Parkinson’s Disease: How It Affects Communication

There are so many conditions that can affect communication, and the first step to overcoming communication challenges is to understand why and how those challenges arise. In this blog, we’ll highlight Parkinson’s, a disease that can cause significant communication challenges.

What is Parkinson’s?

Like so many diseases, Parkinson’s remains an enigma, despite our continued medical advances.  It is progressive, which means it gets worse over time.  There is no cure.  We also don’t know its cause. There are, however, some treatment options, including medication and even surgery. The big take-away’s about Parkinson’s are:

• It is neurological.  Parkinson’s results from an imbalance of chemicals within the basal ganglia, a structure within the brainstem. Neurons in that region that are responsible for creating the chemical dopamine, which helps to send signals to initiate movement, are killed. The rate at which this happens is not the same for everyone.
• It affects movement.  Due to the decrease of the chemical, dopamine, it gets harder and harder for people with Parkinson’s to move normally.  This may result in tremors throughout the body, slow movement, stiffness of body parts, and impaired balance and coordination.

Parkinson’s & communication

We often take for granted our ability to speak.  Speaking involves precise, coordinated movements.  First, your lungs must push air through your vocal cords, which must function properly to create sound.  Then, your mouth, nose, lips, cheeks, and tongue must all coordinate to properly articulate speech sounds.  This requires not only precise movement, but also coordination of all of these systems.  This can be very difficult, then, for someone with Parkinson’s, who is having trouble with movement.  The big ways Parkinson’s may affect communication are:

• Decreased volume.  It is common that people with Parkinson’s speak very quietly, but may not notice this themselves.
• Decreased intelligibility.  This means it may be harder to understand the speech (how the person it talking, not necessarily the content of what they are saying) of someone with Parkinson’s.  The complicated movements and coordination of the articulatory system may be affected, and speech sounds may not be precise or clear.
• Decreased facial expression.  Whether we realize it or not, we do a lot of our communicating and understanding without using speech – we also use facial expressions every day.  Because movement of facial muscles may also be restricted, people with Parkinson’s may appear to have a “mask”-like face, that does not show a great deal of expression.
• Swallowing.  Many clinicians who treat communication concerns also treat swallowing difficulties.  Persons with Parkinson’s should be aware and on the look out for signs of difficulties with swallowing, such as difficulty starting a swallow, the feeling of foods or liquids “going down the wrong pipe”, or coughing during or after meals.  Just like speech is a complicated motor movement, so is swallowing, and this can be a serious health risk as food or liquid going into the lungs (we call this “aspiration”) can cause pneumonia.

Try a voice meter

Constant Therapy‘s Voice Meter helps patients track how loud they are. By practicing getting your volume into the “green zone”, it becomes more of a habit to speak more loudly, which has been shown to make people with Parkinson’s easier to understand.  Additionally, it makes the person more mindful of their volume level during conversation, and helps them to learn to adjust when needed.