17 Medical speech-language pathologists are vital members of the interdisciplinary healthcare team. SLPs collaborate with neurologists, occupational therapists, physical therapists, dietitians, social workers, nurses, and other allied health professionals in the care of persons with multiple sclerosis. This collaboration ensures a holistic, coordinated and patient-centered care for individuals with MS – a chronic, often progressive, autoimmune, neurodegenerative disease that affects the central nervous system. MS can affect many areas of function, including speech, swallowing, language, and cognition. These are areas within the SLP’s scope of clinical and research practice, making them a key professional in the care of persons with MS. Speech production disorder Speech production disorder Dysarthria, a motor speech disorder due to impaired movement of the muscles used for speech, is one of the most common speech-language impairments in MS. The presence of dysarthria can affect the overall communicative abilities of persons with MS, leading to social isolation and a decline in quality of life. Studies have reported dysarthria prevalence in persons with MS to be between 40–50 percent, depending on disease progression and the diagnostic criteria used. The most prevalent type of dysarthria in persons with MS is mixed type, combining the features of both spastic and ataxic dysarthria. This is the result of the disease process affecting multiple areas of the central nervous system. Common dysarthria symptoms are slurred speech, scanning speech (abnormal prosody with long pauses between syllables or words), hypernasality, weak voice, reduced volume and difficulty with volume control, changes to voice quality (harsh, hoarse, strained, or breathy), and fatigue and worsening of speech clarity over time. Swallowing disorder Swallowing disorder Dysphagia is the clinical term for difficulty swallowing. This is linked to brainstem involvement, cranial nerves, bulbar muscle, and cerebellar dysfunction. Dysphagia is a serious medical issue and can cause dehydration, malnutrition, and a life-threating condition called aspiration pneumonia. This is a specific type of pneumonia caused by food or liquid entering the lungs, instead of the stomach. It is the leading cause of death in some neurological conditions. Dysphagia is prevalent in persons with MS, with some studies reporting swallowing difficulty in up to 45-56 percent of individuals, and some estimates as high as 90 percent, depending on the disease progression and course. In individuals with MS, prevalent dysphagia symptoms include weakness or incoordination of the muscle in the oral and pharyngeal phases (e.g., tongue, lips, throat muscles), which causes prolonged and inefficient chewing and globus sensation (a feeling of something stuck in the throat). Mealtime fatigue can Specialists Address Speech, Specialists Address Speech, Swallowing and Language Problems Swallowing and Language Problems The importance of a speech-language pathologist. The importance of a speech-language pathologist. By Dr. Barbara O’Connor Wells and Dr. Marissa A. Barrera msfocusmagazine.org
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