Speech and Communication

Speech difficulties are common in MS and especially in people with advanced disease. Speech difficulties result from damage to areas of the brain that control language, speech production, swallowing, breathing, and cognition, and range from mild difficulties to severe problems that make it difficult to speak and be understood. Speech problems can be very isolating and extremely frustrating for Care Givers. 

This section offers guidance on maximizing the ways you and your loved one can continue to communicate.

One pattern of speech dysfunction commonly associated with MS is scanning speech, in which there are long pauses between words or syllables of words. People with MS may also slur words intermittently as the result of weak tongue, lip, and mouth muscles.
Dysarthria is the term that describes a disorder characterised by slurred speech, abnormal rate of speech, and low voice. The cause of dysarthria is weakness, in-coordination of the speech muscles, and in-coordination of breathing and sound production.

  • Slurred speech
  • Mispronunciation of words
  • Slowed speech 
  • Low voice
  • Monotonous (dull) voice 
  • Inability to complete words

The first step is a thorough assessment of the problem and its cause. A speech/ & language therapist can conduct a thorough assessment and may be able to help people with MS improve their speech patterns, pronunciation of words, and oral communication.

If your loved one is able, oral exercises can enhance speech. Exercises focusing on the lips, tongue movement, and strength can make the speech clearer. In addition, decreasing the rate of speech and increasing breath support can make the speech better.

If volume is a problem in understanding speech, voice amplifiers may be helpful. They are usually small and battery operated, and totally portable.

Positioning of the device is important, and avoiding competing background noise is critical.

Also consider ‘speech conservation’, making the most important points first when energy levels are highest.

The inability to speak is devastating and its loss is felt deeply by both the person with MS and family members. However, there are many assistive devices available that may help with communication. These range from alphabet cards to computers. People with disabilities can control computers using adaptive keyboards, sticks held in the mouth, or wireless devices worn on the head or eyeglasses. There are even computers that can be controlled by blinking the eyes and Light Writers which can convert type to speech

The goal for people with MS and their Care Givers is to learn to use compensatory mechanisms or aids to improve communication and better understand each other’s needs (A speech and language therapist can help).

As the disease progresses, an augmentative communication system might be considered.