Speech Therapy for Parkinson's Disease
Dysarthria (difficulty speaking) and dysphagia (difficulty swallowing) can be
severely limiting symptoms of Parkinson’s disease and can be helped by
referral to a speech therapist. Until recently, traditional speech therapy had
not provided sustained improvement. A new program called the Lee Silverman Voice
Therapy Program has been developed, which has demonstrated significant value for
patients with Parkinson’s disease. The patient should be referred to a speech
experienced in administering the Lee Silverman Voice Therapy Program.
Information tips for improving communication
the muscles weaken in the voice box (larynx), throat (pharynx), roof of the
mouth (soft palate) tongue, and lips, people with Parkinson’s disease might find
it difficult to pronounce words clearly.
Some resulting speech impairments might be:
- Hoarse or strained voice
- Muffled or nasal-sounding voice
- Unclear or slurred speech
Speech-language therapists can help people with Parkinson’s disease
maintain as many communication skills as possible. They also teach techniques
that conserve energy, including non-verbal communication skills. Speech-language
therapists are also available to:
- Recommend appropriate communication techniques to provide treatment that
will aid in the success of daily activities.
- Treat all types of speech, language, and communication problems.
- Evaluate swallowing function and recommend changes as necessary.
Tips to maintain and enhance communication
- Choose an environment with reduced noise. It can be quite tiring to try
to "talk over" the television or radio.
- Speak slowly.
- Be certain your listener can see your face. Look at the person while you
are talking. A well-lit room enhances face-to-face conversation, increasing
- Use short phrases. Say one or two words, or syllables per breath.
- Over-articulate your speech by prolonging the vowels and exaggerating the
- Choose a comfortable posture and position that provide support during long
and stressful conversations.
- Be aware that exercises intended to strengthen weakening muscles might be
counter-productive. Always ask your speech-language therapist which
exercises are right for you.
- Plan periods of vocal rest before planned conversations or phone calls.
Know that fatigue significantly affects your speaking ability. Techniques
that work in the morning might not work later in the day.
- If you are soft spoken and your voice has become low, consider using an
- If you are on a respirator (with fully inflated cuffs), an electrolarynx
or respiratory tube that provides an alternative air source might be used.
If some people have difficulty understanding you, the following strategies
--If you are able to write without difficulty, always carry a paper and pen as
a backup so you can write down what you are trying to say.
--If writing is difficult, use an alphabet board to point or scan to the first
letter of the words that are spoken.
--Spell words out loud or on an alphabet board if they are not understood.
--Establish the topic before speaking.
--Use telegraphic speech. Leave out unnecessary words to communicate the
meaning of the topic.
- Non-verbal communication, also called augmentative and alternative
communication (AAC), is a method of communicating without spoken words. When
communication needs cannot be met through speech, the following techniques can
be practiced by people with Parkinson’s disease:
- Residual speech (making the best use out of what
speaking ability is left)
- Effective use of expressions and gestures
- Non-verbal communication can help people with speech difficulties actually
speak better by:
- Reducing the frustration and stress of being unable
- Alleviating the pressure to speak
- Allowing the person to be more relaxed and come
across in a more intelligible manner
Here’s a sample of the assistive devices that are available to help people
with Parkinson’s disease communicate more clearly.
- Palatal lift — This is a dental apparatus that is similar to a retainer. It lifts
the soft palate and stops air from escaping out of the nose during speech.
- Amplification — This is a personal amplifier that can be used to increase vocal
loudness in soft-spoken people. The amplifier also decreases voice fatigue.
- TTY telephone relay system — This is a telephone equipped with a keyboard so speech
can be typed and read by a relay operator to the listener. Either the whole
message can be typed or just the words that are not understood can be typed.
- Low-technology devices — Notebooks and language boards can be used as
alternative communication techniques.
- High-technology electronic speech enhancers, communication devices —
Computers with voice synthesizers and dedicated communication devices are
Patients who are interested in purchasing electronic communication aids
should discuss this with a speech-language therapist before contacting sales
representatives for these devices.
Here are some ways in which listeners can help people who have difficulty
speaking and communicating:
- Talk to the person face-to-face only, and look at the person as he or she is
- Ask questions that require a "yes" or "no" answer.
- Repeat the part of the sentence that you understood. (For example,
"You want me to go upstairs and get the what?")
- Ask the person to repeat what he or she said, or ask him or her to speak
more slowly or spell out the words you did not understand.
Preparing for emergencies
- Use an intercom system or baby monitor to alert others that there is an
- Use bells or buzzers if you are not able to speak. Use "codes"
that signify urgency. For example, a tinkling bell might mean, "I’d like
company," while an air horn might mean there’s an emergency.
- Carry a portable phone that is equipped with pre-programmed numbers. Pre-program all of your telephones so they can automatically dial the
necessary emergency number(s).
- Consider a "Life Call" button if you spend time alone.
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