NWPF

PD Community BlogRead Blog

More than Our Words: Speech Pathology & Parkinson's

Monday August 20, 2018

Dr. Kristie Spencer

                       

PhD Students Katie Cornell and Jenni Smasne

 

More than Our Words:

Speech Pathology & Parkinson's

 

Dr. Kristie Spencer is a Speech Language Pathologist, professor, and researcher at the UW, Seattle. Spencer and two PhD students are celebrating the completion of a very new kind of study: individualized speech therapy. Her work focuses on some of the cognitive as well as motor changes that people with Parkinson's can experience.

 

You’re a Speech Language Pathologist and faculty member at the University of Washington, Seattle. How does your work involve the Parkinson’s community?

For the majority of my career I have really focused on what drives the speech difficulties for some people with Parkinson’s. It was only in the last two years that I got back to my roots of treatment research because I was getting so frustrated with the lack of [resources] for people with Parkinson’s; so many had not had a full discussion around the potential cognitive changes that can happen with Parkinson’s.

Inevitably, when [working with people with Parkinson’s], conversation would lead to day-to-day challenges. Cognition, and missing appointments, not being able to pay bills or maintain employment; these things were so frustrating.

It became clear that [most] had not learned that they might experience cognitive changes. They felt like they were “going nuts”, to use their words, or that they had some other medical issue. Some were aware of it but missing guidance and resources, things they could do that might help or improve the cognitive difficulties they were experiencing.

 

Does cognition mean overall mental functions, as well as emotional wellbeing?

[Cognition] generally refers to attention, memory, and what we call executive processes. So being able to problem solve, and organize your thoughts.

However, your point about mental wellbeing is a good one, and some of the measures that we take before and after treatment have to do with depression, and social engagementthe overall level of wellbeing. [In our research], we saw improvements there as well as speech.

Granted, it was small scale, so we are limited in what we can assert based on a few people. However, we did see enough improvements on their home goals as well as emotional wellbeing that it was really encouraging to continue down this path of small-scale studies. All of them focused on the things that the participants wanted to improve in their day-to-day life. And we saw really good outcomes for those folks. It’s really encouraging!

Past research to support cognition in people with Parkinson’s was focused on impairment level measures: increasing the score on a memory test, or on an attention test. Nobody was working on training goals that are important to the individuals themselves. For example, “I don’t want to miss this appointment”, or “I need to remember to take my medications more regularly”things that were personally relevant.


It sounds pretty challenging to build on and create theory, but is that especially difficult because people with Parkinson’s differ so much?

Yes, that actually is one of the projects that my PhD students just completed: to better understand some of the heterogeneity in the speech of those with Parkinson’s. Some people may have a stuttering component to their speech, many talk really fast, some talk quite slowly. You see differences that really aren’t explained in our textbooks and our models. We’ve been trying to understand those processes better.

  

There can be such a divide between the academic or medical world and the people they study and provide for. Does that shift towards greater understanding of Parkinson’s have to happen in the academic world—not just the patients in their doctor’s office?

It has to come from all angles. But if the research isn’t there, then you have very little to stand on in terms of [calling for changes to] diagnostic and treatment processes. We definitely have to have that paradigm shift.

There are theories in Parkinson’s research on general motor control that say that internally generated strategies aren’t as helpful as something external. So for example if someone has really small handwriting, or micrographia, having someone remind themselves to write bigger isn’t going to be very effective. But if you provide wider lines on paper, then they’re cued by an externally generated strategy, which will encourage their cognition and ability and generally allow them to perform better.

There isn’t research on, say, pill box reminders, or alerts or calendar applications. These external strategies that can be very helpful for all of us but particularly helpful to someone experiencing cognitive changes from Parkinson’s.


Do you feel that there is more comprehensive support and research for people with Parkinson’s today? Including cognition?

Different disciplines will support [people with Parkinson’s through] cognition. Speech pathology is one of them; sometimes a psychologist, a neuropsychologist, or an occupational therapist might provide strategies that help cognition. But that’s where I feel that we as instructors and professors really bear the burden of ensuring that students are trained appropriately, and understand the current literature. Then it’s my job to get our pilot studies published, so that across disciplines we can say [prioritize cognition].

 

It’s marvelous that you are so open to the reality of the people that you’re working with, and allow that to move you in your work and in the questions you ask. It’s just so nice to hear about! [laughs]

You know, I had to get to a point in my academic career where I have tenure, and I can take some risk in research. So that’s very freeing, to start a new line of research at this point of my career. I’m really hoping we can get some momentum and funding so that we can continue down this path.

I know my studies are small...but mighty! [laughs]. I hope that they can encourage the notion that yes it is a lot more time consuming to do research this way, but it is worth it: we have very good indicators that it might be fruitful and helpful for people with Parkinson’s.

 

 

Bette Jane Camp
NWPF Blogger

Recent Posts

Punch-Drunk Parkinson's
Pass to Pass to Pass...
Terry & Marian's Thanksgiving for Two
"Pilot to Co-Pilot"
A Gem in the Healthcare Haystack

Topics

Ability (1)
access (1)
Active (2)
Activist (1)
Affordable (1)
Approach (1)
art and culture (1)
astrophotography (1)
Athletic Training (1)
attitude (23)
Attitude (7)
Auction (1)
Author (1)
Autonomy (1)
Benefits of exercise (1)
book (1)
Book (4)
Book review (18)
Book Reviews (1)
Books (1)
Boxing (1)
care (1)
care partner (1)
Caregiving (1)
Caregiving & Relationships (41)
carepartner (1)
Celebrate (1)
Ceremony (1)
Choice (1)
Cognition (1)
Cognitive Decline (1)
community (1)
Community (5)
Connect (1)
curiosity (1)
dance (1)
dance for Parkinson's (1)
Dance for PD (1)
diagnosis (1)
Diagnosis & Progression (35)
diet (1)
Diet (1)
Disability (1)
Dopamine (1)
Easy meals (1)
Education (2)
empower (1)
end of life (1)
Engage (2)
engagement (1)
English (1)
Enjoy (1)
Executive Director (1)
exercise (1)
Exercise (39)
Exercise & Movement (6)
Experiencing Parkinson's (1)
Facts (2)
fall (1)
Fall (1)
Family (2)
Friends & Family (1)
Friendship (1)
Fun (1)
Fundraising (3)
Gala (1)
Golf (1)
Golf Lessons (1)
Golf with Parkinson's (1)
Grandparent (1)
Grandson (1)
Grant writing (1)
Greet (1)
Halloween (1)
healthcare (1)
Hero (1)
Hike (1)
Hike for Parkinson's (1)
Holiday (2)
Hope (38)
HOPE Conference (1)
Hot (1)
Humor (1)
Iced (1)
Illustrator (1)
Inland Empire (2)
Julio Angulo (14)
Legacy (1)
legislation (1)
Life with Parkinson's (1)
Lifestyle (20)
Literature (1)
Living with Parkinson's (106)
Medicare (1)
Melissa Tribelhorn (1)
motor symptoms (38)
Motor symptoms (2)
Move Connect Engage (2)
Movement (2)
Movement Disorders Specialist (1)
Never say never (1)
Newsletter (1)
nonmotor symptoms (41)
Nonprofit (3)
Nonprofit Mission (1)
northwest (1)
Northwest (1)
northwest parkinson's (1)
Northwest Parkinson's (1)
NW Parkinson's (1)
Outlook (1)
pacific northwest (1)
Pacific Northwest (2)
Pain (1)
parkinsons (2)
parkinson's (4)
Parkinson's (10)
parkinsons awareness (1)
parkinson's awareness (2)
Parkinson's awareness (2)
Parkinson's Awareness (4)
Parkinson's Community (5)
Parkinson's Diagnosis (1)
parkinson's disease (12)
Parkinson's Disease (2)
Parkinson's Disease Symptoms (7)
parkinson's family (2)
Parkinson's in the Media (11)
Parkinson's Nonprofit (1)
Parkinsons Research (2)
Parkinson's Research (2)
Parkinson's Story (1)
Parkinson's Writers (1)
PasstoPass (1)
Pause (1)
perseverance (1)
Perspective (2)
Peter Dunlap-Shohl (33)
philosophy (1)
photography (1)
Planning (1)
pnw (1)
Pour (1)
Programs (1)
quality care (1)
Quality of life (1)
Reaction time (1)
REI (1)
Research (27)
Resources (1)
retirement (1)
Reviews (1)
run (1)
running (1)
Services (1)
Sharing your diagnosis (1)
Sports (1)
Spring (1)
Stories (1)
Story (1)
strength (1)
Submission (1)
Summer (1)
Support (5)
support groups (5)
Support Groups (1)
tai chi (1)
take control (1)
tango (1)
Tea (1)
Teacher (1)
Team (1)
technology (1)
Terry Tuesday (2)
Thanksgiving (1)
The Weekly (1)
Therapy (1)
trails (1)
Treatment options (1)
Treatment Options (55)
Tuesday Terry (2)
Tuesdays with Terry (2)
Veterans (1)
Video (1)
Volunteer (1)
vulnerable (1)
Walk for Parkinson's (1)
wellness (1)
Winter (1)
working with parkinsons (1)
working with Parkinson's (1)
World Parkinson Congress (1)
Writer (2)
Writing (1)
young onset (1)
young onset parkinson's (20)

Archives

2018
Punch-Drunk Parkinson's
Pass to Pass to Pass...
Terry & Marian's Thanksgiving for Two
"Pilot to Co-Pilot"
A Gem in the Healthcare Haystack
Never Say Never
The Parkinson's Holiday
Melissa’s Vote Note
Baguette and Red
Pete Beidler: The Man Behind the Books
Decisions
Reimagining Our Approach to Parkinson’s
Celebrating Fall
Board Member Spotlight on Pinky Reeve
Inattention
Whispers on the Run
More than Our Words: Speech Pathology & Parkinson's
Hardwired for Humor
Golf & Parkinson's
Tea with Terry
Welcome to The Weekly!
Never Stop Learning: an Astrophotographer's Approach
Board Spotlight on Doreen Nicholas
Second Opinions
Parkinson's Pete Reviews "Perseverance" by Tim Hague
Pathway to Picnic Perfection
Board Member Spotlight on Gloria Gottesman
Care Cat
"We'll Never Leave Anybody Behind"
Parkinson's Pete Reviews "The Highest Tide"
Uniting the Parkinson's Community
Horse Sense & Parkinson's
The Ballard Wave
Parkinson's Pete Reviews "I Give My Eyes" by Brian Peterson
Board Spotlight on Elizabeth Keller
Who, What, When?
Controlled Flight into Terrain
No Good Deed Goes Unpunished
Guitar Therapy
A New Parkinson's Perspective
Pete Beidler Reviews "The Heartbeat of Creativity"
Board Member Spotlight on David Newsom
Pete Beidler Reviews "A Parkinson's Life"
We're Listening: NWPF 2017 Community Survey
Lessons From Having Parkinson's
Fundraising with Family: Meet the Hankens
Feel it in the Gut: Daughters of People with Parkinson’s
Pairing Tango & Parkinson's
New Diagnoses, New Posses
Meet your new Executive Director!
Outside the Ring: Rock Steady Boxing
Poetry & Parkinson's
Holding on to Hope
Confessions of a Pill Head
Tackling PD Together
Pulling the Plug
Five Important Questions: How Do I Make the Best Decision?
Love Your Body Week
A Review on Parkinson Pete’s Bookshelves
Why me?
Parkinson Voice Project
2017 2016
Lies That Parkinson's Disease Told Me
Managing the Holiday Blues 2016
Who Was That Masked Man?
The Rain Is Shining — A Thanksgiving Message
Book Review - H.O.P.E.: Four Keys to a Better Quality of Life for Parkinson's
David Leventhal: Dancer, Teacher, Community Leader, Humanitarian, Movement Specialist
Meet Emily!
Rhonda Foulds, Outrunning Parkinson's Disease
Book Review: The Perapatetic Pursuit of Parkinson Disease
Staff Stories - Melanie
Snake Oil, the Cure for Parkinson's.
Book Review: Nan Little
Life's a Lot Better with NWPF
Tipping Points
Book Review: Natural Therapies for Parkinson's Disease
Dare to Attend a Support Group
Ten for David
Time After Time: Kim Farmer's Story
The Glass is Half-Full
Book Review: Reverse Parkinson's Disease
Contentment
Parkinson's and Free Will
A positive attitude is everything
Book Review - Lucky Man: A Memoir
Alexithymia, the Parkinson’s Get Out of Jail Free Card
We Make Them Together: Major Decisions in Caregiving
Boxing is cool
Safety with Style: House Renovations you can hold on to
Book review: On My Own
Shaken to the Core
Isolation and Parkinson's Disease, The hiding and the hidden
Camp Brian Interview
Safety with Style: House design ideas you can hold on to
Book review: Shake Well Before Use
Notes on Acceptance
"Advice" to a person with Advancing Parkinson's Disease
Needed: New Parkinson’s Vocabulary
Caregiving: Ken's Story
A Well-Tested Testimonial, or Spin for Parkinson's
Safety with Style: House design ideas you can hold on to
Caregiving: Susan's Story
Rock Steady Boxing: Emily
Book Review: My Degeneration, A Journey Through Parkinson's
The Marble Halls of Power
Safety with Style: House design ideas you can hold on to
2015
ROCKIN’ AROUND THE GROCERY CART
Managing the Holiday Blues
Book Review: A Complete Guide for Patients and Families
The joke is on Parkinson's
I don't always like groups, but when I do...
JBC + DBS: A Mostly-Love Story (Continued)
Rock Steady Boxing: Fred Hyde
Present Moment: A Continued Conversation
Book Review: Navigating Life with Parkinson's Disease
JBC + DBS: A Mostly-Love Story
Present Moment
On the scent of Parkinson’s disease
Harold Allen (Hal) Newsom
The 2016 World Parkinson’s Congress in Portland, Oregon is Fast Approaching: Make Plans to Attend
Flowers on Dr. Starr's Tie
Leading the life of malicious whimsy
Listen: Unlocking Parkinson's Disease
Book Review: If I Can Climb Kilimanjaro, Why Can't I Brush My Teeth?
The Evolution of HOPE
QUIZ: How well do you know your Parkinson’s Disease?
Living with Hope
Notes on Hope
Tug, tug, tug
Denial on Trial
Flowers in Our Hair
Resilience: Bouncing Back from Adversity
Summer Travel
Tina Sawyer Steps Up Fundraising in Seaside
The uncooperative patient
To be in June
Pressure Sores
Caring for a Spouse Living with PD
Life Lessons
Doc Parkinson - A Eulogy
Boom Go Parkinson’s Costs
From the Depths of the Cupboards: Pumpkin Bars
Doctor's Visits
Get Moving!
Choosing a shared burden
Our Brain's "Negativity Bias" Part 2
Outside of Language
Managing Constipation in Parkinson’s Disease
Replacements
Finding Time for Caregiver Care
The Helplessness Antidote
Examples of living your best
10 exercise tips for people with Parkinson's
Bit on Basketball
Suggestions for the Shaken
Parkinson's Action Network (PAN) Report
Our Brain’s “Negativity Bias”
Living for a Cure
Three Huge Changes for People with Parkinson's
Caregiving, the Next Level
Parkinson's Pundit
Perseverance
Making Spousal Relationships Work
Parkinson’s and Luck
Strength. Courage.
Resolve to be a Better Caregiver!
Update from the Parkinson's Action Network
Strategies to Achieve our New Year’s Resolutions and Goals
Movement is Medicine
2014 2013 2012
Most popular posts of 2012
What are you grateful for this holiday season?
How can I tell whether medications are wearing off or Parkinson’s disease is progressing?
Can a person with Parkinson’s give blood?
When is the right time to start Levodopa?
Can acupuncture help PD symptoms?
Support the Caregiver in your Life
Power of the mind to move treatment further
Top 10 Foods for Parkinson’s (and counting!)
How can I prevent dizziness?
What can you tell me about laser light therapy and Parkinson’s
What is music therapy?
Should I take Coenzyme Q10 for my Parkinson’s?
How do I treat my cough at night?
Parkinson’s fitness programs need to be tailored to the individual to get results
Carrying the Olympic Torch for Parkinson’s today
Coffee reduces risk of Parkinson’s. What about other foods?
Facts about depression
How can I find a good doctor who is knowledgeable about PD and is caring as well? My doctor does not always listen.
Help for constipation
Sex, Intimacy and Parkinson’s
Does DBS affect speech?
Walking and balance can significantly impact quality of life- but is treatable.
Depression is common with Parkinson’s
Ode to Parkinson’s- Poem from Member
Music Enhances Brain Activity
How does posture change with Parkinson’s?
What is important to you?
Are hallucinations caused by Parkinson’s?
Hot Off the Press – Neupro approved by FDA
How do I find a Parkinson’s physical therapist to keep me exercising?
Does Azilect slow disease progression?
Manage nausea from medicines
Is delaying medication harmful?
Advice for newly diagnosed
Is Parkinson’s Hereditary?
Medication Timing
Is gambling a side effect of medicine?
Medication Assistance
Does stress cause Parkinson’s?
When to see a physical therapist
FDA approves DATScan
Coconut Oil
Protein’s effect on medicine
Restless Leg Syndrome