Speech Problems in Multiple Sclerosis

Fatigue, one of the most common symptoms of MS, can make speech dysfunction worse. Many people with speech dysfunction also have dysphagia (difficulty in swallowing)." c-nmssatomrichtext_nmssatomrichtext-host="">

The inability to express yourself through speech can affect your sense of identity, your self-confidence, your relationships and your sense of safety. If you have multiple sclerosis and you struggle with speech, you aren’t alone. Twenty-five to 40% of people living with MS experience changes to their speech and their ability to be understood.Speech refers to the ability to use your tongue, lips, jaw, soft palate, diaphragm and lungs to produce sounds that are shaped into communication. Many different parts of the brain, cranial nerves and muscles work together to generate clear and loud speech that others can easily understand.

Causes of Speech Challenges in MS

Changes in speech associated with MS are caused by lesions in the brain. The changes in speech patterns you experience depend on which part of the brain is affected. Speech changes can range from mild difficulties that can cause intermittent frustration to severe problems that interfere with effective communication and quality of life. Fatigue, one of the most common symptoms of MS, can make speech dysfunction worse. Many people with speech dysfunction also have dysphagia (difficulty in swallowing).

Causes of Speech Challenges in MS

Types of Speech Challenges in MS

American Speech-Language-Hearing Association.

Speech Assistive Devices

If speech problems make communication challenging, you might consider assistive devices. Smart phone apps can help with communication, and other devices, such as those to amplify your voice, may also be helpful.If MS severely limits your ability to communicate because your speech is hard to understand, or your fatigue makes communication difficult, augmentative and alternative communication (AAC) may replace speech or supplement it. An SLP may evaluate you, suggest assistive devices and teach you to how use them. The adaptations may be as basic as using a pencil and paper, a picture book or an alphabet board to help you communicate. They may recommend more sophisticated devices including those that generate voice or written messages." c-nmssatomrichtext_nmssatomrichtext-host="">

The 2 main categories of speech problems are dysarthria and dysphonia.

Dysarthria is caused by weakness, slowness, changes in muscle tone, or lack of coordination of the tongue, lips, soft palate, throat, vocal cords and diaphragm. With this symptom, your speech may sound slurred, harsh and uncoordinated and be difficult to understand. Up to 70% of individuals with MS experience some degree of change in speech clarity.
With dysphonia, changes with airflow from the lungs or abnormalities with the structures of the throat near the vocal cords may cause you to run out of air when communicating, speaking loudly and creating pitch changes.

Symptoms of Dysarthria and Dysphonia Associated With MS

Common speech challenges with MS include scanning speech, slurred speech, nasal speech and difficulties with volume.

With scanning speech, your normal “melody,” or speech pattern is disrupted. You may create abnormally long pauses between words or syllables of words.
Slurred speech usually results from weakness and/or incoordination of the muscles of the tongue, lips, cheeks and mouth.
Nasal speech is caused by too much or too little air in the nose. It may sound as though you have a cold or nasal obstruction.
Weakness in the diaphragm can affect speech volume and make it difficult for you to be heard.
You might also have noticed that you place unusual stress or emphasis on words, or that your voice is strained, strangled-sounding, harsh, hoarse or breathy.

Treating Speech Dysfunction

Most speech issues can be managed with interventions such as speech therapy and assistive devices.

Speech Therapy for People Living With Multiple Sclerosis

Speech-language pathologists (SLPs) are licensed healthcare providers trained to evaluate, diagnose and treat changes with speech, cognition, language, voice and swallowing associated with MS.After doing an evaluation, they may offer exercises to strengthen and improve the function of the muscles involved in breathing and speaking. They can also teach you techniques to improve speech clarity. These can include slowing your speech down, over-articulating sounds and generating shorter units of communication paired with pauses. If necessary, they can recommend assistive devices to supplement your expression.SLPs are also effective in providing therapy for cognitive, communication and swallowing dysfunction caused by MS lesions. Learn more about speech disorders and swallowing problems from the American Speech-Language-Hearing Association.