individual treatment sessions over four weeks, patients learn to use increased effort when communicating. LSVT improves overall strength, endurance, and coordination of the speech and swallowing mechanism. All treatment is provided by a master’s level speech-language pathologists who are LSVT certified.

Following completion of the four week program each patient enters the maintenance phase of the program and becomes a member of the “LOUD Crowd.” Parkinson’s is a progressive disease and it is necessary to meet the challenge of maintaining the speech and swallowing gains attained from the intensive therapy program. The Loud Crowd provides support, encouragement, and continued care from a certified speech pathologist. Patients who participate in continued voice maintenance have been shown to maintain their improved voices for more than five years.

    Speech and Swallowing Screening

  • Do people ask you to repeat?
  • Does your voice sound hoarse, scratchy, or breathy?
  • Does your family say you speak too softly?
  • Does your voice fatigue easily?
  • Does your voice sound strong on some days and weak on others?
  • Do you cough when you eat or drink?
  • Do you experience drooling?

*If you answered “yes” to any of these questions, call to schedule a voice evaluation with The Swain Center 707-575-1468

My Experience With LSVT LOUD —by Anne

Today I completed my 4th week of LSVT LOUD therapy sessions (1 hour a day, 4 days a week) with Michelle Chastain-Gaid, Speech-Language Pathologist, at The Swain Center in Santa Rosa, CA. Looking back over the journal Michelle had me keep I remember my feelings and concerns during this time.

In the beginning I was given a baseline evaluation. At that time my voice was quite raspy, strained and weak. It was not steady and would fade in and out. Michelle said I have nice, high pitches, but my lower register sounds were much more unsteady and difficult. I had an ‘ah-ha’ moment about the importance of taking a deep breath before speaking, making it easier to project so much better. With each session I have become more aware of how I am sounding and how my throat is feeling. I have been trying to control my breath so that it can help me to project. THINK LOUD is a constant reminder—whether it is from Michelle, the sign on the wall, my own thoughts or the red button that says those words! Since Parkinson’s came into my life (my diagnosis was a year and a half ago) I have felt my speech was not only weak, but also slow and hesitant. Often it was difficult for me to formulate what I was wanting to say. I also felt I had lost some of the expression and animation in my voice. Since being involved with the LSVT therapy I have become much more aware of the concentration it takes to overcome these weak areas. It takes work—and homework!—but it has definitely been worth the effort. I feel so much better about the way I sound and this has boosted my confidence.

I was videotaped at the beginning of the course and again on the last day. The improvement shown is remarkable! My plan is to keep practicing all the things I have learned these past 4 weeks so that my voice will sound strong and confident for a long, long time!