Communication Changes Following SPEAK OUT!: Perspectives of People With Parkinson's Disease and Their Care Partners

Purpose: The purpose of this study was to examine whether the SPEAK OUT!® Therapy Program impacts patient self-reported outcomes in communicative effectiveness and voice function for people with Parkinson's disease (PwPD) and hypokinetic dysarthria and to identify patient factors (e.g., cognition, dysarthria severity) that influence treatment response. In addition, we examined how care partners perceived changes in PwPD's communicative effectiveness following SPEAK OUT! and how self-ratings and care partner ratings compared to each other. Method: Twenty-seven PwPD completed the SPEAK OUT! Therapy Program via telehealth. Two patient-reported outcome measures (i.e., Communication Effectiveness Survey [CES] and Voice Handicap Index-10 [VHI-10]) were collected at three pretreatment and three posttreatment timepoints. A subset of 13 PwPD had care partners who also provided CES ratings at pre- and posttreatment timepoints. Linear mixed-effects models were used to determine whether CES and VHI-10 scores significantly changed following treatment, to identify individual factors that influenced treatment response, and to assess alignment between PwPD's self-rated CES scores and care partner CES scores at pre- and posttreatment timepoints. Results: PwPD's self-rated CES scores and VHI-10 scores significantly improved between pretreatment and posttreatment timepoints. Three individual factors—Montreal Cognitive Assessment score, dysarthria severity, and homework completion—significantly influenced treatment gains in CES and/or VHI-10 scores. Alignment between PwPD self-rated CES scores and care partner CES ratings did not change between pretreatment and posttreatment. Discussion: These findings provide preliminary support for the effectiveness of the SPEAK OUT! Therapy Program in improving self-perceived communicative effectiveness and voice function for PwPD. This study is also the first to demonstrate positive outcomes of the program administered via telehealth. These findings provide preliminary comparisons of PwPD and care partner perspectives throughout the therapy program. Supplemental Material: https://doi.org/10.23641/asha.33210768