Boulder Language Technologies

Project Team:
Ron Cole, Angela Halpern, Nattawut Ngampatipatpong, Lorraine Ramig & Sarel van Vuuren

Project Overview:

LSVT (Lee Silverman Voice Treatment) is a speech and voice treatment for individuals with Parkinson disease invented by Dr. Lorraine Ramig and colleagues. The treatment, described in several articles, produces dramatic improvements in the speech communication abilities of individuals with Parkinson disease. Over fifteen years of research by Dr. Ramig and her colleagues funded by the National Institutes of Health-National Institutes for Deafness and other Communicative Disorders (NIH-NIDCD) has demonstrated the efficacy of LSVT. The research has shown that individuals who receive LSVT produced many additional benefits beyond improved speech communication, including improved swallowing, and more natural and expressive facial expressions and gestures while speaking. This video of an interview of "Shirley" before and after receiving LSVT shows the dramatic effects of the treatment. LSVT is considered a globally effective treatment. There are currently over 3000 certified LSVT clinician worldwide who have received training workshops through the LSVT foundation. The LSVT Foundation web site provides a list of LSVT Certified clinicians and references to articles on LSVT.

The idea behind LSVT Virtual Therapist, or LSVT VT, is to provide an accessible and affordable computer-based treatment that can be used independently by individuals with Parkinson disease as an adjunct to the face-to-face treatments they receive with certified LSVT clinicians. LSVT VT was invented by Ron Cole, Sarel van Vuuren and Nattawut Ngampatipatpong at CSLR, Angela Halpern at NCVS and Lorraine Ramig in the Department of Speech Language and Hearing Science at CU and NCVS and funded by a two year Exploratory Research Grant from NIH-NIDCD to Drs. Cole and Ramig.

LSVT VT is now a reality. In October 2006, we completed the initial clinical trials of the LSVT Virtual Therapist system, with individuals with Parkinson disease using the program independently for either 8 or 12 of the 16 one hour LSVT sessions. This  article describes the LSVT VT program, the experiences of its initial users, and initial results achieved when the program was integrated into LSVT sessions. A video of LSVT VT is also available. An  article describing LSVT VT also appeared in Applause magazine, a publication of the Denver Center for the Performing Arts (DCPA).

Figure 1: LSVT VT Main Screen

Figure 2: LSVT VT activities (Loud AH)

Figure 3: LSVT VT activities (Pitch LOW)

Figure 4: LSVT VT activities (Loud Reading)

Background:

LSVT was invented by Dr. Lorraine Ramig and her colleagues. Dr. Ramig is a Professor of Speech, Language and Hearing Sciences at the University of Colorado and a Senior Scientist at the National Center for Voice and Speech at the Denver Center for Performing Arts in Colorado where most of the research on the efficacy of LSVT was conducted. LSVT stands for Lee Silverman Voice Treatment; Lee Silverman's family was frustrated that they could no longer communicate with Lee because of the effects of Parkinson disease on her voice. The family funded a center in Scottsdale, Arizona where Dr. Ramig and Carolyn Mead Bonitati began development of what is known globally today as LSVT.

The feasibility of LSVT VT was originally funded by the Coleman Foundation for Cognitive Disabilities. Ron Cole and Lori Ramig first met at the second annual Coleman Institute Conference in Aspen Colorado, and proposed a feasibility study that was funded by the Institute. The initial LSVT virtual therapist bears a striking resemblance to Dr. Ramig, shown in this photo with Ron Cole and Senator Mark Udall. Lori had a "bad photo moment" so we replaced her face with the 3D virtual tutor (enabling the head to blink in the image.) A  poster of the LSVT VT project was presented at the 2005 Coleman Institute meeting in Boulder CO.

Figure 5: Mark Udall, Virtual Lori and Ron Cole

LSVT Articles:

• Cynthia M. Fox(1), Chris E. Morrison(2), Lorraine Olson Ramig(3), Shimon Sapir(4),  "Current Perspectives on the Lee Silverman Voice Treatment (LSVT) for Individuals With Idiopathic Parkinson Disease", (1)University of Arizona, Tucson, (2)Mount Sinai Medical Center, New York, NY, (3)University of Colorado, Boulder and Wilbur James Gould Voice Center, The Denver Center for the Performing Arts, Denver, CO, (4)Wilbur James Gould Voice Center, The Denver Center for the Performing Arts, Denver, CO.
• M. Liotti, MD, PhD; L.O. Ramig, PhD; D. Vogel, PhD; P. New, MD; C.I. Cook, MS; R.J. Ingham, PhD; J.C. Ingham, PhD; and P.T. Fox, MD,  "Hypophonia in Parkinson's disease: Neural correlates of voice treatment revealed by PET", Lippincott Williams & Wilkins.
• L.O. Ramig, S. Sapir, S. Countryman, A. A. Pawlas, C. O'Brien, M. Hoehn, L. L. Thompson,  "Intensive voice treatment (LSVT) for patients with Parkinson's disease: a 2 year follow up", Neurol Neurosurg Psychiatry 2001; 71:493-498.