How the SPEAK OUT!® Program Helps People with Parkinson's Reclaim Their Voice
Imagine calling your grandson for his birthday, only to have him ask you to repeat yourself three times. You weren't whispering, or at least, you didn't think you were.
But your voice had changed, becoming softer and harder to understand. For someone who had always been known for animated storytelling, the silence that followed felt devastating.
For individuals living with Parkinson's disease in Boynton Beach and throughout Palm Beach County, changes in speech and voice like these are common and often deeply frustrating.
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Words may become soft, mumbled, or monotone, making it difficult to be heard or understood in everyday conversations. Simple interactions at Publix, during family dinners, or over the phone can become exhausting challenges. Over time, many people begin to withdraw from social situations, leading to isolation and a diminished quality of life.
But here's the encouraging truth: specialized speech therapy can help restore your voice and rebuild your confidence in communication.
At Palm Beach Speech Therapy, Nina Minervini, M.S., CCC-SLP, offers the SPEAK OUT!® program right here in Boynton Beach, providing an evidence-based approach designed specifically to help people with Parkinson's rediscover the power of their voice through focused, intentional communication.
Understanding Voice Changes in Parkinson's Disease
Before exploring the solution, it's important to understand why Parkinson's affects speech in the first place.
Parkinson's disease impacts the brain's ability to produce dopamine, a neurotransmitter essential for controlling movement. While most people associate Parkinson's with tremors or difficulty walking, the disease also affects the fine motor control needed for speech production. This collection of speech and voice symptoms is called hypokinetic dysarthria.
Common voice and speech changes include:
Reduced vocal volume: Your voice may sound quieter than you intend, even when you feel like you're speaking at a normal volume. This phenomenon, called hypophonia, affects up to 90% of people with Parkinson's at some point in their journey.
Monotone quality: The natural melody and rhythm of speech may flatten, making you sound less expressive or engaged, even when you're feeling excited or emotional.
Breathiness or hoarseness: The vocal cords may not close completely during speech, creating a breathy or strained quality.
Rushed or slurred speech: Words may run together, or you might speak in short bursts that are difficult for others to follow.
Difficulty articulating: Consonants may become less crisp, causing words to blur together.
Reduced facial expression: The muscles of the face may move less, which affects both verbal and non-verbal communication.
These changes don't just affect how others hear you, and they can fundamentally alter how you feel about communicating. Many people with Parkinson's report feeling like they're "trapped" inside their own body, with thoughts and personality that remain vibrant but a voice that no longer matches their inner experience.
What Is SPEAK OUT!®?
SPEAK OUT!® was developed by the Parkinson Voice Project, a nonprofit organization in Richardson, Texas, founded in 1999 by speech-language pathologist Samantha Elandary. The organization is dedicated to helping individuals with Parkinson's maintain their ability to communicate effectively throughout the progression of their disease.
Unlike traditional speech therapy approaches, this innovative program teaches participants to speak with intent by training both the mind and body to work together for clear, confident speech. Rather than simply focusing on increasing volume, SPEAK OUT!® emphasizes purposeful effort, attention, and intention behind every word.
The philosophy is elegantly simple yet profoundly effective: when you speak with purpose and conscious effort, your voice naturally becomes stronger, clearer, and more controlled.
The program centers around a specially designed workbook that guides participants through daily exercises, creating a structured yet personalized pathway to vocal improvement. Each exercise is crafted to retrain the neural pathways involved in speech, helping your brain remember how to produce clear, strong communication.
How the SPEAK OUT!® Program Works
Each therapy session integrates vocal and cognitive exercises designed to strengthen the muscles used for speech and improve coordination between the brain and body. The program recognizes that speech is both a physical and mental activity—you need strong muscles and focused intention to communicate effectively.
The Core Components
Breathing and warm-up exercises prepare your respiratory system and voice for the work ahead. Proper breath support is the foundation of strong speech, and many people with Parkinson's develop shallow breathing patterns that undermine vocal power.
Vocal strengthening tasks increase loudness and projection through carefully calibrated exercises that build stamina without straining. You'll practice sustaining sounds, varying pitch, and projecting your voice across distances.
Articulation drills improve clarity by targeting the precise movements of the lips, tongue, and jaw. These exercises help sharpen consonants and ensure each word is distinct and understandable.
Cognitive-speech activities enhance focus and memory while engaging in communication tasks. This dual approach addresses both the physical and neurological aspects of speech affected by Parkinson's.
Conversational practice applies everything you've learned in real-world scenarios, from ordering at a restaurant to participating in family discussions. This ensures the skills transfer beyond the therapy room into your daily life.
The Treatment Timeline
Therapy typically involves 12 individual sessions conducted over several weeks, with each session lasting 45-60 minutes. This initial intensive phase establishes the foundation and teaches you the core techniques.
However, the program doesn't end after 12 sessions. SPEAK OUT!® includes a transition to ongoing maintenance and practice, recognizing that Parkinson's is a progressive condition requiring continued attention. Many clients continue through group programs called "The LOUD Crowd®" or maintain home practice routines to reinforce their progress and prevent decline.
Daily homework exercises, which usually last 15-20 minutes, are a crucial component of success. Like physical therapy for your legs, speech therapy requires consistent practice to create lasting neurological changes.
Why SPEAK OUT!® Is Effective: The Science Behind the Method
Parkinson's disease affects the basal ganglia, structures deep in the brain that control the neurological programming of movement sequences, including the complex motor patterns needed for speech. As these structures deteriorate, movements become smaller and require more conscious effort—a phenomenon called hypokinesia.
This is why people with Parkinson's often don't realize their voice has become quiet. The internal sensation feels normal, but the actual output has decreased. Scientists call this a "perceptual deficit"—your brain's calibration of what's "normal" has shifted downward.
SPEAK OUT!® helps by:
Recalibrating your internal perception
Through consistent practice, you learn to recognize what adequate vocal effort feels like, resetting your internal baseline for normal speech volume and clarity.
Increasing vocal strength and clarity
Targeted exercises strengthen the muscles of the larynx, diaphragm, and articulators, providing the physical foundation for better speech.
Improving breath support and projection
'Enhanced respiratory control gives you the power behind your voice, allowing words to carry further and sound more robust.
Encouraging expressive, natural intonation
By focusing on intent and meaning, you rediscover the natural melody of speech that conveys emotion and personality.
Enhancing memory and focus through cognitive engagement
The intentional approach keeps your brain actively involved in the speech process, strengthening the neural pathways that control communication.
Restoring confidence in social communication
As your voice becomes more reliable, you'll feel more comfortable participating in conversations, speaking up in groups, and staying connected with loved ones.
By teaching participants to use intentional effort rather than relying on automatic speech patterns, SPEAK OUT!® transforms passive, fading communication into active, confident expression. You're not just speaking—you're speaking with purpose.
Who Can Benefit from SPEAK OUT!®
SPEAK OUT!® is designed specifically for individuals with Parkinson's disease or Parkinsonism-related disorders such as Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP), or Corticobasal Degeneration (CBD).
However, it can also benefit anyone experiencing reduced vocal volume or difficulty being understood due to neurological changes affecting speech production.
Timing Matters: When to Start Therapy
Therapy can begin at any stage of Parkinson's diagnosis—and research consistently shows that earlier intervention often leads to stronger, longer-lasting outcomes. You don't need to wait until speech problems become severe.
Consider starting SPEAK OUT!® if you notice:
Family members or friends frequently asking you to repeat yourself
Difficulty being heard in noisy environments like restaurants
Feeling like your voice tires easily during conversations
Others commenting that you sound quieter or different
Reduced confidence in speaking situations
Avoiding social situations because of communication concerns
Even if speech changes are mild, proactive therapy can help you maintain your communication abilities and potentially slow decline. Think of it as preventive care for your voice.
Research on the SPEAK OUT!® program has demonstrated improvements in:
Vocal loudness and intensity
Speech intelligibility (how well others understand you)
Sustained vocal quality during longer conversations
Self-confidence in communication situations
Overall quality of life related to communication
In-Home Speech Therapy in Boynton Beach and Virtual Options
Palm Beach Speech Therapy understands that getting to appointments can be challenging, especially for individuals with mobility concerns. That's why Nina Minervini offers flexible service delivery options designed around your needs and preferences.
In-Home Therapy Throughout Boynton Beach
Nina provides in-home speech therapy throughout Boynton Beach and the surrounding Palm Beach County communities, bringing specialized Parkinson's speech therapy directly to your home. Whether you live near the beaches, in Canyon Lakes, Aberdeen, or any Boynton Beach neighborhood, Nina comes to you.
Home-based therapy offers several advantages:
No driving stress – Especially important in South Florida traffic and during busy season when snowbirds return
Comfort of your own environment – Practice communication in the spaces where you actually live and talk
Energy conservation – Save your energy for therapy rather than spending it on transportation
Family involvement – Spouses, adult children, or caregivers can easily participate and learn strategies to support your progress
Reduced illness exposure – Particularly valuable during flu season or for individuals with compromised immune systems
Real-world practice – Work on functional communication in your actual kitchen, living room, or patio where conversations naturally happen
Virtual Therapy for Maximum Flexibility
For clients who prefer remote services or live in other parts of Florida, virtual therapy via secure video conferencing provides an effective alternative. Research shows that telepractice speech therapy can be just as effective as in-person sessions for many voice and speech goals.
Virtual therapy offers:
Convenience of attending from anywhere with internet access
Flexible scheduling that fits around medical appointments, which many Boynton Beach residents have
No concerns about parking or building access
Easy incorporation into busy schedules
Continued therapy even when travel isn't possible
Whether in person or online, Nina tailors each SPEAK OUT!® session to your individual goals, medical background, speech baseline, and daily communication needs. Your therapy is never one-size-fits-all—it's designed specifically for you and your life in South Florida.
More Than Speech Therapy: Supporting Your Communication Journey
While SPEAK OUT!® provides powerful clinical intervention, supporting your voice health involves lifestyle strategies too:
Stay hydrated in Florida's climate – South Florida's heat and humidity can be deceptive. Vocal cords need adequate moisture to function optimally. Drink water throughout the day, especially before important conversations and when using air conditioning, which dries the air.
Practice daily – Even 10-15 minutes of daily exercise makes a significant difference in maintaining speech improvements. Consider practicing during the cooler morning hours on your patio or lanai.
Reduce background noise – When possible, communicate in quieter environments where you won't need to compete with TV, music, or crowd noise. During busy season in Boynton Beach, restaurants can be especially loud—request quieter seating when possible.
Face your conversation partner – Visual cues help communication, and facing someone ensures your voice projects toward them. This is especially important outdoors or in breezy conditions near the beach.
Take communication breaks – If your voice fatigues during long conversations, it's okay to take breaks or save topics for when you're rested. Florida's lifestyle often involves long social gatherings—pace yourself.
Stay socially engaged – Regular conversation provides natural practice and prevents the isolation that can worsen communication challenges. Boynton Beach offers many opportunities through senior centers, clubs, places of worship, and community activities.
Join support groups – Connecting with others who understand your experience provides emotional support and practical tips. Local Parkinson's support groups meet throughout Palm Beach County.
Start SPEAKING OUT with Nina Minervini in Boynton Beach
If Parkinson's has made your voice softer, your speech less clear, or your confidence in communication lower, specialized therapy can make a profound difference in your quality of life.
You deserve to be heard. Your stories matter. Your voice matters.
Nina Minervini, M.S., CCC-SLP, provides SPEAK OUT!® therapy through Palm Beach Speech Therapy, serving Boynton Beach and surrounding Palm Beach County communities. With years of experience in neurological communication disorders and a genuine passion for helping people reclaim their voice, Nina creates a supportive, encouraging environment where progress happens—right in the comfort of your own home.
Don't let communication challenges keep you on the sidelines of your own life.
Contact Nina Today
📞 Call or Text: (561) 797-2343
📧 Email: ninaminervini11@gmail.com
👉 Ready to get started? Contact Nina for a SPEAK OUT!® Evaluation
During your initial evaluation, Nina will:
Assess your current speech and voice function
Discuss your communication goals and challenges
Explain how SPEAK OUT!® can specifically help you
Answer all your questions about the program
Develop a personalized therapy plan
Take the first step toward reclaiming your voice and reconnecting with the people and activities you love here in Boynton Beach.
Frequently Asked Questions About SPEAK OUT!®
How is SPEAK OUT!® different from LSVT LOUD®?
Both SPEAK OUT!® and LSVT LOUD® are evidence-based programs designed to improve speech for people with Parkinson's, and both can be highly effective. The key differences lie in their approach and philosophy:
LSVT LOUD® focuses intensively on increasing vocal loudness through the principle "think LOUD, talk LOUD." It involves 16 sessions over four consecutive weeks (four times per week), with a strong emphasis on producing loud voice consistently.
SPEAK OUT!® emphasizes speaking with intent—using cognitive effort and purpose behind your speech. Rather than focusing solely on loudness, it encourages you to consciously engage in the act of speaking. Many patients find this "intentional effort" framework easier to apply outside therapy sessions because it doesn't require constantly monitoring volume levels.
The choice between programs often comes down to individual preference, therapy schedule compatibility, and which approach resonates more with your learning style. Nina can help you determine which program might be the best fit for your specific situation.
Can SPEAK OUT!® help with swallowing difficulties?
Yes—because the program strengthens muscles in the throat, mouth, and respiratory system, many participants notice improvements in both speech and swallowing function. The same muscle groups are involved in both activities.
However, if you're experiencing significant swallowing difficulties (dysphagia), Nina may recommend a comprehensive swallowing evaluation and potentially additional targeted swallowing therapy alongside SPEAK OUT!®. Swallowing problems can lead to serious health complications, so they deserve dedicated attention.
Do I need a doctor's prescription to start therapy?
A prescription or referral is not required to begin speech therapy in Florida. However, coordination with your physician, neurologist, or movement disorder specialist is highly recommended to ensure continuity of care and optimal outcomes.
Many Boynton Beach residents receive their Parkinson's care from neurologists at Bethesda Hospital East, Cleveland Clinic Florida, or other area medical centers. Nina can coordinate with your medical team regardless of where you receive care.
If you're planning to use health insurance benefits, many insurance companies do require a physician's order for therapy to be covered. Nina can help you navigate these requirements and work with your medical team.
How long does it take to see results?
Most clients notice improvement in clarity and projection within the first few sessions—often by session 3 or 4. However, the full benefits of the program emerge with completion of the initial 12-session protocol and continued practice.
Early changes might include:
Greater awareness of your voice and speech patterns
Improved breath support during speaking
Increased vocal volume with conscious effort
Better articulation on specific sounds or words
Long-term benefits with consistent practice include:
Sustained improvements in everyday communication
Automatic use of intentional speech strategies
Maintained voice quality over months and years
Greater confidence and reduced communication anxiety
Remember, Parkinson's is progressive, so ongoing practice is essential to maintain gains and potentially slow decline in communication abilities.
Will my insurance cover SPEAK OUT!® therapy?
Coverage varies by insurance plan. Medicare and many private insurance plans cover speech therapy for medical conditions like Parkinson's disease, though benefits, copays, and session limits differ.
Nina can provide documentation and work with you to pursue insurance reimbursement. For clients paying privately, flexible payment options may be available.
It's worth checking your specific benefits before starting therapy, but don't let insurance uncertainty stop you from getting an evaluation—many clients find the investment in their communication is invaluable regardless of coverage.
What areas do you serve besides Boynton Beach?
While based in Boynton Beach, Nina provides in-home therapy throughout Palm Beach County, including Delray Beach, Lake Worth, West Boca Raton, Wellington, and surrounding communities. Virtual therapy extends services throughout Florida and other states where Nina is licensed. Contact Nina to discuss whether your location works for in-home visits.
Let’s SPEAK OUT together!
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