These conditions involve a progressive deterioration in functioning and are likely to affect the individual for life. They include amongst others multiple sclerosis, motor neurone disease, and Parkinson's disease. Some of the disorders progress more rapidly than others. Some are unpredictable and typically have periods of relapse and periods of remission. Communication problems associated with progressive neurological disorders may be similar to those caused by injury or other non-progressive disorders affecting the brain and the body's nervous (neurological) system.
Recognised characteristics of progressive neurological disorders that affect communication:
- Flaccid/spastic/hyperkinetic dysarthria (when the muscles needed for speaking and breath control are affected).
- Dysphonia (voice problems).
- Dysphagia (swallowing difficulties).
- Cognitive impairment (at a late stage in some disorders memory and/or thought processes may be affected).
- No speech at all (alternative communication - AAC - may be needed).
Speech and language therapists are often involved with multi-professional teams working with progressive neurological disorders. Speech and voice therapy may begin at the first signs of the disorder and continue on an ongoing basis, depending on need and fatigue levels. Management strategies will be given and reviewed as therapy progresses.
The following may form part of therapy input for people with progressive neurological disorders:
- Swallowing management advice e.g. food and/or fluid modification; enteral feeding; posture strategies; swallow manoevres.
- Speech exercises for lips, tongue, palate, jaw.
- Facial exercises to maintain strength.
- Speech articulation programmes and focus on the rate of speech.
- Voice programmes for breathing, breath control, volume, pitch, syllable stress, vocal tone.
- Assessment and trials of augmentative and alternative communication aids (low and high tech AAC).
- Conversation practice.
- Fatigue management for speech production.
- Advice to carers.
Some points you may wish to discuss with any therapist you contact:
- The therapist's specialist credentials in the area of progressive neurological disorders. (There are different training courses which provide approaches to the problems e.g. Lee Silverman Voice Therapy - LSVT; Stardust Dysarthria Management Programme.)
- If you are already involved in a special programme (e.g. LSVT), you may wish to talk to the therapist about that.
- How much experience the therapist has with progressive neurological disorders.
- Where the therapist sees people for assessment/therapy.
- How much the therapist charges for assessment and/or regular therapy.
Click here to search for Speech Therapists in your area with Progressive Neurological Disorders as a specialty.