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Home > MSAA Publications > The Motivator > The Motivator: Winter/Spring 2009 > Cover Story - Symptom Management Update > SECTION 14: SPEECH AND SWALLOWING
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SECTION 14: SPEECH AND SWALLOWING

A wide variety of speech and swallowing difficulties may occur with MS, depending on the areas in the brain where demyelination occurs. These problems are usually considered together, because they tend to result from the same problems in the muscles of the throat used for speech production and for swallowing. These include spasticity, tremor, or weakness in the muscles involved in producing speech or controlling swallowing, or from a lack of muscle coordination. Speech and language therapists are trained to manage both types of problems.

A. SPEECH


The most common speech problems seen in MS are dysarthria and dysphonia. Dysarthria involves speech that is slurred or poorly articulated; it can involve a loss of volume control, unnatural emphasis on words or sentences, and a slower rate of speaking. Dysphonia results in changes in the quality of speech, such as a breathless quality to the voice, or speech that sounds harsh.

A speech therapist can help with exercises and adaptive equipment, depending on the type of problem you are experiencing.

NON-PHARMACOLOGIC MANAGEMENT

Exercise

Some exercises can strengthen and improve the muscles involved in the production of speech, or improve breathing through relaxation of the affected muscles.

Modifying Speech Patterns

A speech language therapist can teach techniques to help slow speech so that it is more understandable, as well as techniques such as improving the way words are articulated and correctly pausing between words. One technique that is particularly helpful is to listen to your own voice using a tape recorder.

Alternative Speech Production

When speech difficulties are severe and cannot be corrected with exercise or speech modification, alternative means of speech production can restore the ability to communicate. These range from technology that amplifies the voice, to alternative communication systems such as computer boards.

PHARMACOLOGIC MANAGEMENT

No medications can specifically improve speech difficulties. However, medications that relieve symptoms such as spasticity may provide some improvement.

B. SWALLOWING


Swallowing is a complex process that involves chewing, then moving food to the back of the mouth, the pharynx, and through the esophagus into the stomach. Depending on lesion pattern, one or more of these processes may be affected. A speech/swallowing pathologist will evaluate the source of the problem and determine how best to manage the problem. The goal of therapy is to ensure that swallowing is safe, to prevent food from entering the airway and lungs, where it can cause aspiration pneumonia. It will also focus on ensuring that food and fluid intake is sufficient for optimal health.

NON-PHARMACOLOGIC MANAGEMENT

Safe Swallowing Techniques

Techniques designed to promote safe swallowing are individually designed based on an evaluation of an individual 's swallowing pattern. To ensure safe swallowing, a medical professional or therapist can provide detailed instructions concerning the kinds of foods that should be eaten, the best way to manage liquids, avoiding foods and liquids that may cause problems, and adjusting posture and head angle when swallowing.

Feeding Tube

If safe swallowing techniques are not sufficient, in rare instances a feeding tube may need to be used.

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Last Updated on Friday, 10 May 2013 10:18