Catriona Lysaght – Senior Speech and Language Therapist, The Speech Centre
This is some general information about the different ways Parkinson’s disease can affect communication, followed by some handy tips for easier communication.
Adequate strength and coordination of the muscles used for breathing is necessary for maintaining sufficient loudness in conversation. If the muscles used for breathing in and out are stiff or poorly coordinated, this will affect the volume of speech.
The person may take shallow breaths, less frequent breaths or have difficulty coordinating their breathing and speaking. Poor posture will also affect the voice.
Voice is produced when the vocal cords close together to vibrate. In Parkinson’s disease the vocal cords may not close completely when the person is speaking resulting in a softer, weaker voice. The person’s voice may also sound monotonous and flat with little variation in pitch.
Speech may sound ‘slurred’ or mumbled. This is usually a result of stiffness, slowness or tremor of the muscles of the face, jaw, lips and tongue, or poor posture.
Facial expression is an essential aspect of communication. Much information is conveyed through facial expression: happiness, excitement, fear or sadness. Lack of facial expression may be a feature of Parkinson’s disease. This ‘masking’ of facial expression is a result of rigidity and reduced movement in the muscles of the face. This may be wrongly interpreted as lack of comprehension or lack of interest in the conversation.
The person with Parkinson’s disease may have difficulty monitoring his/her speech. He/she may feel that their conversational partner needs a hearing aid rather than realising that it is his/her own voice that has become softer and more difficult to understand.
Tips to improve Communication
For the person with Parkinson’s disease
It is a good idea to tape your speech using a tape-recorder. This will help to give you an idea of how your speech sounds.
- Try to talk more slowly and exaggerate your mouth movements
This will help to make your speech clearer and easier to understand.
- If asked to repeat, try to speak more slowly and emphasise key words in the sentence
This may make the message easier to understand
- Encourage the use of shorter sentences while speaking
Speaking in shorter sentences gives the person with Parkinson’s disease a chance to take a breath between each sentence.
- Think Loud, Think Shout
If you imagine that you are speaking loud, this will automatically encourage you to sit with better posture, take deeper breaths, exaggerate your mouth movements, and generally make you easier to understand. It does not mean that you need to shout, you just need to imagine you are going to!
For carers/conversational partners
- Get into the habit of looking at one another while having a conversation
Watching the person’s lips and face can greatly improve comprehension.
- Reduce background noise during conversation
Turn off the radio or TV, close doors to noisy areas, etc.
- Be aware that facial stiffness is a feature of Parkinson’s disease
Avoid depending on facial expression to read the emotions felt by the individual with Parkinson’s disease. Do not assume that the person does not understand what you have said as ‘masked ’ facial expression may be due to rigidity of facial muscles.
- Be patient. Try not to rush responses in conversation.
Allow plenty of time for the person with Parkinson’s disease to communicate their message.