Articles on Medical Diseases and Conditions

Tag: Speech difficulties

  • Speech difficulties: Further help

    Communication technology is advancing rapidly. The newer computer voice recognition programmes are still very expensive but are improving quickly. Some other computerized systems may be of help but, before you think of high technology solutions, many much simpler devices and procedures may be better, including such things as:

    • picture or word charts;
    • alphabet charts where you can spell out the words that you want with your fingers or eyes;
    • agreed signals with your partner/family/friends for yes, no and other words, or
    • eye blink systems.

    Your choice is likely to be influenced by your own skills, how comfortable you and others feel with a particular system, and the costs (financial and otherwise) that your choice may incur.
    If you are buying a computer, get independent advice on which system is the most appropriate for you. Think about the future also before you buy because computer systems quickly become outdated! There are currently systems, portable as well as desk-top, that automatically print out your messages and translate your words into speech. Some allow you to use single key strokes, not only to create more complex messages but to control other facilities around the home. It is not possible to give individual advice to you here, because of the rapid changes occurring, as well as because everyone’s abilities and needs are so personal. A range of communication aids can be supplied by the statutory services depending on your circumstances, including your local education authority, NHS Trusts, GP fund holders, and the Department of Employment; there are also Communication Aids Centres, in addition to individual professional advice. You should ask your GP, neurologist or occupational or speech therapist for a referral to a specialist centre if possible.

  • Speech difficulties: Helping yourself

    The first thing is to be aware of when your speech is unclear or slurred. Ask others sympathetically to understand what your problem is. People tend to do things more quickly nowadays, and seem to have less patience with others, who may not keep up with their fast pace. This is true even in family settings. Tell people that you are not drunk or have anything wrong with your mental state, just a problem of coordination of your voice.
    Check how long people have the time to talk with you, so that you are not disappointed if they leave in the middle of a conversation. When people understand your situation, they will be willing to spend more time in conversation with you. You can help also by:

    • being much more deliberate in your speech;
    • trying to pronounce your words much more precisely;
    • slowing down your normal pace of speech, and
    • giving yourself more time by pausing periodically.

    Through these means you can maintain a good rhythm, even if you speak much more slowly than you would normally.
    Learn to breathe in ways that assist the production of speech –
    coordinated breathing in sequence with your speech is crucial.
    Don’t try and speak for too long as this could exacerbate the problems with your speech, and both you and your friends may ‘lose the thread’ of what you are saying. After all some of the most memorable or amusing things that we hear are very short and to the point!

  • Speech difficulties: Dysarthria

    When people speak it requires considerable coordination of a large number of facial and related muscles. Your speech may slur because the normal muscular control of voice production has failed through weakness, or because the muscles are not operating in the right sequence. As a result your speech may sound slurred or be uncoordinated. ‘Dysarthria’ is the name given to general problems like this and may be associated with several neurological diseases. Sometimes your speech will just sound slightly slurred, but still be intelligible to others, but with more serious problems of coordination it may be difficult for others to understand you.

  • Speech difficulties: Voice production

    Voice production is a complicated process involving coordination between the relevant muscle groups, which in normal life (without Multiple Sclerosis or other condition af fecting voice production) we tend to take for granted. Speech problems are normally assessed by speech therapists – they need to know just where the problem lies for management:

    • Breathing: You may not be able to exhale in a slow and measured enough way needed for good speech production.
    • Phonation: You may not be able to speak loudly enough or with sufficient clarity or tone of voice.
    • Resonance: This additional quality of sound may be hampered by your palate not working properly.
    • Articulation: Your vocal movements may not be sufficiently precise to articulate sounds properly.
    • Phrasing and continuity: You may have difficulty in putting all the sounds together to produce sentences with appropriate pauses and so on.

    Sometimes speech may be ‘scanning’, which means that each syllable is pronounced as if it is a separate word. Occasionally speech may be
    ‘explosive/staccato’, where a syllable is forced out in a loud manner. Both these problems arise when Multiple Sclerosis affects the ‘cerebellum’, the part of the brain that deals with coordination.
    Each of these areas can be af fected by particular combinations of defective muscle control.
    If you can manage your level of fatigue well, and reduce or shorten the effects of exacerbations or attacks of MS, you may find that you have fewer problems with your speech. However, this will not always be the case and, of course, if the Multiple Sclerosis progresses, it is more likely that problems with speech will arise at some point.
    As far as the sound and tone of your voice is concerned, these change in any case as we grow older, which is why it is generally quite easy to recognize the voice of a child as different from that of an older person. In MS different aspects of voice production may change more quickly as the disease af fects the various muscles of the face, mouth and throat in different ways. Because of the damage to muscle control, your voice may be more difficult to control – it may sound high or low quite suddenly, or your speech may not sound very smooth, or perhaps you may lose your voice in mid-sentence. These problems are mainly caused by the varying, and sometimes sudden, changes in the way that your nervous system is transmitting messages to this sophisticated and normally coordinated system of voice production. There is little that can be done for the neurological difficulty itself. It is mainly a question of being aware of the problems that you have, as well as pacing your speech, and exercising the muscles to try and retain their maximum use for as long as possible.

  • Speech difficulties

    Such things as facial expression, body movement and gesture are all linked with speech, in order to communicate our thoughts and needs. Nevertheless, it is speech itself which is often the focus of concern. As with other symptoms of Multiple Sclerosis, problems with speech can vary, particularly in the earlier stages of the disease. Although the problem cannot currently be remedied by curing the neurological problem, appropriate advice, support and exercises can improve things considerably.