Speech therapy can help people with Parkinson’s disease manage speech and swallowing concerns so they can stay as social, healthy and safe as possible
By Rosemary Griffin, MA, CCC-SLP, Director of Speech Pathology, Northern Dutchess Hospital, Vassar Brothers Medical Center
People with Parkinson’s disease may experience problems speaking and swallowing. Trouble communicating can be very frustrating and lead to isolation. Trouble swallowing can lead to additional medical problems such as malnutrition and aspiration.
While there is no cure for Parkinson’s disease, there are ways to manage symptoms so people with the neurological condition can maintain their independence and quality of life as much as possible.
Here is how speech therapy can help people manage speech and swallowing challenges associated with Parkinson’s disease.
What is Parkinson’s disease?
Parkinson’s disease is a progressive movement disorder and the second most common neurodegenerative disease in the United States. About 60 thousand Americans are diagnosed with Parkinson’s disease each year, and 10 million people are living with it worldwide.
Parkinson’s disease causes trembling of hands, arms, legs, jaw and face and poor balance and coordination. As symptoms worsen, individuals may have difficulty chewing, swallowing or speaking, talking or walking.
How does Parkinson’s disease affect speech?
Dysarthria is a combination of impairments in articulation, speech rate, timbre or resonance, and volume. Someone with dysarthria from Parkinson’s disease may lack emphasis and emotion, speak in a low volume, sound muffled or trail off.
Parkinson’s disease may also affect face and mouth muscles movement, which can then affect how someone communicates.
Finally, a relatively smaller group of people with Parkinson’s disease may experience cognitive changes that impact memory, planning and word retrieval.
How does Parkinson’s disease affect swallowing?
People with Parkinson’s disease often experience swallowing difficulty, called dysphagia. Dysphagia can cause dehydration, malnutrition and aspiration, which is when food or liquid enters the airway or lungs by accident. Aspiration pneumonia is the leading cause of death in people with Parkinson’s disease.
What is speech therapy for Parkinson’s disease?
People with Parkinson’s disease can meet with their neurologist to determine if they will benefit from speech therapy. Their neurologist may recommend they see a speech-language pathologist who can provide the following speech services:
- Evaluate speech, language and voice, which includes a computerized assessment of vocal parameters.
- Introduce speech interventions to increase loudness and intelligibility (understandability). At Nuvance Health, individualized treatment may include the Lee Silverman Voice Treatment — LOUD® program or the Parkinson’s Voice Project SPEAK OUT® program.
- Weekly coaching, speaking practice and voice enhancing strategies through the LOUD Crowd® support group.
The Parkinson’s Voice Project has awarded grants to Nuvance Health’s Norwalk Hospital, Northern Dutchess Hospital, Putnam Hospital and Vassar Brothers Medical Center for supplies and training to care for patients with Parkinson’s disease.
What is swallowing therapy for Parkinson’s disease?
Therapy for swallowing problems associated with Parkinson’s disease aims to address motor weakness or compensate for neuromuscular changes to maintain someone’s ability to safely eat and drink.
A speech-language pathologist first evaluates someone’s swallowing by observing how they consume food, liquids and medications. They note coughing, throat clearing and changes in voice quality.
Then, they may recommend someone have a modified barium swallow study. The patient consumes liquid and solid foods mixed with barium and then the speech-language pathologist and a radiologist view how they swallow through videofluoroscopic images.
The study shows specific aspects of swallowing affected by Parkinson’s disease so the speech-language pathologist can create a personalized treatment program. The program may include certain food textures and liquid thicknesses so swallowing is as safe as possible.
Some Nuvance Health locations also offer Fiberoptic Endoscopic Evaluation of Swallowing (FEES) as an alternative or supplement to the modified barium swallow study. This procedure allows direct viewing of the larynx and pharynx during speaking and swallowing. Similar to the modified barium swallow study, it will reveal the swallowing impairment so the speech-language pathologist can recommend techniques for the patient to minimize the risk of aspiration.
Related article: Parkinson Voice Project awards grant to Norwalk Hospital
What is cognitive-linguistic therapy for Parkinson’s disease?
A speech-language pathologist evaluates someone’s cognitive-linguistic skills through standardized tests and quality of life ratings. Based on the results, they will develop a personalized treatment plan for someone with Parkinson’s disease to compensate for cognitive difficulties, and engage caregivers as effective communication partners.
Related article: Parkinson Voice Project awards grant to Northern Dutchess Hospital
The bottom line: Speech-language pathologists can help people with Parkinson’s disease manage speech and swallowing concerns so they can maintain their independence, health and wellness as much as possible.