Parkinson’s symptoms can bring about changes in communication affecting speech, voice, thinking speed, language, handwriting, and facial expressions.
Understanding these challenges, for you and those around you, is the first step toward developing alternative strategies that empower you to maintain communication.
Understanding the dynamics of communication
Importance of communication
Effective communication is not just about exchanging words, emails, texts or looks; it’s a vital tool for maintaining social connections, expressing emotions, having confidence in the workplace, and navigating your daily life with ease.
Parkinson’s & communication skills
Parkinson’s can affect all aspects of communication including speaking, language and thinking, as well as non-verbal communication skills such as facial expression. It is estimated that around 90% of individuals with Parkinson’s will experience changes in speech due to coordination issues and reduced muscle activity, significantly impacting day-to-day functioning.
Changes in voice volume, monotone voice, huskiness, stuttering, slurred speech, rapid or slow speech patterns can be challenging for people with Parkinson’s and those around them. Both the person and their communication partner can benefit from strategies to aid communication.
The types of communication difficulties experienced by people with Parkinson’s include:
- Hypokinetic dysarthria: This is characterised by low volume, monotone speech, poor articulation, and slurred sounds. People with Parkinson’s may also experience breathiness and irregular pauses with rapid speech rates (1).
- Word-finding difficulties: Many people with Parkinson’s report trouble finding the right words.
- Comprehension Difficulties: Caregivers often identify comprehension difficulties as having a greater impact on everyday communication than word-finding difficulties.
- Reduced intelligibility: People with Parkinson’s may have lower intelligibility in both read and conversational sentences.
- Emotional expression: Stiff facial muscles can make it harder for people to express their emotions through facial expressions.
Treatments for communication changes
Speech pathology
Speech pathologists provide assessment and therapy for communication changes. This can include individual or group-based therapy programs, e.g. the Lee Silverman Voice Treatment (LSVT LOUD), the Parkinson’s Voice Project, – SPEAK OUT! online voice training, and singing (ParkinSong).
Speech pathologists can also work with you on other communication changes, as well as provide strategies and training for your communication partners. Explore options that suit your preferences and specific needs with a speech pathologist.
Visual aids & technology
Leverage visual aids and technology to support your communication. From communication apps and AI to gesture-enhancing tools, these resources can help you to express yourself more effectively.
If your voice is soft, explore the use of amplification devices that can enhance your voice and make it easier to understand you. Your speech pathologist can guide you in selecting the right devices to suit your needs.
Taking control of your own communication journey
Daily vocal exercises
Incorporate daily vocal exercises into your routine to help maintain and strengthen your voice. Simple exercises, such as humming, pitch variations, and articulation drills can help.
Consciously pay attention to the volume and rate of your speech. Speaking with intent helps maintain clarity and ensures your message is effectively conveyed.
Take deep breaths before speaking, rehearse what you want to say before you say it, and reduce background noise for important conversations.
Addressing non-verbal challenges
Lack of facial expression & body language
Parkinson’s can result in less facial expression (aka masked face), a slower blink rate, reduced and slowed body movements.
You can use facial exercises to maintain muscle flexibility. Maintain conscious attention to body language by expressing emotions or nodding your head to avoid misunderstandings about your cognition and level of interest.
Written communication & typing
Parkinson‘s affects automatic gestures and skills. Tremors, reduced movements and slowness may also make handwriting smaller (micrographia) and affect the use of certain technologies.
When typing or handwriting becomes difficult, use lined paper, audio recording and AI technology. AI transcripts can capture what is said in meetings.
Instead of texting, use voice to text options e.g. Hey “insert voice assistant here,“ send a text message to dad. You can change or send the message when the voice assistant reads it back if it’s not quite right. These assistants can read out unread messages, open contact cards, call numbers, and help navigate for you.
Consult with an OT experienced in Parkinson’s for more assistance and explore available aids and software to minimise these challenges.
Augmentative and Alternative Communication (AAC)
Augmentative and alternative communication (AAC) covers a range of strategies, aids, voice amplification, speech-generating devices and communication Apps that may be of use when successful verbal communication has become more difficult. Speech pathologists have expertise in prescribing and customising AAC options to meet individual needs
By working with a speech pathologist, individuals with Parkinson’s can continue to communicate effectively and participate in daily activities, enhancing their overall quality of life.
Creating supportive environments
Educating your support network
Share information about Parkinson’s-related communication challenges and frustrations with your friends, family, and colleagues. Ask them to give you the necessary time to process what is being said and then respond in conversations.
Let them know while there may be times when support is needed, to respect your autonomy unless you ask for help. Building awareness around these issues fosters a supportive environment where those around you understand and assist in having positive interactions.
Infosheet kindly reviewed by Speech Pathology Australia.
To find a speech pathologist go to: www.speechpathologyaustralia.org.au
References:
- Miller N Communication changes in Parkinson’s disease. Practical Neurology 2017;17:266-274.
- Pitts E, Wylie K, Loftus AM, Cocks N. Communication strategies used by Parkinson’s nurse specialists during healthcare interactions: A qualitative descriptive study. J Adv Nurs. 2022 Jun;78(6):1773-1786. doi: 10.1111/jan.15196. Epub 2022 Mar 14. PMID: 35285973; PMCID: PMC9313789.
- Smith KM, Caplan DN. Communication impairment in Parkinson’s disease: Impact of motor and cognitive symptoms on speech and language. Brain Lang. 2018 Oct;185:38-46. doi: 10.1016/j.bandl.2018.08.002. Epub 2018 Aug 6. PMID: 30092448.
- Ireland, S., Carroll, V., Blanchard, D., & Rossiter, R. (2022). Recognising and responding to communication and swallowing difficulties in Parkinson’s disease. Australian Journal of General Practice, 51(4), 10.31128/AJGP-07-21-6094. https://doi.org/10.31128/AJGP-07-21-609.
- Barnish, M. S., Horton, S. M. C., Butterfint, Z. R., Clark, A. B., Atkinson, R. A., & Deane, K. H. O. (2017). Speech and communication in Parkinson’s disease: a cross-sectional exploratory study in the UK. BMJ Open, 7(5), e014642. https://doi.org/10.1136/bmjopen-2016-014642
