Parkinson’s disease can lead to dysarthria and dysphagia. Dysarthria refers to speech difficulties, while dysphagia refers to swallowing difficulties.
It is common for people with Parkinson’s disease to have reduced speech volumes and difficulty expressing their thoughts. As Parkinson’s disease progresses, sufferers may also have difficulty swallowing and getting enough food and water to maintain a healthy weight.
Speech therapy is usually the best approach to managing these difficulties. It can help people with Parkinson’s disease manage communication and swallowing problems.
Keep reading to learn more about the speech features of Parkinson’s disease and the therapies that may help.
Parkinson’s disease can cause problems with voice, speech, communication and swallowing. These difficulties can vary from person to person with Parkinson’s disease.
Voice and speech
Common voice and speech difficulties, called dysarthria, include:
- reduced speech volume
- hoarse or strained voice
- breathy voice
- monotonous voice
- trembling voice or tremor in the voice
- more energy needed to form words
- difficulty with pronunciation of letters and words
- mixing certain combinations of letters or sounds
- changes the speed at which you speak
- change the tone of your voice
- difficulty finding the right words to express your thoughts
People with Parkinson’s disease may have difficulty making facial expressions. They may also have difficulty expressing their emotions through vocal tone when speaking. This can make it difficult to communicate clearly and effectively.
Parkinson’s disease can also affect swallowing. Swallowing difficulties are called dysphagia and can include:
- choke on eating and drinking
- keeping food in your cheeks or mouth
- frequent sore throats
- food or saliva entering your lungs (aspiration)
There are several reasons why Parkinson’s disease can lead to difficulty speaking and swallowing. For instance:
- Parkinson’s disease affects the muscles and nerves of the face, throat, mouth, tongue, respiratory system and larynx. As these muscles and nerves weaken, you may have more difficulty speaking and swallowing.
- Parkinson’s disease makes it difficult to activate your muscles. This includes the muscles you need for speaking and swallowing, such as the throat, tongue, and larynx.
- Parkinson’s disease affects the areas of your brain that control the speech process.
- Parkinson’s disease changes the way your brain processes information. This can make it difficult to participate in conversations and communicate your thoughts.
- Parkinson’s disease can make your movements smaller and less powerful. This includes the movements you make with your mouth and throat that affect speech and swallowing.
- Parkinson’s disease can reduce your sensory awareness. You may not realize that the volume, speed or pitch of your voice has changed. You may feel like you are screaming even when speaking at a normal volume.
- Parkinson’s disease can reduce your ability to trigger your own outward talk and start conversations. Often people with Parkinson’s disease who are able to answer questions or respond to others have difficulty expressing their thoughts without being asked.
Speech therapy may be beneficial for people with Parkinson’s disease.
Speech-language pathologists are healthcare professionals who can work with patients to help improve:
They can assess current abilities, develop treatment plans, help you build capacity, recommend assistive technologies, and more. You may see a speech-language pathologist when you are first diagnosed with Parkinson’s disease, and then regularly over the years.
Therapists can help you through every stage of Parkinson’s disease. They can detect new difficulties and prevent them from getting worse, and they can help you deal with whatever is causing you problems.
During sessions, your speech therapist may:
- guide you through exercises that can improve muscle strength
- guide you through exercises that can help make your voice louder
- teach you exercises to do at home
- teach you communication skills to help you express your thoughts and needs
- teach you ways to conserve your energy while speaking
- teach you non-verbal communication techniques
- teach you how to use assistive devices
Assistive devices for speech and swallowing difficulties can help you maintain your independence. Your speech therapist may recommend different options to help you. Which devices and software applications are right for you will depend on your specific challenges.
Here are some hearing and speech recommendations:
- Use text, email, and other touch-tone communication as much as possible.
- Have specific tablets or smartphones dedicated to communication.
- Download voice recognition software to your phone, tablet or computer that can be trained to recognize your voice and speaking habits.
- Use applications designed for people with Parkinson’s disease which can remind you to speak louder and slower.
- Use tablets and communication devices that can read the words you type on them.
Speech therapists can also help you with swallowing and determine which therapy is best for you. Treatment options depend on how difficult you are to swallow and whether you meet the recommended daily nutrient intake.
First-line treatment may involve adjusting your diet to softer, easier-to-swallow foods while working on exercises to strengthen your throat muscles.
Other potential treatment options, depending on research 2021to understand:
- Video Assisted Swallowing Therapy (VAST). This therapy shows people videos of a typical swallowing process versus videos of their own impaired swallowing process. A
2012 studyfound a significant improvement in swallowing following this type of visual therapy.
- Botulinum toxin (Botox).
Botox injectionsin the cricopharyngeal muscle (located at the junction of the throat and esophagus) have been shown to relieve oropharyngeal dysphagia in 43 percentof cases. Botox injections into the salivary glands can also be used to treat drooling, for research 2016.
- Percutaneous endoscopic gastronomy (PEG) diet. Dysphagia that causes malnutrition and weight loss may require PEG diet. PEG feeding uses a flexible feeding tube inserted through the abdominal wall into the stomach. It allows fluids, nutrition, and medications to be placed directly into the stomach without the need for chewing or swallowing.
Parkinson’s disease can cause difficulty speaking and swallowing.
People with Parkinson’s disease can often have problems with the volume, speed and pitch of their voice. They may also have difficulty expressing their thoughts and emotions. Swallowing difficulties can lead to weight loss, choking, and even food getting into the lungs.
Speech therapists are professionals who can help overcome these difficulties.
They can help people with Parkinson’s disease strengthen their muscles, improve their speech and swallowing, and manage communication difficulties. They can also recommend assistive devices and show you how to use them.
Talk to your doctor about finding a qualified speech-language pathologist who specializes in Parkinson’s disease.