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Dr. Mahler

When to start speech therapy

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The data show that 89% of people with Parkinson disease will develop speech problems (Logemann, et al., 1989). Only about 4% of people are referred for speech therapy and that happens for a number of reasons. Some people will experience gradual changes in their speech so may not notice when it becomes difficult for others to understand them. There is a perception that the speech changes that happen with PD are just part of normal aging. That is not true. People with PD are statistically significantly quieter than age-matched peers (Fox & Ramig, 1997). They are also less likely to be understood in conversation and less likely to participate in conversation so there is a negative impact on quality of life. If you have PD, then you will need speech therapy at some point. It is better to receive speech therapy earlier rather than later so you can have the best outcome and more years to reap the benefits of treatment. Talk to your physician about a referral to a speech-language pathologist for an evaluation and treatment recommendations soon.

 

Please send your questions about speech, language, cognition or swallowing to this forum. We look forward to hearing from you.

 

Sincerely,

 

Leslie Mahler, PhD, CCC-SLP

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My spouse was diagnosed this summer with PD after months of medical dead ends. He has quite a list of PD-related symptoms, mostly non-motor. He's been told he's in the early stages of the disease, and he's worked hard to integrate regular exercise to his schedule while still working FT.

 

Yet, I think speech therapy should be near the top of his priority list and would like to hear your advice. When I asked asked him what about PD frustrates him the most, he cites two areas:

* Insomnia.

* How it's affected his speaking.

 

He's been known all his life for his wonderful speaking abilities and his precision with language. It's also at the heart of his profession, broadcasting - although he's no longer on the air. Should I be leaning on him to explore speech therapy now, rather than later? I want to be helpful, not add to his stress.

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Receiving the initial diagnosis of PD can be very stressful. Patients and families deal with multiple issues upon learning of their diagnosis. I would not want to add to his stress but I would like him to start speech therapy as soon as possible if changes in speaking are one of the two thing frustrating him the most. The good news is that speech is something that can improve with behavioral treatment. I would recommend the LSVT LOUD program because it is a treatment technique with demonstrated efficacy for people with idiopathic PD. I would emphasize to your husband that this is something positive he can do and empower him to take control of his ability to communicate clearly. He should at least receive an evaluation with a speech-language pathologist who specializes in PD. Then he can consider the results of the evaluation and the recommendations and make the treatment decision that is best for him. Early treatment provides a greater opportunity for change and the potential for years of improved communication.

 

Thank you for writing. Please write again if you have any further questions.

 

Sincerely,

Leslie Mahler, PhD, CCC-SLP

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Thanks so much for your advice. There IS a lot to process at once, and sometimes I think it's a bit overwhelming about where to put one's priorities. But like you, speech therapy feels like one in which he might get some real positive results. I'll let you know what happens.

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