The Foundation of DixieRegional Medical Center salutesgrateful patient and donorRobert Simonsen for joiningcourage and philanthropy tomake these f i r s t - in -UtahLSVT®LOUD and LSVT®BIGWorkshops possible.

Founder and leader of a highlysuccessful real estate company,avid equestrian and outdoorsman,dedicated father to 10 childrenand 28 grandchildren … all theingredients of an active life welllived by a man whose mantra,even in the face of great adversity, has always been“never give up” and “always give back.” Such is the lifeof Mr. Robert Simonsen. Some years ago, his businessactivities led him to establish a family-owned real estatecompany known as Simpar (Simonsen Partners)Associates, LLC that invested mostly in Utah property,including a home and small farm in Washington County.

Of his lovely wife, Alice, Robert says she is a wonderfulpartner in life, a devoted and committed caregiver. Sheenjoys with him the “golden years” of retirement whilewintering in the mild climate of Utah’s Dixie. Not so longago, however, Robert’s retirement years seemedanything but golden. It started with his handwriting.Though once a master of calligraphy, he began noticingabout five years ago that his script became ever smallerand more slanted. He also found he couldn’t turn over inbed and began experiencing balance problems. At thetime, these seemed like random symptoms.

Unfortunately, though, he soon found they were verymuch related – clearly indicative of early-onset ParkinsonDisease. It was a difficult reality for Robert as he hadwatched his brother, today wheelchairbound, suffer withthe disease for 25 years. But unlike his brother who hadthe more debilitating form of the disease — often called

Q U A R T E R L Y N E W S L E T T E R O F L S V T G L O B A LVol. 1, No. 3 • Fall 2008 6890 E. Sunrise Dr., Ste. 120 #241 • Tucson, AZ 85750 • 1.888.438.5788

the “freezing disease”because it made the body’smuscles increasingly rigid —Robert’s early diagnosisindicated he could have agreater positive response torehabilitation therapies.By his own admission,Robert Simonsen wasfortunate. Not only wasearly intervention possible,but through his interfacewith Dixie RegionalMedical Center as a

“snowbird” in the St. George area, he wasintroduced to and became a participant of somethingcalled the Lee Silverman Voice Treatmentprogram – LSVT®LOUD and LSVT®BIG. DixieRegional was distinguished as the only hospital inUtah to offer LSVT® programs and 14 patients havenow successfully completed these programs. RobertSimonsen is one of them.

LSVT® therapies help restore oral communicationand motor coordination in individuals with PDbeyond what other interventions — such aspharmacological or surgical — offer. LSVT® patientsare more effective and emotionally engagedcommunicators after treatment. The LSVT®LOUDprogram itself is an intensive voice treatmentprogram based on motor learning theory and is givenin 16 sessions in one month. Homework consists ofintensive practicing outside the clinical setting —once a day on clinic days and twice a day otherwise.The LSVT®BIG program applies the principles andapproach of LSVT®LOUD to improving major motorskills, to improve things like gait, limb movement, andbalance. Overall, both program componentspositively impact the patient’s quality of life.

Courage and Philanthropy Make Utah First!Alice & Robert Simonsen

Continued on Page 6

Texas Voice Project for Parkinson Disease (TVP) is anon-profit organization founded by Samantha Elandary,LSVT® certified speech-language pathologist in 2006,under the auspices of the National ParkinsonFoundation, Inc. The mission of TVP is to provide everyParkinson patient in the Dallas Area the opportunity toimprove their speech and swallowing in an effort tominimize the risk of life-threatening aspiration-inducedpneumonia. Over the past 21/2 years, TVP has evaluatedand treated over three hundred patients with Parkinson’sand related neurological disorders.

Since Parkinson Disease (PD) is progressive andcontinuously challenges people who have the disease, TVPhas created a unique maintenance program called “TheLOUD Crowd™” to help provide greater accountabilityand the additional encouragement necessary to sustainimprovements patients achieve in four weeks of LeeSilverman Voice Treatment (LSVT®). The LOUDCrowd™ program consists of seven weekly speech groups,a singing program, 6-month LSVT® re-evaluations andother engaging activities geared toward helping patientsmaintain the communication skills they regained throughtreatment. Ongoing LSVT® treatments can help patientsretain vocal improvements for up to eight years.

This past spring, TVP received a $400,000 gift whichenabled the organization to rent a 4,000 sq. ft. facility forthe next five and a half years. During the week of July 19th,over 400 Parkinson patients, their families, and healthcareprofessionals celebrated the Grand Opening of TVP’s newfacility in the Promenade Shopping Center in Richardson,Texas.

The festivities began with a Physicians’ Breakfast, whichfeatured an opening address from Joyce Oberdorf,President and CEO of the National Parkinson Foundationand then a special presentation by Dr. Lorraine Ramig,LSVT Global’s Co-founder and Chief Scientific Officer. Thatsame afternoon, over 250 Parkinson patients and their

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Texas Voice Project

families gathered under a giant canopy in the center’sparking lot to celebrate the official ribbon cutting. Thecrowd toured the new facility, which was specificallyremodeled with the needs of Parkinson patients as toppriority: an automatic door at the entrance, emergencybuttons in the restrooms, a library full of books about thedisease and chairs that are easy to get in and out of. Thenew facility will also serve as a training center to teachother healthcare professionals about PD.

All services provided by TVP are offered to the Parkinsonpopulation at no cost. The organization relies on grantsand monetary support from local businesses to fund theseservices. On August 1, 2008, TVP implemented “Pay itForward,” as part of its principle practices, to encourageclients who are financially able to “Pay it Forward” whichwill help generate the additional revenue necessary tocontinue providing services to other patients with PD thatwill help improve their speech and swallowing.

For more information about Texas Voice Project, call (469)375-6500 or go to www.texasvoiceproject.org andcheck out their new website.

Samantha Elandary, Director of the Texas Voice Project(right), Ms. Oberdorf, President and CEO of the NationalParkinson Foundation (left), cut the ribbon with BobTownsend, Richardson’s Mayor Pro Tem (center).

Patients CornerIn each LSVT LINK, we would like to share your stories and glories!

LSVT®LOUD and LSVT®BIG have helped thousands of patients not onlyrecapture their voice and mobility, but also self-confidence and engagement in life.

If you would like to share your experience in our upcoming LSVT LINK newsletter,please send your story (and any accompanying JPEG photos) toinfo@lsvtglobal.com. Your input will inspire both patients and cliniciansworldwide. Please keep it coming!

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DVDs• LSVT®LOUD Homework Helper

(currently available)Speech exercises for people with Parkinson Disease and other neurological conditions

• LSVT®LOUD 101 DVD (currently available)A 42 minute introduction lecture ideal for patientsupport groups, introductory student lectures, orbasic in-service presentations.

• LSVT®LOUD Homework HelperCantonese (now available)Speech exercises for people with Parkinson diseaseand other neurological conditions

• LSVT®LOUD 202 DVD (coming soon)Intermediate lecture for either patient supportgroups, academic lectures or in-service for healthcare professionals

LSVT®LOUD & LSVT®BIG Marketing Brochures (currently available)

As a Certified LSVT® Clinician, you need to get theword out that you are ready for LSVT business. LSVTmarketing brochures are the perfect way for you toadvertise yourself as a Certified LSVT® Clinician.

LSVT®BIG Homework Helper Card Series (coming soon)

This series of exercise cards will help patients recallthe therapeutic movements that unlocked the key totheir mobility. Designed by leading experts in theLSVT®BIG method, patients will have this practical,hands-on exercise regimen at their fingertips,bridging the time between therapy sessions.

LSVT Global OfferingsLSVT Global has exciting products and workshops for patients and clinicians alike.

LSVT®LOUD LAUNCHER (coming soon)

Will provide clinicians with a variety of materialscritical to the successful implementation andintegration of LSVT®LOUD into their individualpractices

E-LEARN SEMINARS (coming soon)

• E-Learn Seminars – On-line learning portalwhere certified clinicians can earn continuingeducation credits and sharpen their skills

WORKSHOPS(currently available)

• Over 20 Workshops Worldwide in 2008 – Forclinicians to become certified in the LSVT®LOUDor LSVT®BIG treatment methods

LSVT®E-LOUD (currently available)

• E-Loud Treatment Delivery – An on-linetreatment method where patients can receivetherapy from the comfort of their own homes viawebcam

LSVT-C SOFTWARE (coming soon)

• A new software program for LSVT® certifiedclinicians that will facilitate data collection, analysis,and treatment delivery... plus a version for clientsthat will allow for continued home-treatment,practice, and exercise at the end of therapy.

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I was particularly glad that I hadgiven my old (pre-LSVT training)voice the heave-ho when I wasrecently asked by a well-knownSanta Fe director to act in a playthat I had written as part of aplaywriting competition. At thispoint, my initial “The Play’s theThing” theatrical image of CynthiaFox became almost eerilyappropriate.

The Santa Fe Playhouse’s BENCHWARMERS, a highly competitiveone-act play competition, was nohigh school amateur hour as itmight be in your typical town of70,000 people. There is nothing typicalabout Santa Fe! For example, one of my fellowplaywrights was a three-time Emmy winner while anotherwrote for the television sitcoms, “All in the Family” and“Three’s Company.”

As a fledgling playwright, I was worried about how myproduction would be received, if anyone would show up,and if the consistently vitriolic Santa Fe theater criticswould trash my oeuvre, an autobiographical story of myearly salad days.

Santa Fe is such a quirky town that it is hard to predict thesuccess of any given event. Lew Wallace, author of “BenHur” (written while he was a governor of the territory ofNew Mexico), said it best: “Every calculation based onexperience elsewhere fails in New Mexico.”

The stars must have been aligned just right because forwhatever reason, in my adopted New Age hometown,boy did people show up at the play! It so happened thatthe entire event was a huge hit and was sold out the lasttwo weeks.

One night in the “Standing Room Only” audience was thetransplanted actress, now a Santa Fean, Ali McGraw who,at an after-hours party complimented the assembled caston their creative plays and good acting.

And the myriad Santa Fe crystal healers must have beensmiling on me because the newspaper reviews named mycollaborator, Deborah Finkelstein and me, as “bestplaywrights” and called our play “delightful and witty.”

Meanwhile back to Act One and the backstory. SuddenlyI had a new concern — as an actor who had the first and

last line in my one-act play, I now had toworry not just about my acting ability butabout my VOICE!

Initially, it was a lark to be performing atThe Santa Fe Playhouse, the oldestcontinually running theater companywest of the Mississippi. This theater isdripping with charm and history. AndSanta Fe itself has a rich literary past;stories abound about D.H. Lawrence andWilla Cather’s lively visits to this inspiring,artistic town. Lynn Riggs, the author of“Green Grow the Lilacs” (the basis for themusical, “Oklahoma”) credits his stay at afamous Santa Fe sanatorium as the placewhere “I found my true writing voice.”

With old world charm and local color, I discovered, cameits nemesis ? old world technology; the playhouse had anarchaic sound system. Forget microphones. ForgetMadonna-like earphones. At this theater, your instrumentof choice was your VOICE, the louder the better.

I was no stranger to the stage having made a pretty goodliving as a public speaker in a previous, pre-Parkinson’slifetime. But even before PD, I had a soft voice and I neverwent anywhere without a microphone in hand.

At the first few rehearsals for the play in early January,after the stress of Christmas (with no time for LSVTpractice sessions) my voice was softer than it needed to beto project to the people in the last row, so I pictured myvoice mentor, Dr. Fox at the back of the theater with alarge black whip in her hand, cheering me on.

“The Great Santini,” I thought.

“Louder, Louder,” Cynthia Fox cried.

Then the “Phantom of the Opera” sprang to mind. Withthe Phantom’s eerie haunting song “Turn your face awayfrom the garish light of day. And listen to the music of thenight.”

These images, on second thought, were too forceful! Astenacious as Cynthia Fox was, she was also a sensitive-caring-likable-teacher. She had such an imperturbable,uncomplaining nature that when I was making excuseafter excuse about why I wasn’t being as LOUD as Ishould, she just smiled. I told her I was putting her namein for sainthood. Sainthood’s are hard to come by evenin Catholic Santa Fe, so imagining Dr. Fox, as a nunseemed the next best thing.

Continued on Page 5

PART TWO HEY, I CAN DO THAT! By Peggy van Hulsteyn

Peggy vanHulsteyn

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Visualize this scene: there I was in that cavernousSanta Fe Theater with no sound system trying to findmy LOUDEST voice when the perfect image came tome. I pictured Cynthia Fox starring in “The Sound ofMusic” as the heroine, Maria, the unconventionalcourageous nurturing nun-in-training who taught thevon Trapp children the joy of singing. Maria is firm butsupportive. She runs a tight ship, but brings warmthand humanity back to the militaristic von Trapphousehold.

It was the ideal image combining two of my loftyambitions ? singing and acting! I could play the eldestdaughter, Lies, while Cynthia Fox took on the role ofthe energetic Maria. It was type casting at its finest,although we would need a make-up-artist-extraordinaire to make me look 16! But the theater isall about the willing suspension of disbelief. And theLSVT training is all about feeling that, no matter what,you can climb every mountain!

And so in my fanciful musings, I spoke back to theimaginary Maria von Trapp (aka Cynthia Fox) in a loudvoice and recited one of my favorite lines from themusical, “A Chorus Line.”

“I can do that. I can do that.”

And I could!!

2008/09 WorkshopsLSVT®LOUDTraining & Certification Workshop ScheduleDallas, TX . . . . . . . . . . . October 3-4Melbourne, Aust. . . . . . October 17-18Charlotte, NC . . . . . . . October 23-24Sheffield, England . . . . November 13-14New York . . . . . . . . . . . December 4-5Pavoda, Italy . . . . . . . . December 12-13Boulder, CO . . . . . . . . . Jan 9-10, 2009Jacksonville, FL . . . . . . Mar 19-20, 2009Singapore, Singapore . April 20-21, 2009London, England . . . . . May11-12, 2009 Chicago, IL . . . . . . . . . . June 18-19, 2009New York, NY. . . . . . . . Aug 6-7, 2009Niigata, Japan . . . . . . . Aug 22-23, 2009Germany . . . . . . . . . . . Sept 11-12, 2009Join the over 4,000 clinicians worldwidealready certified in this valuable treatmenttechnique for patients with neurologicaldisorders!

2008/09 LSVT®BIGTraining & Certification Workshops ScheduleDallas, TX . . . . . . . . . . . October 3-4Charlotte, NC . . . . . . . October 23-24Chicago, IL . . . . . . . . . . June 18-19, 2009

For more information and to register for either

LSVT®LOUD or LSVT®BIG visit:

website: www.LSVTGlobal.comCall: 1-888-438-5788

Email: info@LSVTGlobal.com

What people are saying!"I will use BIG to back up my multidisciplinary

team members."

"Now I know how to transfer BIG to practice!"

What people are saying!"Wow! This will change forever how

I deliver therapy."

"I finally have a treatment that will actually work with PD patients"

Dixie Regional currently employs two therapists who areLSVT® certified. Physical Therapist Scott Gillespie, whois LSVT®BIG-certified, worked with Robert to enhancehis physical mobility. Of Robert’s progress throughout theprogram, Scott said, “Bob initially had very rigid trunkmovements, short, shuffled, slow steps, and trouble withbalance. He had a tendency to fall or was unable toquickly pull out of a fall when he tipped out of his base ofsupport. After four weeks of LSVT®BIG training, Robertwas standing taller, walking faster, taking bigger steps andkeeping his balance better. He he had energy to do morethings throughout the day, and was more confident withgetting up and going places - and less fearful of losing hisbalance or falling.”

Speech Language Pathologist, Jane Peters,LSVT®LOUD-certified, echoes Scott’s sentiments andreflects on Robert Simonsen’s progress. “Initially, Bob’sspeech was understood about 60% of the time in a quietenvironment. His voice was weak and his speech wasmuffled. In addition, his face was masked and his voicemonotone, lacking in emotion and melody. I was unableto understand him on the telephone and others couldn’tunderstand him.” After four weeks of LSVT®LOUDtherapy, Mrs. Simonsen estimated others understood Bob75% of the time. She said, “His speech was louder, clearerand more easily understood.” Of his progress, Bob said,“I’m enjoying speaking with people in the community tosee their response to my loud voice, and doing morespontaneous talking.”

In April 2008, Robert Simonsen graduated from bothLSVT® programs – and very thankfully. Of his experience,he says, “The speech and balance therapies demanded agreat deal. But they returned an even greater impact onmy quality of life – something I wish my brother couldhave benefited from.” And true to form, he has put hisimmense gratitude for the LSVT® experience into action.Through a very generous gift to The Foundation ofDixie Regional Medical Center, he will now touch thelives of many who deal with the debilitating challenges ofPD because his philanthropy will, for the first time, bringLSVT®LOUD and LSVT®BIG Certification Workshops toUtah. Over 45 therapists from across the state will havethe opportunity to undergo intensive LSVT® training andearn certification. These newly-certified therapists will inturn be able to work one-on-one to empower hundredsof patients by enabling them to maintain or regainfunctioning in their workplace, community or homeenvironment. All of which will lead to enhanced self-confidence and quality of life.

Like a declaration of war against the disease, Roberthopes others will follow his mantra and never give up. “Ihope they will be able to exclaim as I did, ‘My voice is aliveagain’!”

Thank you Robert Simonsen ...

For embracing so many in their quest to live bigger and louder lives!

Courage andPhilanthropy Make Utah First!Continued from Page 1

Pictured from Left to Right:Ms. Shiree Smith, Dr. LorraineRamig, Dr. Cynthia Fox, Dr. Clarie McLean, Mr. RobertSimonsen, Dr. Becky Farley, Mr. Scott Gillespie, and Ms.Janey Peters. This photo wastaken at the August 15-16, 2008LSVT LOUD and LSVT BIGWorkshops in Salt Lake City,Utah.

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First Intenational LSVT®BIG Training and CertificationWorkshop!On June 30 through July 1, 2008, LSVT Global in part-nership with Mater Misericordiae Hospital in Dublin,Ireland, hosted the first Internationanl LSVT®BIGTraining and Certification Workshop. An LSVT®LOUDTraining and Certification Workshop was held simulta-neously. Over 60 therapists from Ireland, Great Britan,Germany, Israel, Switzerland, Sweden and the UnitedStates attended these two courses. Frances Shinkins,an LSVT®LOUD certified therapist was our localorganizer extrodinairre. LSVT®BIG faculty Drs. BekcyFarly, Valerie Carter and Claire McClean andLSVT®LOUD faculty Drs. Cynthia Fox and LeslieMahler conducted the courses.

A special “Thanks” to Frances and the MaterMisericordiae Hospital for making this landmark eventhappen!

12th International Congress of Parkinson Disease & Movement DisordersDr. Lorraine Ramig and colleagues Drs. Emily Wang (RushUniversity) and LSVT Global co-founder Dr. DavidMcFarland (University of Montreal) presented an invitedsymposium on “Speech and Swallowing Disorders inParkinson Disease” at the International MovementDisorders Congress in Chicago, June 22-26, 2008. Thissymposium on speech and swallowing was attended by over100 movement disorder neurologists and other health carespecialists from countries around the world. In addition, aseries of posters were presented at this congress:

Intensive Voice Treatment (LSVT®LOUD) for Childrenwith Spastic Cerebral Palsy. Authors: C.M. Fox, C.A. Bolieck,N. Namdaran, C. Nickerson, B. Gardner, C. Piccott, J. Hilstad,E. Archibald

Effects of LSVT® on Four Participants with PD WhoReceived Deep Brain Stimulation. Authors: L.A. Mahler, L.O.Ramig, J. Spielman, A. Halpern

Description of Subjective and Objective SwallowCharacteristics for People with PD. Authors: L.A. Mahler,L.O. Ramig, J. Logemann, A. Halpern

Emotional Experience and Expression in Parkinson’sDisease (PD). Authors: J.C. Borod, K. Rogers, J. Spielman,M. Halfacre, D. McCabe, T. Flanagan, L. Ramig

Pictured from Left to Right: Frances Shinkins,Becky Farley, Valerie Carter, Leslie Mahler,Cynthia Fox, and Claire McLean.

Pictured from Left to Right: Drs. Emily Wang, Lorraine Ramig, David McFarland, and Cynthia Fox.

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CALLING ALLCLINICIANS!

Log on to www.LSVTGlobal.com

to confirm your certification status

and update your contact information.

LSVT to present at the2008 ASHA Convention!

November 20–22, 2008McCormick Place West

Chicago, IllinoisPRESENTATION SCHEDULE

Session Number: 1254 Poster Board 230 Title: Changes in Acoustic Parameters of

Speech Following Intensive Voice Treatment of Dysarthria Secondary to Stroke

Session Format: Poster Day/Time: 11/20/08 – 8:00AM-9:30AMRoom: Hall F2Location: McCormick Place West

Session Number: 1260 Poster Board 236 Title: Changes in Speech Following Intensive

Voice Versus Intensive Articulation Therapy in Parkinson’s Disease

Session Format: Poster Day/Time: 11/20/08 – 10:00AM-11:30AMRoom: Hall F2Location: McCormick Place West

Session Number: 1262 Poster Board 238 Title: The Effects of Noise on Speech

Intelligibility in Parkinson’s DiseaseSession Format: Poster Day/Time: 11/20/08 – 1:00PM-2:30PMRoom: Hall F2Location: McCormick Place West

Session Number: 1246 Title: New Perspectives in Treating Pediatric

Motor Speech DisordersSession Format: Seminar - 2 Hours Day/Time: 11/20/08 – 3:30PM-5:30PMRoom: W190BLocation: McCormick Place West

Session Number: 2348 Title: Evolution of Evidence-Based Practice:

Lessons Learned From LSVT®LOUDSession Format: Seminar - 2 Hours Day/Time: 11/22/08 – 3:30PM-5:30PMRoom: W183BLocation: McCormick Place West