Parkinson’s disease affects approximately 1 million people in the United States and 10 million people worldwide, according to the American Parkinson Disease Association.

Nonprofit health organization Hackensack Meridian Health, which is based in New Jersey, introduced a new speech therapy program on Monday to help patients with Parkinson’s disease resist one of the disease’s most common symptoms: reduced speech.

This new therapy will be split into two steps. By starting with the individualized approach for patients, “SPEAK OUT!” will work with patients to “convert speech from an automatic function to an intentional act,” Hackensack Meridian Health wrote in a statement. This focus on maintaining speech and language ability will continue with part two of the program in a group setting, called “LOUD Crowd.”

“Up to 90% of people with Parkinson’s are at high risk of losing their ability to speak, and swallowing complications account for 70% of the mortality rate in this patient population,” Samantha Elandary, Parkinson Voice Project’s founder, said in the statement

Parkinson’s disease symptoms

As part of the U.S. National Institutes of Health, the National Institute of Aging states that Parkinson’s disease is caused when neurons die or become impaired deep in the part of the brain that’s known to control movement, called the basal ganglia.

There are upward of 20 different muscles used within speech and language, although the exact amount is debated by scientists.

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Per the NIH, early symptoms of the disease start slowly and can include tremors in the hands, jaw, arms, legs or head; stiff muscles; slow movement; impaired balance and coordination; difficulty swallowing and forming words; urinary and bowel problems; and depression.

Scientists aren’t sure what causes these neurons to become damaged, but have learned that the process can be slowed down with medication and therapies such as specialized speech training.

Controlling one’s movements can be more difficult as the disease progresses, which is why speech becomes more difficult in the later stages of the disease, the Parkinson’s Foundation states. It’s possible that the symptoms can develop over 20 years or more.

The foundation says that straining the voice to amplify volume, feeling left out of conversations because of being self-conscious of one’s voice, or unpredictable clarity when speaking could be signs of declining speech, but speech therapy can help.