When we think of Parkinson’s, we quickly form a picture of someone experiencing tremors, unsteadiness, maybe a hunched posture, and overall slowness of movement. As anyone with Parkinson’s knows, that’s just the tip of the proverbial iceberg. A common symptom that isn’t often discussed is speech changes. It’s estimated that more than 90% of people with Parkinson’s disease will experience changes to their speech (Logemann, Fisher, Boshes, & Blonsky, 1978). In this post, we’ll define hypokinetic dysarthria, show an example of it, and provide 5 tips for talking with your doctor about your Parkinson’s speech problems.
What is Parkinson’s Dysarthria?
Hypokinetic dysarthria is the most common Parkinson’s voice diagnosis.
The hallmark features are:
- Lack of intonation/vocal stress
- Reduced loudness
- Slurred speech
- Inappropriate pauses or silences while speaking
- Short rushes of speech
- A harsh and/or breathy voice quality
(Darley, et. al.)
Muhammad Ali experienced the typical speech and voice changes associated with Parkinson’s disease. Listen.
Why is it Important to know about Parkinson’s speech problems?
At the heart of it, you need to know what symptoms you may expect during the progression of your Parkinson’s disease. It’s often said that everyone has their own unique experience when it comes to Parkinson’s, but frequently speech problems are part of that. In fact, Linda Ronstadt claims that changes to her singing voice were one of her earliest signs of the disease.
Speech problems often lead to feelings of loneliness and isolation. Struggling to be understood takes effort. The increased effort and frequent communication breakdowns routinely lead to a decline in communicating. It can be easier to let your carepartner take on the brunt of the speaking. While that can be effective for some communication such as scheduling appointments on the phone and ordering in a restaurant, for the types of communication that create and strengthen our connections with others, you can feel like you’re fading away.
At the heart of it, speech problems are motor problems just like the changes to walking and moving that you experience with Parkinson’s. Being able to name and identify your symptoms is the first step toward seeking treatment.
Tips For Discussing your Speech Problems with your Doctor
While over 90% of people with Parkinson’s disease will have symptoms of hypokinetic dysarthria, it’s estimated only 14% will be referred to a speech-language pathologist. (Nijkrake, M., 2008). What does this mean? There’s a good chance that communication changes won’t come up during your typical medical appointments if you don’t mention it.
When discussing Parkinson’s speech problems with your doctor, topics to discuss may include:
- Specific symptoms
- Times of day (on/off periods) and the effect on your speech
- What others tell you about your speech
- Situations where communicating becomes difficult
- Types of therapy, exercises, or devices you’ve tried in the past
As a result of your discussion, your doctor may recommend seeing a Speech-language pathologist, ENT, and/or trying the SpeechVive or other voice technologies.
Hypokinetic dysarthria is a common Parkinson’s voice diagnosis. Chances are, at some point in your journey you will experience changes to your communication. Understanding the symptoms and how to discuss them with your doctor are the first steps towards identifying the interventions and technologies that can improve your speech now, and in the future.
Logemann, J. A., Fisher, H. B., Boshes, B., & Blonsky, E. R. (1978). Frequency and co occurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. Journal of Speech and Hearing Disorders, 43, 47–57.
Darley, F. L., Aronson, A. E., & Brown, J. R. (1969). Differential Diagnostic Patterns of Dysarthria. Journal of Speech and Hearing Research, 12(2), 246-269. doi:10.1044/jshr.1202.246
Nijkrake, M. J., Keus, S. H., Oostendorp, R. A., Overeem, S., Mulleners, W., Bloem, B. R., & Munneke, M. (2008). Allied health care in Parkinson’s disease: Referral, consultation, and professional expertise. Movement Disorders, 24(2), 282-286. doi:10.1002/mds.22377