What is speech and language therapy?
Speech and language therapists help people communicate to the best of their
ability by assessing and treating speech, language and communication problems.
They also treat people who have eating, swallowing and drooling problems
Ways in which the therapist can help include:
providing exercises to improve communication on a one-to-one basis, or in
a group advising on specific communication difficulties suggesting breathing
and postural techniques to facilitate better voice and overall communication
offering tips and strategies to make particular activities easier, such as talking
on the telephone recommending special tools and equipment to aid
communication assessing and treating difficulties with eating, drooling and
swallowing advising carers.
Speech and language therapists can be based in both hospital and community
settings. When treating people with Parkinson’s, they tend to work alongside
other healthcare professionals as part of a multidisciplinary team. They are
also involved with a growing number of initiatives that work on voice in a
group setting such as "Quivers and Quavers"1, an exciting voice therapy
project in the UK.
Drooling
Drooling (where people find saliva leaks out of their mouth) is a common
problem that is partly related to swallowing difficulties and can cause
considerable social embarrassment.
The problem may not be that too much saliva is produced, but that the
natural tendency to swallow regularly is slowed down. This causes the
saliva to accumulate in the mouth, rather than being swallowed regularly,
and sometimes leak out of the mouth. Drooling is often aggravated by
the stooped posture and poor lip closure that some people with Parkinson’s
experience.
Treatment strategies may include:
alleviating swallowing problems
improving Posture and seating
advising on exercises and techniques to improve lip closure
exercise programmes such as LSVT which strengthen the pharyngeal and laryngeal
muscles prescribing anticholinergic medications to reduce the production of saliva
injections of botulinum toxin (sometimes used to treat Dystonia in Parkinson’s)
using special buttons or brooches that bleep discretely to remind the wearer to
consciously swallow.
Speech and language therapy and cognition
Some mental processes are important factors in a person’s ability to communicate,
learn and adapt. If these are impaired or slowed down, most strategies that a
speech and language therapist may suggest will not work.
Depression, which is very common in Parkinson’s, can have a considerable affect
on communication and a person’s motivation to adopt any approaches the speech
and language therapist suggests.
Some people with Parkinson’s can also experience changes in cognitive functioning
as the condition progresses. Sometimes these indicate the presence of a Dementia,
but in many cases they are specific to Parkinson’s and may include:
slow thinking
slow learning
difficulty switching from one subject to another in a conversation or doing two things
at once problems with internal cues to trigger normally automatic and unconscious
movements.
Speech and language therapists need to be aware of any Cognitive problems that
a person has. This will help them to communicate more effectively with their client
and plan appropriate treatment strategies that take account of these factors.
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