Speech and Swallowing Problems

People with Parkinson’s may notice changes in or difficulty with chewing, eating, speaking or swallowing. These changes can happen at any time, but they tend to increase as PD progresses.

The self-assessments below can help you figure out if you have a speech, voice or swallowing problem. Carefully consider the statements. If many of them apply to you, you may need to see a speech-language pathologist (SLP). You should see an SLP if you begin to notice changes in your speech, swallowing or memory, and especially if these changes begin to cause limitations in your life.

How do I know if I have a speech or voice problem?

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 feel as though I have to strain to produce voice.

The clarity of my voice is unpredicable.

My voice problem upsets me.

My voice makes me feel handicapped.

People ask, "What's wrong with your voice?"

How do I know if I have a swallowing problem?

•  I have recently lost weight without trying.

•  I tend to avoid drinking liquids.

•  I get the sensation of food being stuck in my throat.

•  I tend to drool.

•  I notice food collecting around my gum line.

•  I tend to cough or choke before, during or after earting or drinking

•  I often have heartburn or a sore throat.

•  I have trouble keeping food or liquid in my mouth. 

http://www.parkinson.org/understanding-parkinsons/non-motor-symptoms/speech-and-swallowing ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Why does Parkinson's affect swallowing?

Published on Jul 14, 2016

Dr Emilia Michou at The University of Manchester explains why many people with Parkinson's find it difficult to swallow, and what science she is doing to improve the situation.

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There are many options to help improve your speech. A speech-language pathologist can help you pick the right approach(es) for you.

Seeking help from a speech-language pathologist

Speech-language pathologists are trained health care professionals who specialize in evaluating and treating people with speech, swallowing, voice, language and memory problems.

Before you contact a speech-language pathologist, talk to your primary care or Parkinson’s doctor for a referral. It is also important to contact your health insurance company to find out what therapy and procedures are eligible for reimbursement, and to find a list of speech-language pathologists covered by your plan. Finally, it is best to visit a speech-language pathologist who has experience treating people with Parkinson’s disease. Call the NPF Helpline at 1-800-4PD-INFO (473-4636) for help locating such a professional.

The Lee Silverman Voice Treatment (LSVT®)

LSVT 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 Parkinson’s syndromes such as multiple-system atrophy (MSA, formerly known as Shy-Drager syndrome) and progressive supranuclear palsy (PSP). 

LSVT must be administered 4 days a week for 4 consecutive weeks in order to be effective.

On days that you have therapy, you should perform your LSVT exercises one other time during the day; on days that you do not have therapy, you should perform your LSVT exercises two times a day

Once you complete the 4-week LSVT therapy, you should perform your LSVT exercises daily in order to maintain your improved voice.

Schedule a 6-month LSVT re-evaluation/follow-up with your LSVT-certified speech pathologist to continually monitor your voice.

If available in your area, participate in a speech group whose focus is on THINKING LOUD.

Unless otherwise directed by a physician, drink plenty of water.

A Digital Sound Level Meter can help you monitor your volume. These meters can be purchased for about $45.00. Place the meter at arm distance to perform the measurement. Normal conversational volume ranges between 68-74dB.

Collagen injections

Collagen injections have been used in the treatment of voice and speech impairment in PD:

•  Contact a recommended Ear, Nose and Throat (ENT) doctor to proceed with this type of treatment.

•  The purpose of collagen injections is to build up vocal folds that do not close completely while talking.

•  The procedure involves injecting collagen directly into the vocal folds.

•  The collagen effect typically lasts for 6 months, then must be re-injected.

•  Some patients have reported improvement in their voice from this procedure.

Assistive Communication Devices

•  When fatigue or other illness makes it difficult to use your normal voice you may find an assistive communication device helpful.

•  A personal amplification device is the device most often used by people with PD.

•  Other communication devices range from hand-made communication boards to sophisticated computerized equipment.

•  A speech-language pathologist can recommend an appropriate device.

•  Speech Easy is an FDA-approved feedback device used for stuttering. It is a small electronic device worn on the ear (similar to a hearing aid). Certain people with Parkinson’s who are having difficulty with their voice and also with verbal fluency and stuttering have benefited from use of this device. 

If you have any questions about speech problems, please visit the Talk to a Speech Clinician forum, where a team of experts answer questions regarding speech and people with Parkinson's disease.

http://www.parkinson.org/understanding-parkinsons/non-motor-symptoms/speech-and-swallowing

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Demonstration: How LSVT LOUD helps people with Parkinson's Disease                           Published on Apr 6, 2016

 This video is for demonstration only. Do not perform these exercises without a trained therapist in LSVT.