Parkinson’s disease can lead to dysarthria and dysphagia. Dysarthria refers to difficulties with speech, while dysphagia refers to difficulties with swallowing.
It’s common for people with Parkinson’s to experience reduced speaking volumes and trouble expressing their thoughts. As Parkinson’s progresses, people with the condition may also have difficulty swallowing and getting enough food and water to maintain a healthy weight.
Speech therapy is generally the best approach for managing these difficulties. It can help people with Parkinson’s manage both communication and swallowing issues.
Keep reading to learn more about the speech characteristics of Parkinson’s and the therapies that can help.
Parkinson’s can cause voice, speech, communication, and swallowing difficulties. These difficulties can vary between individual people with Parkinson’s.
Voice and speech
Common voice and speech difficulties, called dysarthria, include:
- reduced speaking volume
- hoarse or strained voice
- breathy-sounding voice
- monotone-sounding voice
- shaky voice or tremor in the voice
- more energy needed to form words
- difficulty with letter and word pronunciation
- slurring of certain letter combinations or sounds
- changes to how fast you speak
- changes to the pitch of your voice
- difficulty finding the right words to express your thoughts
People with Parkinson’s can have trouble making facial expressions. They might also find it difficult to express emotions through vocal tone when they speak. This can make it hard to communicate clearly and effectively.
Parkinson’s can also affect swallowing. Difficulties with swallowing are called dysphagia and might include:
- weight loss
- choking while eating and drinking
- keeping food in your cheeks or mouth
- frequent sore throats
- food or saliva going into your lungs (aspiration)
There are multiple reasons why Parkinson’s can lead to speech and swallowing difficulties. For example:
- Parkinson’s affects the muscles and nerves in your face, throat, mouth, tongue, respiratory system, and larynx. As these muscles and nerves weaken, you might have more speaking and swallowing difficulties.
- Parkinson’s makes it difficult for your muscles to activate. This includes the muscles you need to speak and swallow, such as your throat, tongue, and larynx.
- Parkinson’s affects the areas of your brain that control the speech process.
- Parkinson’s changes the way your brain processes information. This can make it difficult to be part of conversations and communicate your thoughts.
- Parkinson’s can cause your movements to become smaller and less powerful. This includes the movements you make with your mouth and throat that affect speech and swallowing.
- Parkinson’s can reduce your sensory awareness. You might not realize that the volume, speed, or pitch of your voice has changed. You might feel that you are shouting even when you are speaking at a normal volume.
- Parkinson’s can reduce your ability to prompt your own outward speech and begin conversations. Often, people with Parkinson’s who are able to answer questions or respond to others have difficulty voicing thoughts without being asked.
Speech therapy can benefit people with Parkinson’s.
Speech and language therapists are healthcare professionals who can work with patients to help improve:
They can assess current abilities, make treatment plans, help you strengthen abilities, recommend assistive technology, and more. You might see a speech therapist when you’re first diagnosed with Parkinson’s, then regularly throughout the years.
Therapists can help you at every stage of Parkinson’s. They can spot any new difficulties and prevent them from becoming worse, and they can help you manage anything that’s been causing you trouble.
During sessions, your speech and language therapist might:
- lead you through exercises that can improve muscle strength
- lead you through exercises that can help make your voice louder
- teach you exercises to do at home
- teach you communication techniques to help you express your thoughts and needs
- teach you ways to conserve your energy while speaking
- teach you nonverbal communication techniques
- teach you how to use assistive devices
Assistive devices for speech and swallowing difficulties can help you maintain independence. Your speech and language therapist might recommend a few different options to help you. The right devices and software applications for you will depend on your specific difficulties.
Here are some hearing and speech recommendations:
- Use texts, email, and other keyboard-based communication as much as possible.
- Have specific tablets or smartphones dedicated to communication.
- Download voice recognition software on your phone, tablet, or computer that can be trained to recognize your voice and speaking patterns.
- Use apps designed for people with Parkinson’s that can remind you to speak louder and slower.
- Use communication tablets and devices that can play back the words you type into them.
Speech therapists can also help with swallowing and determining what therapy may work best for you. Therapy options depend on how much difficulty you’re having with swallowing and meeting your daily recommended nutrient intake.
First-line therapy might involve adjusting your diet to softer, more easily swallowed food while at the same time working on exercises to strengthen the muscles in the throat.
Other potential treatment options, according to 2021 research, include:
- Video-assisted swallowing therapy (VAST). This therapy shows people videos of a typical swallowing process compared to videos of their own impaired swallowing process. A
2012 studyfound significant improvement in swallowing following this kind of visual therapy.
- Botulinum toxin (Botox).
Botox injectionsinto the cricopharyngeus 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, per 2016 research.
- Percutaneous endoscopic gastronomy (PEG) feeding. Dysphagia that is causing malnutrition and weight loss may require PEG feeding. PEG feeding uses a flexible feeding tube inserted through the abdominal wall into the stomach. It allows for fluids, nutrition, and medications to be placed directly into the stomach without the need for chewing or swallowing.
Where to find qualified speech therapists for Parkinson’s
Your primary care doctor can recommend a speech therapist to you. You can also check out The American Speech-Language-Hearing Association website to find speech therapists in your area.
For more support during speech therapy and all aspects of Parkinson’s, you can turn to:
- The Michael J. Fox Foundation. You’ll find advocacy, informational resources, podcasts for people with Parkinson’s, and more on The Michael J. Fox Foundation site.
- The Parkinson’s Foundation. The Parkinson’s Foundation can help you find local resources and also offers online support, learning resources, and more.
- The American Parkinson Disease Association. The American Parkinson Disease Association is a great way to find support in your local community, including wellness, informational, and health programs.
- The Davis Phinney Foundation. The Davis Phinney Foundation offers webinars, podcasts, blogs, and live events dedicated to helping people with Parkinson’s lead full and active lives.
Parkinson’s can cause difficulties with speech and swallowing.
People with Parkinson’s can often have trouble with the volume, speed, and pitch of their voice. They might also have difficulty expressing their thoughts and emotions. Difficulties with swallowing can lead to weight loss, choking, and even food entering the lungs.
Speech and language therapists are professionals who can help with these difficulties.
They can help people with Parkinson’s strengthen their muscles, improve their speech and swallowing, and manage any communication difficulties they have. They can also recommend assistive devices and show you how to use them.
Talk with your doctor about finding a qualified speech therapist that specializes in Parkinson’s.