Speech

75% of people with Parkinson's experience changes in speech and voice at some time during their disease. These changes usually come on gradually and can vary from mild to severe. Communication is a vital part of daily life and extends beyond speech and voice abilities. It also includes the ability to formulate your ideas into a message; understand messages and words conveyed by others; and the ability to put your ideas into words. Communication also includes the ability to use body language, gestures, and voice pitch/loudness changes to emphasize ideas, add humor, and convey emotions.  Problems communicating can lead to feelings of frustration, depression, and withdrawal. Learning how PD affects communication and what you can do about it can help you better cope with problems that you might experience.

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Many of the problem areas can be improved with PD-specific exercise programs, devices that help communication, and strategies/techniques that can help you and your conversation partners to communicate more effectively and efficiently.

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To improve speech and communication, seek a speech-language pathologist to work on some strategies to improve overall communication. This includes:

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• Taking Care of Your Voice: Drink plenty of water, avoid straining your voice and rest it when it is tired. Reduce clearing or coughing and use a humidifier.

• Posture: Keeping an upright posture and straight neck with lifted chin helps you move air from your lungs through your vocal cords, helping to produce louder speech sounds.

• Breathing Exercises: Sit up straight and take deep breaths. When exhaling, voice a loud and clear "ah" or other sounds - try to exaggerate your tongue and lip movements.

• Practicing Good Conversation: Work with a conversation partner to have conversations that include listening, sending clear messages, and looking for signals of conversation breakdowns.

• Facial Exercises: Smile, hold, relax, and repeat - Pucker your lips, hold, relax, and repeat. Alternate puckering and smiling. Open your mouth and move the tip of your tongue all around the lips and around the gum line. Open your mouth as wide as you can, hold, relax, and repeat.

• Monitoring Hearing Health: While hearing loss is not a symptom of PD directly, it is the third most common health problem in the United States, especially for people over the age of 60. If you suspect you have hearing loss, contact your physician or a local audiologist for a hearing assessment and treatment options.

• Keep Talking: If you don't use it, you lose it -- applies to speech too. If you don't have a companion to talk to, talk out loud to yourself.

• Singing: One of the best exercises for the voice is singing because it uses the same muscles as speech but forces you to try different pitches or inflections. Even if you don't sing well, sing along to your favorite songs.

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Treatment options include therapies specific to PD, including LSVT BIG Therapy or SPEAK OUT programs.

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Assistive devices come in all shapes, sizes and prices. A personal amplification system is a device most often used by persons with PD. It is most effective for people who have a soft voice. Using a microphone and speaker system, the device amplifies speech. Wearable devices, such as the SpeechVive device, plays multi-talker babble noise in one ear while the person wearing the device is talking. It has been shown to improve vocal intensity in over 75% of PD patients and improve speech in over 60% by encouraging the intent to speak loudly and with clarity. Other communication devices range from hand-made communication boards to sophisticated computerized equipment.

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Collagen injections have also been used in the treatment of voice and speech impairment in PD to build up vocal folds that do not completely close while talking. These injections are generally obtained by consulting with an ear, nose and throat specialist.

Sources:

Parkinson's Foundation. Speech and Swallowing. A Body Guide to Parkinson's Disease. "Brochure." Pages 7-8.

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