by Yonca Berk-Giray, SLP
Eighty-nine percent of individuals with PD have speech and voice difficulties at the onset of the disease. As the disease progresses, this number rises to 100%. Most individuals with PD also experience varying degrees of swallowing difficulties.
Speech and voice difficulties are often overlooked by the patients and their physicians until the problem becomes severe enough that communication is affected. Many patients with PD experience difficulty socializing and being understood by others, and feel left out of conversations. Individuals experience decreases in vocal loudness levels, speech intelligibility, expression in their
speech and voice, and facial expression, as well as hoarse voice quality. Since these changes happen slowly over many years, most patients are not aware of them. Often it is their loved ones who first become aware of the communication issues.
Lee Silverman Voice Therapy (LSVT) is a voice and speech therapy program that is specifically designed for treating individuals with PD. It has been scientifically researched for the past 25 years and proven to be effective in treating voice, speech and communication difficulties associated with PD. LSVT follows a standardized treatment protocol that is customized to the needs of the individual. Mid Coast Rehabilitation Services currently has two clinicians who are certified in delivering this program. For those patients who are homebound, the therapy is also available through certified clinicians at CHANS home health services. For more information on LSVT Loud, and a list of certified clinicians, please see www.LSVTGlobal.com.
Swallowing difficulties associated with PD are much more subtle at the onset of disease, and can become serious and life threating as the disease progresses. Patients usually complain of drooling, foods getting stuck in the cheeks or throat, coughing with liquids or solids during meals, and difficulty taking their pills. Two main concerns with swallowing difficulties are the risk of aspiration related pneumonia and weight loss. Recognizing early signs of swallowing difficulties, and receiving treatment for them, is very important in staying ahead of the muscle atrophy that can happen. There are various methods and treatments available that are proven to be effective in treating swallowing difficulties in PD. See a physician or speech pathologist for more information.
It is important and strongly recommended that patients are proactive in receiving treatment early for speech, voice and swallowing difficulties to maximize their functioning for years to come.
