PARKINSON'S SPEECH THERAPY
What Parkinson's speech signs and symptoms to look out for?
There are many different symptoms that can present themselves when an individual is suffering from Parkinson’s disease. Some physical symptoms include:
Coughing/choking during meals or when drinking.
Difficulty elevating vocal quality (i.e., not being able to be heard in a loud room).
Slurred or imprecise speech.
Hoarse or breathy voice.
Reduced facial expressions.
Along with the physical aspect of Parkinson’s disease, an individual might present with several cognitive changes as well. These might include:
Memory: An individual with Parkinson’s may present with memory difficulties. These memory issues can range from simply struggling to remember one’s password to an app, all the way to forgetting the name of one’s own spouse. This depends on the progression and severity of the disease.
Attention: Someone with Parkinson’s disease might struggle to remain attentive. These attention difficulties can present themselves in an inability to remain engaged in a conversation or difficulty in carrying out tasks they never struggled with before the onset of symptoms (i.e., making it through an entire workday without significant distraction).
Executive Functioning: Difficulty with executive functioning in Parkinson’s might present itself in issues with organization, impulse control, planning, or emotional control.
Individuals that are suffering from Parkinson’s disease can take several steps to improve or maintain the speech functions they currently have. The first step for some individuals is to seek out speech-language therapy. Once treatment has been established, an individual might practice some of the following with the guidance of their speech therapist:
Vocal exercises: Vocal exercises might include learning how to increase volume and project one’s voice. Such as utilizing open vowels for projection practice. Or increasing one’s volume might include learning to use some sort of outside help, such as a vocal amplifier. A speech-language pathologist can assist an individual in learning to utilize said device when it is necessary.
Swallowing exercises: Utilized to strengthen the swallowing mechanisms. Some of these exercises include the Mendelsohn maneuver (elevating the larynx and swallowing), Masako maneuver (biting one’s tongue and swallowing), and effortful swallow (push down and swallow).
Breath support exercises: Similar to learning to project one’s voice, breath support exercises assist in teaching the individual breathing exercises to make one’s voice louder and more comprehensible.
PARKINSON'S SPEECH EVALUATION
Why should you see a speech-language therapist for an evaluation?
There are many reasons why an individual with Parkinson’s may want to consider seeing a speech-language pathologist for an evaluation, including:
Maintaining current voice functions or improving functions. This may involve learning to increase one’s volume, as Parkinson’s disease can cause an individual to struggle with loudness and maintaining volume. Parkinson’s disease is also considered to be a degenerative disease, so maintenance is a very important aspect of treatment, in order to maintain vocal functions as long as possible.
Improving swallowing and maintenance of the current diet. Many individuals with Parkinson’s might lose the ability to maintain a regular diet and they might require swallowing exercises to strengthen the swallowing mechanisms. Similar to vocal functions, Parkinson’s can be degenerative towards the swallowing mechanisms as well and maintenance is typically a big goal of treatment.
Emotional support. Many individuals with Parkinson’s might struggle to communicate and struggle to accept their new diagnosis. Parkinson’s disease can be isolating and cause a person to have a bleak outlook on their prognosis. A speech-language pathologist can assist in working through said emotions as well as offering alternative forms of communication.
PARKINSON'S TREATMENT
How speech therapy works for Parkinson’s disease?
Speech therapy can look different for many people that are suffering from Parkinson’s disease, especially depending on how far the Parkinson’s disease has progressed and the personal goals of the individual that has Parkinson’s disease, as well as which areas of speech, communication, cognition, or swallowing might be affected. Speech therapy for an individual with Parkinson’s disease might look as follows:
Vocal exercises, such as open vowel exercises to assist in relearning vocal projection.
Learning new forms of communication, such as the use of vocal amplifiers.
Swallow exercises, such as the Mendelsohn maneuver or the Masako maneuver in order to restrengthen the swallowing mechanisms and assist in maintaining a regular solid and liquid diet.
Emotional support, such as working through the new forms of communication and eating/drinking.
Cognitive treatment, such as working through impulsive actions (both physical and emotional), goal planning to assist in carrying out daily tasks, practicing certain exercises to improve/maintain working memory, organization exercises, etc.
PARKINSON'S SPEECH THERAPY
What to expect during a Parkinson's speech therapy session?
A speech therapy session can look different for each individual with Parkinson’s disease. If an individual is looking to improve their volume, they may utilize LSVT LOUD during their sessions or other similar exercises (LSVT LOUD assists the individual in improving the loudness of their voice/projection through a series of exercises).
A speech therapist can also introduce alternative forms of communication through things such as technology, like the utilization of a vocal amplifier or an AAC device. If an individual’s goal is to return to or maintain their current diet, a therapy session may involve primarily focusing on utilizing swallowing exercises such as the Mendelsohn maneuver (elevating the larynx during a swallow) or the Masako maneuver (biting one’s tongue and swallowing).
A speech therapist/the individual being treated might also desire to involve their loved ones in treatment. This could involve including their loved one during a session, educating said individual on their loved one’s new forms of communication/swallowing, and having them practice exercises with their loved one. Or finally, if an individual’s goal is simply to work through the emotions of their new communication, a speech-language pathologist might work with them to find acceptance.
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