Parkinson’s can affect your speech and swallowing. Some studies show that 80% of people with PD have a hard time swallowing, and 75-90% of people experience difficulty with their speech. Learning how to recognize signs of speech and swallowing changes, and what to do about it is crucial.
What are different swallowing problems?
Dysphagia means difficulty swallowing. This can present initially as taking more time to eat a meal or coughing when eating. Overtime, it can progress and really impact someone's quality of life. Dysphagia can lead to malnutrition, dehydration, and aspiration.
Aspiration means when “food goes down the wrong pipe”. Aspiration is a risk factor for aspiration pneumonia, which is an infection of the lungs or airway when food and liquids goes into the lungs or airway. Aspiration pneumonia is a leading cause of death in PD.
How do I know if I have a swallowing problem?
I have recently lost weight without trying.
I tend to avoid drinking liquids.
I get the sensation of food being stuck in my throat.
I tend to drool.
I notice food collecting around my gum line.
I tend to cough or choke before, during or after eating or drinking.
I often have heartburn or a sore throat.
I have trouble keeping food or liquid in my mouth.
Swallowing problems can be evaluated by taking x-rays while you swallow foods and liquids of different consistencies. This helps show where the swallowing problems might be along the swallowing tract and if the foods are going into the airway instead of the stomach.
What are different speech problems?
Dysarthria is commonly referred to speaking like you have marbles in your month. This is when your muscles are having a hard time forming words.
Other speech changes may involve speaking slowly or rapidly, speaking with a low tone, or speaking with a stutter. Parkinson's symptoms can also impact your facial expressions, making it harder to communicate nonverbally.
How do I know if I have a speech problem?
I speak quietly
I speak in one tone or do not convey emotion
I have hoarseness
I talk slowly
I talk too fast
I slur my words
I drool or have a hard time managing my saliva
What can cause speech and swallowing changes?
Changes in jaw and face muscles
The muscles in your face and jaw can become less efficient in those with PD. This will impact the control you have over chewing and swallowing, and it can impact how tight you can close your lips which make it difficult to swallow when eating or drinking.
Problems with tongue muscles
We use our tongue to move food around and push the food to the back of our mouth when we are eating. This is important because it triggers the swallowing reflexes. The swallowing reflex is what helps protect our windpipe from any food or liquids that we ingest.
Slow muscles carrying food to your stomach
Parkinson’s may also slow down the muscles carrying food down into your stomach. Food moving slowly down your food pipe to your stomach can make you feel full, but once it arrives at your stomach you realize you’re still hungry. By this time the food on your plate may have gone cold and be unappealing.
Dry mouth
Dry mouth can be another feature of Parkinson’s and can affect the comfort and pleasure of eating and drinking. Saliva helps us to break down food as we chew it and enables us to taste our food. Tasting your food produces more saliva that lubricates what you’re chewing and makes chewing and swallowing comfortable.
Treatments for speech and swallowing problems
Working with a speech-language pathologist (SLP) is the gold-standard treatment. SLPs are trained health care professionals who are specialized in evaluating and treating people with any speech, swallowing, voice, cognitive, and language challenges due to PD. Your SLP can help you determine how to modify your liquids and solids to eat and drink easier. Click here to see the list of SLPs in the Capital District Area.
The Lee Silverman Voice Treatment (LSVT) LOUD
LSVT LOUD is an evidence-based, intensive speech therapy treatment for people with PD and other neurological conditions. This treatment helps people relearn how to use a louder and clearer speech through strengthening muscles needed to produce voice and speech.
This treatment involves 4, one-on-one speech therapy sessions a week for 4 consecutive weeks. Patients are expected to complete daily homework on both therapy and non-therapy days. Patients are also expected to continue with the exercises daily after the treatment ends.
SPEAK OUT!
This is an evidence-based speech therapy treatment that was developed by Parkinson Voice Project. The program focuses on speaking with intent and works to strengthen the muscles used for speaking and swallowing.
This treatment involves 8-12 sessions, daily exercises at home using a specific SPEAK OUT! Workbook, participation in speech and singing groups, and a re-evaluation every 6 months.
Vocal fold injections
Natural or synthetic materials are injected directly into the vocal folds to improve the loudness and quality of your voice. Injections are used to build up vocal folds that do not close completely while talking. These injections are shown to last about 3-6 months. An ENT specialist (ear, nose, and throat doctor) will help determine if this is the best treatment for you.
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