Speech Therapy for Parkinson’s Disease: Overview

The Lee Silverman Voice Therapy Program has demonstrated significant value for patients with Parkinson’s disease. Tips for improved communication are presented.

Information tips for improving communication

Dysarthria (difficulty speaking) and dysphagia (difficulty swallowing) can be severely limiting symptoms of Parkinson’s disease (PD). These conditions can be helped by referral to a speech therapist.

The Lee Silverman Voice Therapy Program has demonstrated significant value for patients with PD. The patient should be referred to a speech therapist experienced in administering the Lee Silverman Voice Therapy Program.

People with PD may find it difficult to pronounce words clearly. This is because the muscles weaken in the voice box (larynx), throat, roof of the mouth, tongue, and lips.

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 PD 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

1. Choose an environment with reduced noise. It can be quite tiring to try to “talk over” the television or radio.
2. Speak slowly.
3. 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 intelligibility.
4. Use short phrases. Say one or two words, or syllables per breath.
5. Over-articulate your speech by prolonging the vowels and exaggerating the consonants.
6. Choose a comfortable posture and position that provide support during long and stressful conversations.
7. 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.
8. 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.
9. If you are soft spoken and your voice has become low, consider using an amplifier.
10. If you are on a respirator (with fully inflated cuffs), an electrolarynx or respiratory tube that provides an alternative air source might be used.
11. If some people have difficulty understanding you, the following strategies might help:
    • 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

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 to communicate
• Alleviating the pressure to speak
• Allowing the person to be more relaxed and come across in a way that can be better understood

Source: https://my.clevelandclinic.org/health/diseases/9392-speech-therapy-for-parkinsons-disease

(Vietnamese temporary translation version: http://speechtherapyvn.net/can-thiep-ngon-ngu-tri-lieu-cho-benh-nhan-mac-benh-parkinson-tong-quan/)