Parkinson’s disease can cause speech to become quiet, slurred, and monotone, which is frustrating and isolating for the people who have it. Thankfully, specialized voice programs can help!
In this article, medical SLP Alisha Kleindel gives her honest review of the popular SPEAK OUT!® program after completing the training. Plus, she shares details about the certification process—and whether it’s worth the cost.
Visit our shop for treatment and assessment templates, patient handouts, worksheets, and much more.
What Is SPEAK OUT! For Parkinson’s Disease?
SPEAK OUT! was created by the Parkinson Voice Project with the mission to help people with Parkinson’s disease regain and retain their speech and swallowing skills (Parkinson Voice Project).
It’s a structured speech therapy program offered by speech-language pathology professionals who are certified in SPEAK OUT!
Because Parkinson’s disease most impacts automatic speech and motor tasks, SPEAK OUT! is based on the principles of motor learning and on how speaking with intention can significantly improve speech (Sullivan et al., 2024).
What Sets SPEAK OUT! Apart?
What sets the SPEAK OUT! program apart is its simplicity. It’s simple for clinicians to implement and for patients to understand. In fact, the only cue the clinician gives throughout treatment is “Speak with intent.”
Although simple, SPEAK OUT! has been proven to work. Not only does the patient with Parkinson’s disease learn to use “INTENT” to improve their speaking, but also to improve swallowing, and the ability to engage with others.
The program touts that it gives patients with Parkinson’s disease a chance to reclaim not only their voice but also their identity.
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What Does The Research Say About SPEAK OUT!?
Research shows that the SPEAK OUT! program yields significant and lasting improvements in patients with Parkinson’s disease and dysarthria, with results maintained for at least one year post-treatment (Behrman et al., 2020, 2021).
Learn more at the Parkinson Voice Project’s dedicated SPEAK OUT! research page.
How Does SPEAK OUT! Work?
Here are the general steps of the SPEAK OUT! program, from assessment, through treatment, to follow-up:
- SPEAK OUT! assessment is completed by a speech-language pathology professional certified in the program.
- Patients and care partners get access to SPEAK OUT! resources. These include flashcards and a free digital booklet that will be used throughout therapy (available on the Parkinson Voice Project website).
- Patients and care partners watch the “What is Parkinson’s?” video on the website.
- Individual treatment consists of around 8-12 speech therapy sessions. Sessions are typically 40 minutes long, and patients are given daily SPEAK OUT! homework.
- SPEAK OUT! therapy groups (formerly called “LOUD CROWD”). At the end of individual treatment, the patient transitions to weekly SPEAK OUT! group therapy sessions, which are held online.
- Follow up. Once treatment is over, the patient is followed up every 3-6 months.
- Keep practicing! Patients are expected to continue daily home practice of the SPEAK OUT! program to retain their speech skills.
Throughout the SPEAK OUT! program, the Parkinson Voice Project offers your patients tons of support. These include daily SPEAK OUT! Home Practice Sessions, access to an eLibrary (with the SPEAK OUT! booklet, flashcards, and songbooks), weekly Online Sing-Alongs, and even an annual concert called SING OUT!
Learn more about the program on the SPEAK OUT! website.
What Does A SPEAK OUT! Session Look Like?
- Warm-up Vocalizations: “May-me-my-mo-moo”
- Sustained vowel production: ‘a’
- Pitch glides: ‘a’
- Counting
- Reading (words, phrases, sentences, and paragraphs of gradually increasing length and complexity)
- Spontaneous language tasks (phrase completion, naming pictures, etc.)
- Conversion & Discussion (‘How will you Speak with Intent today?’ Carryover, planning, and self-monitoring)
Again, the clinician’s only cue, along with general encouragement, is “Speak with intent.” There are no cues to slow the patient down, for breathing, or to speak louder.
SPEAK OUT! Exercise Example Video
In this video by the Parkinson Voice Project, a clinician demonstrates a SPEAK OUT! exercise.
What Is SPEAK OUT! Certification Like?
The Parkinson Voice Project sells an online certification course to speech-language pathologists and speech-language pathology assistants.
Cost: $475 USD
What’s Included In SPEAK OUT! Certification?
The SPEAK OUT! certification includes:
- 10.5 ASHA CEUs
- Training to conduct a speech evaluation with stimulability testing
- Training for SPEAK OUT! individual therapy
- Training for SPEAK OUT! group sessions
- Training for clinical documentation
- Access to eLibrary (flashcards, booklets in English, French, German, Hebrew, Italian, Japanese, and Spanish)
- Other online clinical resources (sample treatment forms, training videos, marketing materials, etc.)
- SPEAK OUT! Therapy Booklet. A physical copy of the booklet is mailed to each U.S. patient with Parkinson’s Disease in the program, without charge.
- SPEAK OUT! Therapy Flashcards (photos, words, conversation)
- Membership in SPEAK OUT! Providers Facebook Group
- Digital SPEAK OUT! Booklet and flashcards included. Physical copies are available for an extra cost
Time required. The course must be completed within 30 days of activation. It takes about 10.5 hours to complete.
Annual recertification is required (at no extra cost!)
Can Students Take SPEAK OUT!?
While students can take the SPEAK OUT! training at a (vastly) discounted price of $47.50, this does not include certification, ASHA CEUs, or access to the e-learning library.
An SLP’s Honest Review Of SPEAK OUT! Training
Researching SPEAK OUT! convinced me to get certified—and I’m so glad that I did!
If you work with patients who have Parkinson’s disease, this program is well worth it. It’s functional, evidence-based, and meaningful. Plus, it targets not only speech but also cognition and swallowing in a single treatment model.
The Parkinson Voice Project community offers a strong support system for both clinicians and patients. As mentioned earlier, the program is easy for patients to understand and for clinicians to deliver.
That said, there were a few small hitches in the certification process. I’ll go over those below.
Navigating The Course Was A Little Clunky
Signing up for SPEAK OUT! was easy, but logging in and navigating the course platform could be a bit clunky. The course kept bringing me back to Module 2, even after I had completed it.
Plus, there were several icons on the dashboard that I couldn’t click.
SPEAK OUT! Training Was Great For New Clinicians
SPEAK OUT! training is very thorough and informative for new clinicians. However, as an experienced clinician (who is already certified in LSVT LOUD®), it was at times a bit repetitive and dry for me.
That said, I loved the module that explained the extrapyramidal and pyramidal pathways of the brain, as well as learning about the research behind Parkinson’s disease.
The videos used throughout were a touch outdated, but overall good.
I’m Confident After SPEAK OUT! Certification
Despite these small issues during the certification process, I left feeling very confident in my ability to use SPEAK OUT! to help my patients with Parkinson’s disease.
If you regularly work with this population, I can confidently recommend SPEAK OUT! as very much worth the time and money spent. The program not only helps patients in important areas of their lives, but it’s also functional and incredibly easy to implement.
More Parkinson’s Disease Treatment Material
Visit our shop for speech therapy materials designed for people with Parkinson’s disease and other common diagnoses.
And check out The Adult Speech Therapy Roadmap course, a step-by-step guide to doing the job of adult speech therapy. Ideal for new graduates or clinicians transitioning from pediatrics.
Adult Speech Therapy Roadmap Course
The Adult Speech Therapy Roadmap is an online course that teaches you how to assess, treat, and document all major areas of adult speech therapy, from Day 1 to Discharge.
References
- Behrman, A., Cody, J., Elandary, S., Flom, P., & Chitnis, S. (2020). The Effect of SPEAK OUT! and The LOUD Crowd on Dysarthria Due to Parkinson’s Disease. American Journal of Speech-Language Pathology, https://doi.org/10.1044/2020_AJSLP-19-00024.
- Behrman, A., Cody, J., Chitnis, S., & Elandary, S. (2021). Dysarthria treatment for Parkinson’s disease: one-year follow-up of SPEAK OUT!® with the LOUD Crowd®. Logopedics Phoniatrics Vocology, 47(4), 271–278. https://doi.org/10.1080/14015439.2021.1958001
- Levitt, J.S., Walker-Batson, D. (2018). The Effects of the “Speak With Intent” Instruction for Individuals With Parkinson’s Disease. Journal of Communication Disorders and Assistive Technology, 1: 1-15. https://www.researchgate.net/publication/327476864_The_Effects_of_The_Speak_with_Intent_Instruction_for_Individuals_with_Parkinson’s_disease
- Parkinson Voice Project (n.d.). Speech Therapy For People With Parkinson’s. Retrieved April, 2025 from https://parkinsonvoiceproject.org.
- Sullivan, L., Martin, E., & Allison, K. M. (2024). Effects of SPEAK OUT! & LOUD Crowd on Functional Speech Measures in Parkinson’s Disease. American journal of speech-language pathology, 33(4), 1930–1951. https://doi.org/10.1044/2024_AJSLP-23-00321
