Speech Therapy and Parkinson's Disease Guest Blog!
Speech Therapy and Parkinson’s Disease
April is Parkinson’s disease Awareness Month. According to the Parkinson’s Foundation, there are nearly 1 million people living with Parkinson’s disease in the United States and approximately 60,000 people are diagnosed in the U.S. each year.
While many people think of the motor symptoms associated with Parkinson’s disease (shuffling, freezing of gait, balance problems, tremor, etc.); many individuals are as equally affected by non-motor symptoms such as speech and swallowing changes, cognitive changes, sleep changes, gastrointestinal issues, etc.
I want to focus this post today on the speech, voice, and swallowing changes as well as cognitive changes in individuals with Parkinson’s disease, and how speech therapy can be beneficial in helping to maintain more intelligible speech and a strong swallow function.
Did you know?
· It is estimated that nearly 90% of individuals with Parkinson’s disease will experience speech and voice changes.
· Research varies widely on the prevalence, but we know that as the disease progresses, most individuals with Parkinson’s disease, will experience swallowing changes.
· Cognitive changes in Parkinson’s disease can include memory changes, but also cognitive-linguistic deficits such as difficulty retrieving or coming up with the word you want to say in conversation or difficulty organizing your thoughts.
· DBS (deep brain stimulation) may be beneficial to capture tremor or other motor symptoms, but its effects on speech performance have been inconsistent and can sometimes have adverse impact on speech intelligibility.
What can you do?
Monitor for symptoms or changes with your voice, speech, swallowing, and/or cognition/language. These may include:
o Difficulty being heard and understood by others
o Repeating yourself frequently
o Thinking “everyone else” has a hearing problem
o Hoarse/breathy voice
o Slow rate or slurred speech
o Coughing while eating or drinking
o Drooling
o Difficulty chewing foods
o Sensation of food sticking in throat
o Difficulty swallowing pills
o Memory changes
o Difficulty planning and executing tasks
o Difficulty with word retrieval and thought organization in conversation
· Talk to your neurologist right away, the sooner that you can be evaluated by a speech pathologist and get started with a rehab or home exercise program, the better! People often make more progress before symptoms are significant.
· There are evidenced based voice therapy programs specifically designed for individuals with Parkinson’s disease including Lee Silverman Voice Therapy (LSVT) and the SPEAK OUT! Programs. Both of which have been shown to improve vocal intensity (loudness/volume) as well as speech intelligibility and speech prosody (tone of voice/rhythm of speech).
· Swallowing will generally be assessed first in a Clinical Swallow Exam and depending on the results, your therapist may recommend more objective swallow imaging such as a Modified Barium Swallow Study which is an x-ray of your swallow. Depending on the results, various swallow strategies and diet modifications may be recommended, as well as swallow function exercises.
· An evaluation of your larynx (voice box) and vocal cords by an ENT (Ear, Nose, and Throat doctor) may also be recommended. There may be specific treatments such as injection laryngoplasty that may benefit the voice as an adjuvant to voice therapy.
· You may be educated and instructed in memory strategies or techniques to help improve daily function.
· Word finding strategies and word games can also be beneficial.
· Remember, the best way to combat these changes is to be proactive! Contact your neurologist and get in touch with a Speech Pathologist today! The best time to start is NOW!
· If you are in need of resources for speech therapy, please feel free to contact myself: Leah Fisher, M.A., CCC-SLP at the Lou Ruvo Center for Brain Health (702-483-6032).
· Some good resources for Speech Therapy and Parkinson’s disease:
o www.parkinsonvoiceproject.org
Leah Fisher is currently a Speech Pathologist at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, NV. She received her undergraduate degree in Speech Pathology from the University of Louisiana-Lafayette in 2006 and a master’s degree in Communication Disorders from Louisiana State University in Baton Rouge, LA in 2008. Throughout her career, Mrs. Fisher has worked with a variety of communication, voice, cognitive, and swallowing disorders in several different locations across the country, receiving advanced training in voice and swallowing. She is LSVT (Lee Silverman Voice Therapy) Loud certified, as well as a SPEAK OUT! certified provider.