Parkinson’s disease can lead to dysarthria (speech difficulties) and dysphagia (swallowing difficulties). Speech and swallowing therapies, as well as other medical treatments like Botox injections, may help.

It’s common for people with Parkinson’s disease to experience reduced speaking volumes and trouble expressing their thoughts. As the disease progresses, people with the condition may also have difficulty swallowing and getting enough nutrition to maintain a weight that’s healthy for them.

Speech therapy is one of the best approaches for managing these difficulties. It can help people with Parkinson’s disease manage both communication and swallowing issues.

Parkinson’s disease can cause voice, speech, communication, and swallowing difficulties. These difficulties can vary among individuals with the condition.

Voice and speech

Common voice and speech difficulties associated with Parkinson’s disease can include:

  • reduced speaking volume
  • hoarse or strained voice
  • breathy-sounding voice
  • monotone-sounding voice
  • shaky voice or tremor in the voice
  • more energy needed to form words
  • difficulty with letter and word pronunciation
  • slurring of certain letter combinations or sounds
  • changes to how fast you speak
  • changes to the pitch of your voice
  • difficulty finding the right words to express your thoughts

Facial expressions and emotions

People with Parkinson’s disease may also find it challenging to make facial expressions or convey emotions through vocal tone when speaking. This can make it hard to communicate clearly and effectively.

Swallowing

Parkinson’s disease can also affect swallowing. Difficulties with swallowing are called dysphagia, and symptoms might include:

  • drooling
  • choking while eating and drinking
  • keeping food in your cheeks or mouth
  • frequent sore throats
  • food or saliva going into your lungs (aspiration)
  • weight loss

There are multiple reasons why Parkinson’s disease can lead to speech and swallowing difficulties:

  • Parkinson’s disease affects the muscles and nerves in your face, throat, mouth, tongue, respiratory system, and larynx. As these muscles and nerves weaken or have trouble activating, you might have more speaking and swallowing difficulties.
  • Parkinson’s disease affects the areas of your brain that control the speech process.
  • The disease changes the way your brain processes information. This can make it difficult to be part of conversations and communicate your thoughts.
  • It can cause your movements to become smaller and less powerful. This includes the movements you make with your mouth and throat that affect speech and swallowing.
  • The condition can reduce your sensory awareness. You might not realize that the volume, speed, or pitch of your voice has changed. You might feel that you are shouting even when you are speaking at a typical volume.
  • Parkinson’s disease can reduce your ability to prompt your own outward speech and begin conversations. People with Parkinson’s disease who are able to answer questions or respond to others may have difficulty voicing thoughts without being prompted.

Speech therapy can benefit people with Parkinson’s disease.

Speech and language therapists, also called speech-language pathologists, are healthcare professionals who can work with patients to help improve:

  • speech
  • language
  • communication
  • swallowing

They can assess current abilities, make treatment plans, recommend assistive technology, and more. You might see a speech therapist when you first receive a Parkinson’s disease diagnosis, then regularly throughout the years.

Therapists can help you at every stage of Parkinson’s disease. They can spot any new difficulties and prevent them from becoming worse, and they can help you manage anything that’s been causing you trouble.

Communication therapy

During sessions, your speech and language therapist might help you with:

  • exercises that can improve muscle strength
  • exercises that can help make your voice louder
  • exercises to do at home
  • communication techniques to help you express your thoughts and needs
  • ways to conserve your energy while speaking
  • nonverbal communication techniques
  • assistive devices

Assistive devices for speech and swallowing difficulties can help you maintain independence. Your speech and language therapist might recommend a few different options to help you. The right devices and software applications for you will depend on your specific needs and challenges.

The following are some hearing and speech recommendations:

  • Use texts, email, and other keyboard-based communication as much as possible.
  • Have specific tablets or smartphones dedicated to communication.
  • Download voice recognition software on your phone, tablet, or computer that can be trained to recognize your voice and speaking patterns.
  • Use apps designed for people with Parkinson’s disease that can remind you to speak louder and slower.
  • Use communication tablets and devices that can play back the words you type into them.

Swallowing therapy

Speech therapists can also assist with swallowing issues and help determine the most effective therapy for you. Therapy options depend on how much difficulty you’re having with swallowing and meeting your daily recommended nutrient intake.

First-line therapy might involve adjusting your diet to softer, more easily swallowed food, while at the same time working on exercises to strengthen the muscles in the throat.

A 2021 expert consensus statement lists other potential treatment options, including:

  • Video-assisted swallowing therapy (VAST): This therapy shows people videos of a typical swallowing process compared to videos of their own swallowing process. It may be helpful for people with mild to moderate dysphagia.
  • Botulinum toxin (Botox): Botox injections may help relieve dysphagia and improve drooling for some people.
  • Percutaneous endoscopic gastronomy (PEG) feeding: Dysphagia that is causing chronic malnutrition and weight loss may require PEG feeding. PEG feeding uses a flexible feeding tube inserted through the abdominal wall into the stomach. It allows for fluids, nutrition, and medications to be placed directly into the stomach without the need for chewing or swallowing.

Where to find qualified speech therapists for Parkinson’s disease

Your primary care doctor or neurologist may be able to recommend a speech therapist. You can also check out The American Speech-Language-Hearing Association website to find speech therapists in your area.

For more support during speech therapy and for all aspects of Parkinson’s disease, you can check out:

  • The Michael J. Fox Foundation: You’ll find advocacy, informational resources, podcasts for people with Parkinson’s disease, and more on The Michael J. Fox Foundation site.
  • The Parkinson’s Foundation: The Parkinson’s Foundation can help you find local resources and also offers online support, learning resources, and more.
  • The American Parkinson Disease Association: The American Parkinson Disease Association is a great way to find support in your local community, including wellness, informational, and health programs.
  • The Davis Phinney Foundation: The Davis Phinney Foundation offers webinars, podcasts, blogs, and live events dedicated to helping people with Parkinson’s disease lead full and active lives.

Parkinson’s disease can cause difficulties with speech and swallowing. Speech and language therapists are professionals who can help with these difficulties.

They can help people with Parkinson’s disease strengthen their muscles, improve their speech and swallowing, and manage any communication difficulties they have. They can also recommend assistive devices and show you how to use them.

Talk with your doctor about finding a qualified speech and language pathologist.