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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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