Speech therapy for multiple sclerosis
Reviewed by Speech therapy can help people with multiple sclerosis (MS) manage changes in speech, voice, swallowing, and communication. A speech-language pathologist (SLP) can assess specific difficulties and recommend individualized exercises, strategies, or assistive communication tools to improve communication and help maintain independence.
Nearly 40%-50% of people with MS experience speech difficulties, which are caused predominantly by damage to the parts of the brain that control the muscles of the tongue, lips, soft palate, cheeks, or diaphragm.
What are speech and language difficulties in MS?
Speech and language difficulties in people with MS can occur when lesions affect areas of the brain involved in speech production, coordination, voice, or cognitive-language processing. Symptoms can range from mild to more noticeable and may vary over time.
Speech difficulties may affect:
- articulation
- speaking rate
- volume
- voice quality
- coordination of breathing and speech
Some people with MS may also experience cognitive-language difficulties, such as:
- trouble finding words
- difficulty organizing thoughts during conversation
If MS lesions affect communication between the brain and the parts of the body responsible for speaking, speech and language difficulties may occur. These parts include:
- tongue
- lips
- mouth
- cheeks
- vocal cords
- throat
- nose
- diaphragm
- lungs
Fatigue, tremor, and spasticity, or muscle stiffness or tightness, can also affect speech, as can some treatments for MS that may cause a dry mouth.
Types of speech and language problems in MS
People with MS may experience different types of speech difficulties. These are summarized below.
Dysarthria
Dysarthria is a speech problem that occurs when the motor muscle components of speech are affected.
The condition can cause:
- slurred, imprecise, or slower speech
- difficulty with resonance and pitch control
- long pauses between words or syllables
- altered pronunciation
Dysphonia
Dysphonia involves changes in voice quality. These can include:
- impaired pitch control
- harshness of voice
- hypernasality
- irregular pitch levels
- breathiness
- hoarseness
Dysphasia
Dysphasia is a language disorder that can occur due to cognitive issues that cause changes in memory and thinking.
People with dysphasia may experience difficulty with the following:
- understanding what’s being said (receptive dysphasia)
- recalling vocabulary
- finding the right way to say something (expressive dysphasia)
How speech therapy helps people with MS
There are many ways in which speech therapy can help people with MS.
Speech exercises may involve:
- drills to help improve the strength and coordination of the muscles in the throat, tongue, cheeks, mouth, diaphragm, soft palate, and lips
- voice training, including slowing down and articulating more carefully when speaking
- exercises that strengthen or relax the muscles controlling the vocal cords for speech difficulties affecting volume, pitch, or voice quality
- drills that help improve breathing, emphasizing certain words in a sentence, and catching quick breaths between thoughts
- exercises that help with the movement of the jaw, tongue, and lips to assist with clear articulation and pronunciation
A doctor can usually refer someone with MS requiring speech therapy to a speech-language pathologist. These specialized therapists can also help if a person is having trouble with swallowing.
Communication devices
A range of special high-tech communication devices can help people with MS who have speech difficulties to communicate more effectively.
Such devices include:
- machines that offer speech output either by typing the message or accessing visual symbols on a voice amplifier
- computers that respond to eye blinks
Lower tech assistive device options are also available, including:
- alphabet cards
- E-tran frames
- partner-assisted scanning
Can medications help with MS speech problems?
There are currently no medications available to specifically treat speech problems in MS. However, medications that help to control other MS symptoms can also be beneficial in improving speech.
Among such medicines are:
- Medications used to treat spasticity may be useful in cases where spasticity affects muscle tone in the vocal cords, tongue, lips, and soft palate or diaphragm. Examples include Lioresal (baclofen) and Zanaflex (tizanidine).
- Drugs used to decrease tremors may improve voice quality. Examples include Klonopin (clonazepam), Inderal (propranolol), and Mysoline (primidone).
- Medications for managing fatigue may improve the muscular coordination and strength necessary for sound production. Examples include amantadine, Provigil (modafinil), and Nuvigil (armodafinil).
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
