Speech Therapy and Parkinson’s

Research shows that 89 percent of people with Parkinson’s disease (PD) experience speech and voice disorders, including soft, monotone, breathy and hoarse voice and uncertain articulation (The Parkinson’s Foundation). As a result, people with PD report they are less likely to participate in conversation, or have less confidence in social settings than healthy individuals in their age group.*

The progressive decline in speech and voice abilities can drastically reduce the quality of life for a person with Parkinson’s. Early detection and intervention can help preserve the person’s ability to be understood. Effective communication is a critical piece in maintaining quality of life for people with Parkinson’s and can reduce social isolation and depression.

Speech and Voice Disorders in Parkinson’s

People with Parkinson’s may have reduced loudness and a monotone, breathy voice. One reason for this is directly related to the disordered motor system that accompanies PD, including rigidity, slowness of movement, and tremor. For example, the poor muscle activation that leads to bradykinesia (slow movement) and hypokinesia (small movements) in the limbs can translate to poor muscle activation in the muscles involved in speech. Decreased muscle activation can also result in reduced movements of the respiratory system (reduced breath support), larynx (reduced vocal loudness) and articulation (reduced speech clarity).*

Another cause of speech and voice impairment in PD is a change in sensory processing that is related to speech. It is believed that people with PD may not be aware that their speech is getting softer and more difficult to understand. When people in this situation are asked to bring their voice to normal loudness, they often feel as though they are shouting, even though they are perceived by listeners to be speaking normally.

Another cause of this condition is that people with PD may have a problem with “cueing” themselves to produce speech with adequate loudness. Individuals with PD can respond to an external cue (e.g., an instruction from someone else to “speak loudly”), but their ability to cue themselves internally to use a louder voice is impaired. These problems can be frustrating both for the person and for the family.*

How to Find a Speech Therapist

Tell your doctor If you are experiencing any changes in your speech or voice. Ask for a referral and a prescription for a speech evaluation and treatment. If you have not noticed changes in your speech, but a spouse, care partner or friend has: pay attention to their comments. The sooner you get a speech evaluation and start speech therapy, the better.

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. (0 = never, 1 = almost never, 2 = sometimes, 3 = almost always, 4 = always).

0 1 2 3 4 It is difficult for people to hear me
0 1 2 3 4 People have difficulty understanding me in a noisy room
0 1 2 3 4 My voice difficulties restrict personal and social life
0 1 2 3 4 I feel left out of conversations because of my voice
0 1 2 3 4 My voice problem causes me to lose income
0 1 2 3 4 I feel as though I have to strain to produce voice
0 1 2 3 4 The clarity of my voice is unpredictable
0 1 2 3 4 My voice problem upsets me
0 1 2 3 4 My voice problem makes me feel handicapped
0 1 2 3 4 People ask, “What’s wrong with your voice?”

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.

Adapted from The Parkinson’s Foundation* - for more information visit www.parkinsons.org or email contact@parkinson.org