Speech and language therapists are healthcare professionals who specialise in all aspects of communication, including non-verbal communication such as facial expressions and body language.
They will give you tips and techniques to help resolve swallowing and communication problems you may experience. For example, difficulty in putting your thoughts into words or understanding what others are saying.
In the early stages of Parkinson’s, a speech and language therapist will focus on maintaining as much of your communication ability as possible.
They will develop strategies and exercises to help you with your volume and speed of speech, breathing, facial expressions and articulation (saying words clearly).
A speech and language therapist will also ask about the different settings you communicate in, as they can play an important part in how your problems affect your everyday life.
They can help you, for example, if you work in a very noisy office where a soft or quiet voice is difficult to hear, or if you work in a very quiet environment that might not lend itself to speaking loudly.
Your therapist can also help you with any problems you have with eating and drinking, such as drooling and difficulty swallowing. They may suggest small pieces of equipment and special tools to help. For example, a device that prompts you to swallow.
If communicating becomes very difficult for you, a speech and language therapist can give you advice on ways to cope. They will be able to recommend tools that support spoken communication or offer a different way of communicating in certain situations, and train you and your family and/or carer to use them.
This may simply mean recommending that you carry a piece of paper and pencil, or a book with key words and pictures in that you can point to, or using email to communicate with people, where possible.
A speech therapist may also recommend that you use technology, such as a computer, voice amplifier or an app (computer applications or programs designed to do a specific action) on your mobile phone or tablet. There are apps available that help you to produce words or sentences, amplify your voice or ‘clean up’ unclear speech.
Clinical guidelines say that people with Parkinson’s should have access to speech and language therapy, and we recommend that you speak to a therapist as soon as you can after you’ve been diagnosed.
Even if you aren’t experiencing any specific problems, a speech and language therapist can give you useful information about problems that may occur in future, how to spot them and what can be done about them.
A therapist may also spot subtle changes you might not be aware of. This will help you cope with the problem before it becomes more difficult to manage.
Your first appointment is likely to involve an assessment. This will give your therapist an idea of what treatment you need.
The therapy that you receive and the number of sessions you have will depend on your individual needs, your preferences and the resources available.
Speech and language therapists can give family and friends detailed explanations about voice and speech changes. They can also give carers or family members strategies and tips to help a person with Parkinson’s to communicate more effectively.
These may include simple things such as watching a speaker’s face while they are talking and limiting background noise. This may also involve discussing strategies to solve communication problems when the person with Parkinson’s or their carer are unable to make themselves understood.
Therapists can give carers and family members advice on how to spot the signs that someone is having problems eating or drinking.
Your GP or Parkinson’s nurse can refer you to a speech and language therapist, or you can refer yourself to the local hospital trust or community therapy team.
Not all speech and language therapists are specialists in Parkinson’s, so make sure you ask to see someone who has experience of working with people living with the condition.
It can be helpful to be referred by a healthcare professional, because the speech and language therapist will then have a point of contact for medical information. Medical referrals are often required for swallowing assessment and treatment.
You can choose to pay for private speech and language therapy, either individually or within a group.
To find a private speech and language therapist in your area, contact the Association of Speech and Language Therapists in Independent Practice.
You can also contact your Parkinson's local adviser for details of speech and language therapy services in your area.
If you are having problems speaking, Parkinson’s medication, such as levodopa, might help improve the volume or clarity of your speech. Speak to your specialist or Parkinson’s nurse for more information.
It is important to take your medication as advised by your specialist or Parkinson’s nurse. Taking your medication at the right time will help you to manage your symptoms more effectively.
There are also practical things you can do that may help you train your voice. These include, for example, trying to imagine that you are speaking in a bigger room than you are or to a larger group of people. Tricks like this can help you to speak more clearly and loudly.
The Lee Silverman Voice Treatment is a type of speech therapy developed specifically for people with Parkinson’s.
The programme helps people to recognise that their voice is too quiet and trains them to speak more loudly. It is an intensive treatment programme and requires daily therapy and homework, with 16 sessions over a month, each lasting up to an hour.
There is evidence to support the benefits of the treatment and it is recommended in clinical guidelines. Unfortunately, however, it isn’t available everywhere – check with your speech and language therapist if it’s available in your area.
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