The most prominent gauge in your car, and perhaps the most important, at least in terms of how many times you look at it while you’re driving, is the speedometer. The job of the speedometer is to indicate the speed of your car in miles per hour, kilometers per hour or both. Even in late-model cars, it’s an analog device that uses a needle to point to a specific speed, which the driver reads as a number printed on a dial.

It wasn’t until 1910 that automobile manufacturers began to include the speedometer as standard equipment, because cars weren’t only becoming more popular, they were also traveling faster. As a result, serious accidents began to increase dramatically, and automobile manufacturers began to include the speedometer as standard equipment. Interestingly, numerous studies which have examined a driver’s perception of speed have shown that drivers tend to underestimate speed  under a variety of laboratory and natural conditions. Speed perception within the context of driving is an everyday example of multisensory integration, or our brain’s ability to deal with lots of incoming stimulus.

Anywhere from 70-90% of persons with Parkinson’s have speech and voice problems, collectively referred to as hypokinetic dysarthria. Problems of reduced loudness, reduced effort, and inaccurate feedback, are common symptoms related to a breakdown in the multisensory integration in the brain. Like the driver who misjudges his speed as too slow, many people with Parkinson’s mis-judge their voice loudness and vocal effort. Patients will often tell me that their very soft speech is “loud enough” and when cued to speak at a normal level of loudness they often say that it’s “too loud” or “it feels like I’m shouting”.

The pathophysiology underlying this impairment in internal cueing is only partially understood but the internal cueing deficit in Parkinson’s can often be improved in response to external cueing. Since speech and voice tend to improve dramatically in response to external cueing, a simple external cueing  device, might be a useful tool for daily practice by providing concurrent feedback and a target for effort so that voice strengthening can occur.

Hi-VOLT® 4 PD, a portable, calibrated, voice activated bracelet, was created with this goal in mind. For years I have seen patients get loud in therapy, only to lose the effect once they leave the treatment room or are back home in their own environment. This is not because of lack of effort on the part of any person, but rather, it is simply the challenge of trying to compensate for a speech mechanism that has been changed, or is changing due to Parkinson’s.

So, if you are someone with a soft voice due to Parkinson’s, and despite speech therapy or other efforts, you still find it difficult to maintain adequate loudness, I invite you to give Hi-VOLT® a try. It’s an affordable and portable device that might help you to start your voice engine!

Try these suggestions for using your Hi-VOLT® voice-activated bracelet

  • Use it daily when completing your speech home practice
  • Use it once a week to re-calibrate your voice to the necessary level of loudness for strengthening
  • Use it in the car when you’re a passenger. Wear it on your wrist and read road signs. Make a 20 minute car ride a practice session.
  • Use it when you are in Physical therapy and count your reps in a LOUD voice.

To Learn more and for ordering information,visit my website:


My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate  and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

Voice Aerobics the heART and Science of Voice Practice