This is one of those symptoms, that makes our invisible illness become visible. When our short circuit on the inside is played out in real time. Like a record when it skips, my mouth betrays me, can’t I just start this minute over?
MS and Speech
Speech disorders and speech difficulties or another symptom that is fairly common within the MS population. (I feel like this phrase of, “it’s fairly common”, is getting used every week). Speech patterns are controlled by several areas of the brain especially in the brainstem and lesions in these areas can create these speech issues. As with most symptoms, speech issues can range from mild to severe. Specific issues include lack of articulation or enunciation, loss of flow in conversations, difficulty with the rate of speech, volume or quality of voice. Most often these issues are noticed by a caregiver or family member first before the individual notices them themselves.
One specific pattern that is commonly found in MS is called scanning speech. In scanning speech, the normal speech pattern is disrupted and there will be abnormally long pauses present between words or individual syllables of words.
Slurring speech is also common. This is usually present when there is weakness in the muscles of the tongue, lips, cheeks and mouth.
Other complications include unclear articulation and enunciation of words, issues controlling the volume and difficulty controlling voice quality (hoarseness, breathiness, nasality).
Treatment of Speech Issues
Working with a speech and language pathologist will be vitally important in the treatment of speech issues. A speech therapist will be able to evaluate muscles and structures in your mouth and body that are contributing to speech difficulties. Usually this includes lips, teeth, tongue, hard and soft pallets. Also this includes structures that provide a breath support and control for speech, like your diaphragm and structures like your larynx that control volume, pitch and voice quality. The speech therapist will also evaluate you for severity and classification of speech difficulties.
Most often they will evaluate you by asking you to read it out loud so they can determine exactly what is happening with your speech. The speech therapist is trained specifically to be able to identify different patterns within your speech. After the evaluation is over, the speech therapist will create a treatment plan based on their findings with the goal of improving and restoring your speech. Often these treatments will include improving breath support, improve in coordination with breathing and phonation, improving phonatory functioning and improving intelligibility. This is accomplished by oral exercises, breathing exercises, voice training, developing awareness around irregular breathing/speech patterns and biofeedback, among others.
I didn’t think I had speech issues really. Until I read this paragraph:
- “One pattern that is commonly associated with MS is so-called scanning speech. Scanning dysarthria produces speech in which the normal “melody” or speech pattern is disrupted, with abnormally long pauses between words or individual syllables of words.”
When I was at my job several years ago, I was notorious for having long pauses in my speech. My co-workers would playfully make fun of me for it, and I would join right in, because I thought it was just as funny as they did. But I never really thought of it as a symptom. I just thought of it as an odd quirk that I had picked up in the last few years. But sure enough, here it is. staring me in the face! I think it comes coupled with my cognitive issues, when I lose a word, it creates a long pause naturally when I sit there for a minute trying to think of it. However, I realize that I had random long pauses too, without word finding to blame.
Becoming visible after being invisible for so long. It’s quite painful really.
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