By Heenal Narsey, Certified Practising Speech Pathologist (MSPA-CPSP) – My Rehab Team.
Parkinson’s disease can gradually take away one of the most personal things we have – our voice. SPEAK OUT!® Therapy Program is a therapy approach designed specifically for people living with Parkinson’s, helping them regain control, strength, and confidence in their voice through structured, evidence-based exercises that focus on intent and effort in speech.
But for many people, especially those from culturally and linguistically diverse (CALD) backgrounds, accessing these services in the community can be incredibly challenging.
What is “SPEAK OUT!” Therapy?
The SPEAK OUT! Therapy Program is a structured speech therapy approach developed by Parkinson Voice Project® in the United States. It is designed to support individuals with Parkinson’s disease and related neurological conditions in regaining and retaining their speech and swallowing abilities. The program focuses on empowering participants to “speak with INTENT” by shifting speech from an automatic process to a purposeful, intentional act (Parkinson Voice Project, 2023). Through targeted voice exercises, conversational practice, and functional carryover tasks, participants develop increased vocal intensity, clarity, and overall communicative effectiveness (Parkinson Voice Project, 2023).
Therapy is most effective when started early, ideally in outpatient or community settings – not just in hospital environments. Unfortunately, many people may never get the chance to access it due to health system barriers, limited referrals, or language barriers (Australian Commission on Safety and Quality in Health Care, 2020).
A Barrier for Many – Language and Service Access
In some communities, people with Parkinson’s may not be referred for outpatient speech therapy, may not understand what services are available, or may be unable to advocate for themselves due to language barriers or limited digital literacy. These barriers are even more pronounced for carers and family members who may not speak English confidently (Cross et al., 2021).
Clients from multilingual and multicultural backgrounds are often underrepresented in voice therapy services, despite facing unique communication barriers and experiencing significant voice-related challenges. This disparity reinforces the need for inclusive, flexible, and culturally safe service delivery models that align with best practice principles in working with CALD communities (Speech Pathology Australia, 2016; Department of Health and Aged Care, 2022; AIHW, 2023).
How Can We Improve Access?
Here’s how we can help more people living with Parkinson’s access the SPEAK OUT! Therapy Program in the community:
1. Interpreter Services in Therapy
- Trained interpreters help ensure that clients understand and engage with therapy goals (Speech Pathology Australia, 2022).
- Interpreters can assist with explaining voice techniques, coaching home exercises, and reducing communication breakdowns during sessions. This is also in line with the NSQHS Standards, which emphasise partnering with consumers and ensuring cultural safety (Australian Commission on Safety and Quality in Health Care, 2020).
2. Translated and Accessible Resources
- Providing written, visual, or audio-based home practice guides in the client’s preferred language supports carryover and health literacy (NSW Health, 2020).
- Families can also receive multilingual guides with carer communication tips and culturally relevant examples.
3. Technology Supports
- Voice-recording and practice apps (e.g., Voice Analyst, Speak Up) support home practice and reinforce motor learning principles (Constantinescu et al., 2021).
- Visual timers, cueing apps, and pre-recorded videos in the client’s first language can support comprehension and independence.
4. Partner and Carer Training
- Including carers in sessions ensures home practice is reinforced consistently and in a culturally appropriate way (Kent et al., 2021). This helps families provide meaningful support using familiar cues, multilingual instructions, and shared routines.
- It also aligns with Speech Pathology Australia’s professional standards for inclusive, culturally responsive practice (Speech Pathology Australia, 2020) and acknowledges the central role that families play in daily communication, especially in CALD households.
Every Voice Matters
Every person with Parkinson’s deserves a chance to keep using their voice. We can’t let language, health literacy, or access barriers silence them. By combining person-centred therapy with inclusive strategies – like interpreters, accessible technology, and cultural understanding, we can ensure more people benefit from life-changing programs like the SPEAK OUT! Therapy Program.
If you’d like to know more about how speech therapy can support someone you care for, especially if English isn’t their first language – please reach out to Heenal, a Certified Practising Speech Pathologist who is certified to provide SPEAK OUT! Therapy at My Rehab Team. We’re here to help every voice be heard, with person-centred care that values culture, communication, and connection.
SPEAK OUT! Therapy Program is a trademarked speech therapy program developed by Parkinson Voice Project. This article discusses its use and accessibility in the community setting for informational purposes only.
References:
- Australian Commission on Safety and Quality in Health Care. (2020). National Safety and Quality Health Service (NSQHS) Standards – Partnering with Consumers Standard. Retrieved from https://www.safetyandquality.gov.au/ standards/nsqhs-standards
- Australian Institute of Health and Welfare. (2023). Older Australians – Culturally and Linguistically Diverse Populations. Retrieved from https://www.aihw.gov.au/reports/ older-people/older australians/contents/diversity/cald
- Constantinescu, G., Theodoros, D., Russell, T., Ward, E., Wilson, S. J., & Wootton, R. (2021). Using technology to deliver speech therapy for adults with neurological conditions: A review of the evidence. Disability and Rehabilitation: Assistive Technology, 16(3), 224–233. https://doi.org/10.1080/17483107.2019.1663114
- Cross, A., Singh, S., & O’Halloran, R. (2021). Barriers to speech-language pathology services for culturally and linguistically diverse populations. International Journal of Speech-Language Pathology, 23(2), 125–133. https://doi.org/10.1080/17549507.2020.1816817
- Department of Health and Aged Care. (2022). Australian Charter of Healthcare Rights (2nd ed.). Retrieved from https://www.safetyandquality.gov.au/publications-and-resources/resource-library/australian-charter-healthcare-rights-second-edition
- Kent, B., Ellis, K., & Woods, K. (2021). Involving carers in speech therapy: A narrative review. Australasian Journal on Ageing, 40(1), 15–22. https://doi.org/10.1111/ajag.12798
- NSW Health. (2020). Health Literacy Framework 2020–2024. Retrieved from https://www.health.nsw.gov.au/healthliteracy
- Parkinson Voice Project. (2023). SPEAK OUT!® Therapy Program Overview. Retrieved from https://www.parkinsonvoiceproject.org/SPEAK-OUT
- Speech Pathology Australia. (2016). Culturally and Linguistically Diverse (CALD)Communities: Position Statement. Retrieved from https://www.speechpathologyaustralia.org.au
- Speech Pathology Australia. (2020). Inclusive and Culturally Responsive Practice:Professional Standards and Code of Ethics. Retrieved from https://www.speechpathologyaustralia.org.au/SPAweb/Members/Ethics/Inclusive_and_Culturally_Responsive_Practice.aspx
- Speech Pathology Australia. (2022). Working with Interpreters in Speech Pathology Practice. Retrieved from https://www.speechpathologyaustralia.org.au
