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Speaking in “Parki-nese”: Challenges with Speech

What if you woke up tomorrow morning and couldn’t speak? How would it affect your life? Think about it. You couldn’t tell your family good morning, cell phones would be useless. Of course you could always text but without the ability to speak, how would people you come in contact with interpret your anxiety driven text? I mean, come on, you just lost the ability to communicate! How could you perform at work? Wait! How could I work today? You’d probably take a sick day or two and eventually lose your job.

The scenario described above, although fictitious, does provoke some questions. In Parkinson’s disease (PD), the loss of speech is normally far more gradual but in some cases, I know people personally whose careers ended because of a speech problem that developed as a result of PD. In fact, my own career as an insurance executive and instructor ended because of speech problems. Usually this happens in later stages of PD however, earlier symptoms do occur on occasion. There are a few specific symptoms of speech problems that I will address.

Problems with speech in PD

  • Volume – The ability to speak loud enough for others to hear and to overcome collateral noise (conversational chatter, clanking of dishes, loud music, crowd noise and other noise distractions).
  • Projection – Similar to volume, this issue is being able to overcome a large space and to be heard.
  • Breath Control – Being able to control the inflow and specifically the rate of exhale because when we speak, it is a reflection of our exhalation.
  • Pronunciation – Often PD affects our speech in a way where pronunciation of some words and syllables is difficult. This can result in slurring of words and can be mistaken as appearing drunk hence Parki-nees.
  • Complications from other symptoms – Speech can also be affected by other symptoms of PD such as: tremor, dyskinesia, dystonia.

Volume

The ability of speaking loud enough to be heard can be impaired by PD. Being heard by other people is important. It is the key to communication and getting your message across. If what you have is important to say, It is essential to be heard. Ignoring this problem can lead to depression, anxiety, and other emotional problems. The good news is there is help in occupational and speech therapy. There are specific exercises that speech pathologists can offer to improve the volume of speech.

Projection

Projection is similar to volume but also contains the element of being able to reach a sustainable rate of speech that can be heard over distance.

Breath Control

Breathing is essential for proper speech. It is the basis for which effective speech comes from. Try this exercise: breathe in, then exhale while saying the word, “ah.” What happens to the sound? It diminishes and the tone softens. We speak on an exhale and if you can’t control your breathing, it affects our speech.

Pronunciation

Living with PD can make it difficult to pronounce many words or syllables which impede the communication process. Sometimes this issue can create the false impression of appearing in a state of drunkenness by slurring your words.

Complications from other symptoms

There are other symptoms that affect speech. Tremor can cause a vibration of the vocal chords causing a trembling of the voice. Dyskinesia and dystonia can further complicate speech issues by restricting the esophagus and vocal chords thereby limiting the ability to speak more clearly and loud.

Are there treatments available?

Problems with speech in PD is not a new phenomenon. It is just more recognized by the medical community and earlier intervention is being taken. Speech pathologists have an arsenal of therapies that include various vocal and physical exercises including singing and music to assist mind and body that strengthen and make control over speech possible. There are also medical interventions such as Botox and medical devices that boost breathing. It is possible to control of the speech problem associated with PD, but it takes a proactive approach and a commitment to overcome the symptoms which are all together intertwined. For example, without breath control, you can’t speak loud enough to be heard or understood. I struggle with speech every day. People are always saying “what did you say?” It is my most frustrating issue in dealing with PD, but I utilize every tool available to me because I am dedicated to being victorious over PD. In the end, when I finally take my last breath, you can be sure it will be long and loud for everyone to hear. Keep fighting the battle against PD. Quitting is not an option.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ParkinsonsDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • gilmore4242
    1 year ago

    Two of the little addressed issues of life with Parkinsons are problems associated with swallowing and diminishing and eventual loss of vocal ability. This does NOT have to be the case! PARKINSON VOICE PROJECT located in Richardson, TX a suburb of Dallas, has developed a simple and effective therapy for both issues entitled SPEAK OUT with a follow-up program called LOUD CROWD. This discipline has enjoyed great success in restoring voices and the ability to swallow properly using a regimen of speaking with INTENT and vocal exercise.
    Please check out the website: ParkinsonVoiceProject.org for more details and be sure to check to see if there is a speech language pathologist in your area who is certified in this treatment. It will change your life!

    Gay Gilmore
    Advocate for Parkinson Voice Project

  • Michael Church author
    1 year ago

    Glad to hear that it is making a difference in your life. Keep talking it up and a shout out to all the speech pathologists out there.

  • lmkb
    1 year ago

    You are so right about the ramifications of PD taking your ability to communicate!
    Going to a speech therapist -especially one trained for Parkinson’s- is So important and So worth it!
    If anyone is looking for more details and explanations, check out the Parkinson’s information Session on the Parkinson Voice Project website:
    http://www.parkinsonvoiceproject.org
    It is very helpful when trying to understand how you are impacted.
    I am extremely thankful that I found the therapy I needed and I believe the same therapy can help most everyone with PD!

  • peter.whyte
    2 years ago

    I am a parkie (for 12 years) who is afflicted with speech problems, both the volume and word clarity, and I have a chronic dry cough which intensifies when I try to speak. I am a singer and public speaker, and I am very opinionated , so my voice is important to me.

    Frankly, I have never met anyone who graduated from speech therapy, even the Lee Silverman program, and felt helped by the experience. I am hoping to hear from people who feel speech therapy was worth the effort. Are you out there?

  • lmkb
    1 year ago

    Receiving therapy through Parkinson Voice Project changed my whole perspective on living with Parkinson’s Disease. It changed my life. PLEASE at least take a look – you won’t regret it!
    Or look for a PD trained speech therapist wherever you are – but please don’t let your voice followed by your swallowing disappear when you can do something about it.
    Parkinson Voiceproject.org is a nonprofit org.

  • Michael Church author
    2 years ago

    Peter, I am always working to improve my speech but I do get lazy occasionally. Once it becomes a problem, I believe you have to be proactive. I hear singing and even vocal exercises help. I applaud you for comments and would love to hear from others also. In addition, I recently learned of a study funded by NIH at Purdue Univ. utilizing new technology that helps. Contact: snyder33@purdue.edu for more info. Thanks for sharing.

  • MarySLP
    2 years ago

    Michael, thank you for discussing the importance of communication for persons living with PD. Early referral to a speech-language pathologist is the key. Even if you don’t think you “need speech therapy yet,” you probably could benefit from some instruction in exercises designed to improve the speech/voice mechanism. I also like to remind patients that breathing, speech and swallowing are all interconnected, so, exercise designed to strengthen voice may transfer to yield some improvement in swallowing. You walk the talk, Michael, and that is motivation to others!

  • Michael Church author
    2 years ago

    Thank you Mary. It is my profound pleasure to present my experience with PD and specifically speech and swallow issues. As a speech pathologist you bring up the importance of early intervention. The more dialogue about this, the better.

  • Michael Church author
    2 years ago

    That is a great point and my wife, who also has PD struggles with that too. Our doctors call that “word recall’ issues. Sometimes, its like your mind goes totally blank in mid sentence. There are several things that can assist in that but the biggest thing is patience. You may be tempted to blurt out the obvious response but try allowing the process to develop. An occupational therapist can suggest several apps for your phone such as: “Heads up” or doing crossword puzzles. There are even websites that exercise the brain. Just to name a couple, “Brain HQ” “Luminosity.” It is very important to keep the brain working, just a little patience goes a long way.

  • victoria
    2 years ago

    My mother often forgets the word she wants to use. She struggles to think of it. Could Parkinsons be causing this or the medication or is it something else?

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