“Growing up, I didn’t know exactly what I wanted to be, but I knew I would want to be the best at it, that wherever my energy was going to go, I was going to put everything into it.” This is what Cynthia Fox has done.
When I met her on Zoom, she was standing in front of the computer, not resting in a desk chair. I could feel her physical presence and her willingness to move, to take up space. Her enthusiasm was palpable.
Cynthia Fox, CCC-SLP, found her way to speech therapy through the help of her mom. Her mom was a physical therapist, her dad was a surgeon. And her siblings went into medicine, too; her sister’s a pediatrician and her brother is in family practice. Cynthia, though, was certain she didn’t want to be a doctor. When her mom suggested speech pathology as a potential alternative, Cynthia considered it: she loved communication and the power of voice (she grew up singing in choir), and while she knew she didn’t want to be a doctor, she still wanted to feel the heart-filling energy of being in the helping professions.
She decided to give it a try. She chose to study speech language pathology in college and, almost immediately, she knew: “This is for me.” She hasn’t stopped since.
The Early Years of LSVT LOUD
Speech pathology is a broad field. As Cynthia shares, “It’s anything related to speech language communication, which means language, cognition, motor speech, voice, and even swallowing.”
Fresh out of college, Cynthia secured a clinical fellowship that was a research position, which was rare. She was working with Dr. Ramig in Boulder, CO, who was focused on the voice elements of communication in people with Parkinson’s and was developing this new speech therapy technique called LSVT LOUD. After her fellowship year, Cynthia got a job in Dr. Ramig’s lab in Tucson, and that’s where she really fell in love with her work.
“Honestly, that’s when I had my ‘aha,’” she said, “because I would recruit and treat patients and it was like magic! In that one month time during their intensive therapy session with me, they would completely transform and I thought, wow, this really changes a person’s life.”
“It was magical and inspirational and I knew I wanted to be part of it.” Laughing, she added, “And I never did anything else ever again.”
In the nearly thirty years since, Cynthia has helped expand LSVT LOUD into pediatric populations and other neurological disorders. Today, she is the Co-Founder and CEO of LSVT Global, Inc. “It’s a true passion.”
The Benefits of LSVT LOUD for People with Parkinson’s
A huge majority—about 90%—of people with Parkinson’s will experience communication challenges. Historically, speech treatments for people with PD are less intensive and focus on articulation and speech rate. The research conducted by Dr. Ramig, Cynthia, and others at LSVT LOUD have encouraged them to take a different approach, honing in on vocal loudness. LSVT LOUD is designed to address motor problems, like the reduced amplitude of movement in a person with PD’s body that affects the voice, including whispered or mumbled speech.
Key to its effectiveness is the way it addresses the sensory element of speech disorders, as well. As Cynthia explained, “A person’s voice may be getting softer but they won’t realize it’s softer. In fact, when we support them to speak louder, at first they feel too loud. Retraining that sensory perception is part of the treatment.”
The sessions are intensive: participants who enroll in LSVT LOUD meet with a therapist for 16 hours over 4 weeks. But the benefits are worth it. Cynthia says, “This technique enables people to be heard, to be understood…For so many people who go through this program, they tell us it gave them their life back. Now, they can keep their jobs. Or they can get back out into the world and people won’t ignore them anymore because they can finally hear them and understand them.” Her participants feel like life returns: conversation, community. She added, “We’ll even have people say, ‘Oh, my gosh, LSVT saved our marriage.’” The LSVT LOUD technique is not just about the person with Parkinson’s; they educate couples “as a whole unit.”
In fact, the impact of LSVT LOUD can be seen on a neural level. Multiple studies of neural imaging of people who have participated show real physiological changes in the brain. “People really do get better,” Cynthia said.
PD Speech Therapy That Lasts
For Cynthia, part of the beauty of this work is that she gets to build lifelong relationships with many of the people she works with. “There’s a bond that forms,” she said about the intensive month they spend together.
What’s powerful is that research shows that the effects of this intensive month of LSVT LOUD treatment can last two years. “It’s amazing, when you think about it,” Cynthia said. “Imagine if you took your pills for one month and, two years later, you were better without any additional therapy.”
Still, the LSVT LOUD therapists love to check in on their patients every six months, deepening the bond and offering tune-up sessions as needed. Therapy participants are given exercises they can do at home, long after their intensive first month. “We follow people over time,” Cynthia explained, “and many times we have had family members contact us after their loved one has passed away, and they’ll tell us, ‘This was one of the most important things in our whole Parkinson’s care.’”
But what participants often love most are the LOUD for LIFE® classes, which are community-based classes which allow LSVT LOUD graduates to practice their exercises and louder voices not just at home by themselves, but in a group with other graduates. These classes are fun and engaging and, the best part, they nourish graduates with the joy of community.
How to Find an LSVT-Certified Clinician
Cynthia Fox and the entire LSVT Global team want to make sure that people everywhere have access to this transformative therapy. “We asked ourselves, how does this treatment live beyond us?”
Cynthia and her team are committed to making sure LSVT outlasts them by working to train therapists and organizational partners. They offer an LSVT certification, which distinguishes a therapist for having learned the effective research and technique behind the treatment program.
Today, people across the globe can find an LSVT certified clinician by using this search tool. Wondering how far their network extends, I curiously typed Rome, Italy into their clinician finder and discovered over 30 clinicians in a 20-mile radius. Global, indeed.
The Heart of LSVT LOUD
When Cynthia started this work, what moved her most was encountering this community’s willingness to give back. Early on, when LSVT LOUD was in its infancy and they were still building the research that would later prove its efficacy, she was touched by how many people with Parkinson’s were willing to give the program a try, telling her, “It may or may not help me, but if it helps people after me, then I’m willing to do whatever it takes.”
In the decades since, the Parkinson’s community has continued to touch her. “Working with this community has been a gift,” she said. “I hope Parkinson’s goes away and I can find a different gift, but it has been beyond rewarding. After 30 years, I still have the same excitement and passion.”
“Communication is at the heart and soul of who we are as human beings,” she went on. “And the important thing is that there’s something we can do to make it better.”
Cynthia knows it’s bigger than the volume of your voice: it’s your capacity to be heard. And feeling heard and sharing in the richness of connection makes our journeys so much brighter.
