Saturday, April 13, 2024

Can Parkinson’s Affect Speech

Speech Problems Of Parkinsons Disease

Parkinson’s disease can quiet the voice but won’t dampen patients’ holiday spirit

The most common speech problems experienced by people with PD involve reduced volume , reduced pitch range , and difficulty with the articulation of sounds or syllables . In essence, you cant speak as loudly as others, you find it more difficult to convey emotion when you do speak, and you find it difficult to form the words you are trying to pronounce.

You dont need me to tell you that this combination of factors makes speaking extremely frustrating. When you couple all of these voicing problems with the so-called masked faces of PD, the difficulty in expressing emotions via facial expression, it’s no wonder that people occasionally find it challenging to understand what you are trying to say.

It may be tempting to withdraw from conversations with others altogether, but that would be a mistake. You need to interact with others on a daily basis, no matter how frustrating it becomes this is critical for your mental health, and be assured that your loved ones want to interact with you. The good news is that there are treatments, such as voice exercises, that can dramatically improve the voicing problems associated with PD.

How Can I Maintain And Enhance My Speech

  • Choose an environment with reduced noise. It can be 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 understanding.
  • Use short phrases. Say one or two words or syllables per breath.
  • Over-articulate your speech by prolonging the vowels and exaggerating the consonants.
  • Choose a comfortable posture and position that provide support during long and stressful conversations.
  • Be aware that exercises intended to strengthen weakening muscles may be counter-productive. Always ask your speech 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 may not work later in the day.
  • If you are soft spoken and your voice has become low, consider using an amplifier.
  • If some people have difficulty understanding you, the following strategies may help:
  • What If I Have An Emergency How Will I Communicate

    • Use an intercom system or baby monitor to alert others that there is an emergency.
    • Use bells or buzzers if you are not able to speak. Use “codes” that signify urgency. For example, a tinkling bell may mean, “I’d like company” while an air-horn means 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.
    • Consider a “life call” button if you spend time alone.

    Show Sources

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    Building Stronger Caregiving Partnerships Through Better Communication

    In this one-hour talk, the speaker explains that diminished communication significantly impacts the social, emotional and physical burdens of caregiving. The fourth speaker at the Parkinsons Foundation Caregiver Summit, Angela Roberts, PhD, explains how changes in speech, cognition and hearing due to Parkinsons disease affects communication. She then offers specific strategies for optimizing communication.

    Swallowing And Saliva Management

    Parkinsons disease

    This one-hour talk is in three parts. What a speech language pathologist is, how they can help someone with PD. Why you should be concerned about swallowing problems, some indications you may have a swallowing issue, what a swallowing assessment by an SLP might look like, and recommendations an SLP might make to improve swallowing. And, why you should be concerned about having either too much or too little saliva and how to manage either situation.

    Also Check: Parkinson’s Support Group For Caregivers

    Living With Parkinson Disease

    These measures can help you live well with Parkinson disease:

    • An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
    • High protein meals can benefit your brain chemistry
    • Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
    • If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.

    Effects On Speech And Voice

    There are three ways that Parkinsons Disease can affect speech: dysarthria, hypophonia, and tachyphemia. Dysarthria affects the muscles required for speech which can cause mumbling or slurring. Hypophonia, also brought on by weakened muscles, is characterized by a soft, abnormally weak voice. Tachyphemia is rapid, stammering speech, also known as cluttering. Knowing these three conditions and their effects can help you find your best methods of treatment following diagnosis.

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    Speech And Swallowing In Pd

    Apathy describes a lack of interest, enthusiasm or motivation. It is a non-motor symptom of Parkinsons Disease and interferes with the effective management of PD symptoms, since apathetic people are less inclined to exercise and follow their medication schedules. Here are some resources to understand apathy and how to cope with it.

    Speech And Language Therapy For Speech Problems In Parkinson’s Disease

    Speech in Parkinsons Disease

    Many people with Parkinson’s disease suffer from disorders of speech. The most frequently reported speech problems are weak, hoarse, nasal or monotonous voice, imprecise articulation, slow or fast speech, difficulty starting speech, impaired stress or rhythm, stuttering and tremor. People with the condition also tend to give fewer non-verbal cues, such as facial expressions and hand gestures. These disabilities tend to increase as the disease progresses and can lead to serious problems with communication.

    This review compared the benefits of speech and language therapy versus placebo or no treatment for speech disorders in Parkinson’s disease. Relevant trials were identified by electronic searches of 16 medical literature databases, various registers of clinical trials and an examination of the reference lists of identified studies and other reviews.

    Only randomised controlled trials were included in this review. These were studies where two groups of patients were compared, one group had speech and language therapy, the other did not receive any therapy intended to improve speech. The patients were assigned to each of the groups in a random fashion so as to reduce the potential for bias.

    To compare the efficacy of speech and language therapy versus placebo or no intervention for speech and voice problems in patients with Parkinson’s disease.

    Only randomised controlled trials of speech and language therapy versus placebo or no intervention were included.

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    What Is Parkinsons Disease

    At the most basic level, Parkinsons Disease is a disorder of the nervous system. PD causes vital nerve cells in the brain to deteriorate, significantly decreasing the bodys stores of dopamine and other essential neuro-chemicals responsible for controlling movement.

    This results in the tremors that are classically associated with PD.

    Tremors, however, are only one of the varied and unpredictable symptoms of PD.

    Persons with PD may also experience muscle rigidity or weakness. Movement may be slowed and problems with balance and coordination are common.

    Additionally, PD can lead to challenges in thinking, concentrating, or remembering. Patients may even experience hallucinations, delusions, or paranoia as a result of changes in the brain.

    Its estimated that more than 10 million people worldwide have PD, with more than 95% of patients diagnosed after the age of 50.

    The Lee Silverman Voice Treatment

    The Lee Silverman Voice Treatment is the first speech treatment for PD proven to significantly improve speech after one month of treatment.

    • Exercises taught in the LSVT method are easy to learn and typically have an immediate impact on communication.
    • Improvements have been shown to last up to two years following treatment.
    • LSVT methods have also been used with some success in treating speech and voice problems in individuals with atypical PD syndromes such as multiple-system atrophy and progressive supranuclear palsy .

    LSVT® Guidelines

    • Must be administered four days a week for four consecutive weeks.
    • On therapy days, perform LSVT exercises one other time during the day. On non-therapy days, perform LSVT exercises two times a day.
    • Once you complete the four-week LSVT therapy, perform LSVT exercises daily to maintain your improved voice.
    • Schedule six-month LSVT re-evaluations with your specialist to monitor your voice.
    • If available in your area, participate in a speech group whose focus is on thinking loud.
    • A Digital Sound Level Meter can help you monitor voice volume. Place the meter at arm distance to perform the measurement. Normal conversational volume ranges between 68-74dB.

    Also Check: Physiotherapy Management For Parkinson’s Disease Ppt

    Ii Characteristics Of Dysarthria In Parkinsons Disease

    Speech rate characteristics as well as dysfluency in PD also deserve comment. Speech rates vary widely in persons with PD. Instrumental measures suggest that some speakers with PD have a normal rate, other individuals have a speech rate that is slower than normal and other persons have a speech rate that is faster than normal. In fact, hypokinetic dysarthria, which is the type of dysarthria most often associated with PD, is the only dysarthria for which rate may be faster than normal. Perceptual impressions of rate in PD must be confirmed with instrumental measures, as listeners perception of the rate of Parkinsonian speech grows abnormally rapidly. That is, for a sentence produced at the same physical rate by a speaker with PD and a neurologically normal speaker, the sentence produced by the speaker with PD will be perceived by listeners to be faster. Imprecise articulation and monopitch or reduced variation in voice fundamental frequency in the acoustic speech signal of PD have been proposed as potential explanations. Dysfluency occurs in approximately 15 to 45% of persons with PD, typically at the beginning of utterances or after a pause. The dysfluency is typically mild in severity and is characterized by rapid, blurred phoneme repetitions.

    How Do I Know If I Have A Speech Or Voice Problem

    Speech Exercise/Therapy for Parkinson Disease (online ...
    • My voice makes it difficult for people to hear me.
    • People have difficulty understanding me in a noisy room.
    • My voice issues limit my personal and social life.
    • I feel left out of conversations because of my voice.
    • My voice problem causes me to lose income.
    • I have to strain to produce voice.
    • My voice clarity is unpredictable.
    • My voice problem upsets me.
    • My voice makes me feel handicapped.
    • People ask, “What’s wrong with your voice?”

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    Confusion With Essential Tremor

    The tremor of Parkinsons disease is often confused with the tremor of a condition called Essential Tremor, or Benign Familial Tremor . Katherine Hepburn had Essential Tremor, and was originally misdiagnosed with Parkinsons. Ronald Reagan also had Essential Tremor. Both had a head tremor and a vocal tremor. In Essential Tremor, the hands are most commonly involved, followed by the head and then the voice. Essential Tremor can also cause the jaw to tremor, and it may be difficult to figure out if a jaw tremor is from Essential Tremor or Parkinsons. Unfortunately, some people may have both disorders. Some authorities believe that there is, in fact, an increased association between the two conditions, so that more people with Parkinsons disease have Essential Tremor than would be expected by chance alone, but this has not been established.

    Language Impairment In Parkinson’s Disease

    In this 1-hour webinar, speech language pathologist Jamie Russell discusses communication and swallowing challenges common in people with Parkinson’s, general interventions and self-management strategies for patients and caregivers, strategies for working through difficulties such as following complex commands, word retrieval, and organizing thought in conversation, as well as general swallowing strategies.

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    B Feeding Modifications And Drooling

    Adaptive utensils may be helpful for promoting and extending independent eating. Later-stage PD may be accompanied by dementia, which complicates management of feeding and swallowing, as patients may be unable to follow directions for some compensatory strategies. Patients also may be unable to feed themselves, necessitating a trained feeder. Feeders should be trained to monitor the safety of each swallow as well speed and duration of meal. Because patients with PD may take longer to swallow, a longer mealtime should be allowed. Relatedly, for patients with reduced pharyngeal wall contraction and posterior tongue base retraction or who demonstrate impulsive feeding behavior, taking too much food too rapidly can result in increased risk of aspiration owing to collection of food in the pharynx. Smaller bites at a slower rate should be encouraged. Enteral feeding by means of a percutaneous endoscopic gastrostomy may improve quality of life by providing nutritional support., For patients who are able, PEG does not preclude some nutrition by mouth for pleasure or nutrition.

    What Is Happening To The Body

    2 – Speech problems and Parkinson’s disease

    Parkinsons mainly affects a part of the brain called the substantia nigra pars compacta. In this part of the brain, neurons are producing dopamine, which transmits signals to other parts of the brain. When Parkinsons occurs these neurons are damaged which reduces the amount of dopamine produced. The decrease in dopamine is causing the movements to be slower and less smooth. These side effects are seen in the movement of the face and mouth muscles, which is how speech is produced.

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    How Are Cognitive Problems Treated

    Much remains to be learned about the basic biology that underlies cognitive changes in PD. Researchers work towards the development of diagnostic tests to identify people who seem to be at greatest risk for cognitive changes and to differentiate cognitive problems in people with PD from those that occur in another disorder related but different known as dementia with Lewy bodies.

    How Does Parkinson’s Improve Speech


    . Similarly one may ask, how does Parkinson’s affect your speech?

    Parkinson’s disease affects approximately one million Americans and can cause several motor and non-motor symptoms. There are several ways PD may affect speech: The voice may get softer, breathy, or hoarse, causing others difficulty hearing what is said. Speech may be slurred.

    Additionally, how does Parkinson’s affect the throat? Speech & Swallowing Problems. People with Parkinson’s may notice changes in or difficulty chewing, eating, speaking or swallowing. Just as PD affects movement in other parts of the body, it also affects the muscles in the face, mouth and throat that are used in speaking and swallowing.

    Consequently, how does speech therapy help Parkinson’s disease?

    Speech therapy also includes non-verbal communication skills to help patients communicate without spoken words, by making use of expressions and gestures. Non-verbal communication can help by reducing the stress of not being able to communicate and alleviating the pressure to speak, thereby relaxing patients.

    How did Michael J Fox know he had Parkinson’s?

    Although Parkinson disease occurs mostly in older people, it sometimes does strike people in their forties or, as with Mr. Fox, even younger people. Mr. Fox was first diagnosed when he noticed a “twitch” in his left little finger while he was working on the set of the 1991 film Doc Hollywood, he told People magazine.

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    For The Person With Parkinsons Disease

    It is a good idea to tape your speech using a tape-recorder. This will help to give you an idea of how your speech sounds.

    • Try to talk more slowly and exaggerate your mouth movements

    This will help to make your speech clearer and easier to understand.

    • If asked to repeat, try to speak more slowly and emphasise key words in the sentence

    This may make the message easier to understand

    • Encourage the use of shorter sentences while speaking

    Speaking in shorter sentences gives the person with Parkinsons disease a chance to take a breath between each sentence.

    • Think Loud, Think Shout

    If you imagine that you are speaking loud, this will automatically encourage you to sit with better posture, take deeper breaths, exaggerate your mouth movements, and generally make you easier to understand. It does not mean that you need to shout, you just need to imagine you are going to!

    • Get into the habit of looking at one another while having a conversation

    Watching the persons lips and face can greatly improve comprehension.

    • Reduce background noise during conversation

    Turn off the radio or TV, close doors to noisy areas, etc.

    • Be aware that facial stiffness is a feature of Parkinsons disease

    Avoid depending on facial expression to read the emotions felt by the individual with Parkinsons disease. Do not assume that the person does not understand what you have said as masked facial expression may be due to rigidity of facial muscles.

    • Be patient. Try not to rush responses in conversation.

    Tip: Do I Have A Speech Or Voice Problem


    These are statements many people have used to describe their voices and the effects of their voices on their lives. Choose the response that indicates how frequently you have the same experience. .

    • It is difficult for people to hear me0 1 2 3 4
    • People have difficulty understanding me in a noisy room0 1 2 3 4
    • My voice difficulties restrict personal and social life0 1 2 3 4
    • I feel left out of conversations because of my voice0 1 2 3 4
    • My voice problem causes me to lose income0 1 2 3 4
    • I feel as though I have to strain to produce voice0 1 2 3 4
    • The clarity of my voice is unpredictable0 1 2 3 4
    • My voice problem upsets me0 1 2 3 4
    • My voice problem makes me feel handicapped0 1 2 3 4
    • People ask, Whats wrong with your voice?0 1 2 3 4

    To find your score, add up your answers. A score of 10 or higher indicates you might have a speech or voice problem that is affecting your quality of life and you should ask for a referral to a speech pathologist.

    *Please note that not all content is available in both languages. If you are interested in receiving Spanish communications, we recommend selecting both” to stay best informed on the Foundation’s work and the latest in PD news.

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