Symptom Management
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msfocusmagazine.org
occur, which causes prolonged mealtimes 
and can lead to weight loss. In the  
pharyngeal (throat) phase, persons with MS 
may have difficulty initiating swallowing and 
managing liquids, which flow quickly  
compared to solid foods. This can lead to  
drooling, coughing, or choking during meals. 
In addition, numbness in the mouth or throat 
can interrupt the safety of swallowing, leaving 
vulnerability to aspiration pneumonia.  
Language disorder
Language disorder 
Anomia, or word-finding difficulty, is less 
frequently reported in persons with MS  
compared to other deficits but is still notable. 
Despite its prevalence (about 30-40 percent), 
anomia 
is 
frequently 
underreported 
 
compared to motor symptoms. A study of 
100 patients with relapsing-remitting MS 
found that 42 percent showed impairment in 
picture naming, with reduced accuracy and 
speed of picture naming. Aside from slowed 
and inaccurate naming skills, semantic level 
deficits, or impairment in the ability to  
retrieve word meanings, and semantic errors 
(i.e., substituting a word with a different one 
in the same semantic category, such as “blue” 
for “black”) were noted. Anomia can present 
challenges in verbal fluency for persons with 
MS, affecting the speed of word retrieval,  
particularly during episodes of exacerbation 
and fatigue. These word retrieval difficulties 
are 
often 
linked 
to 
underlying 
 
cognitive-communication deficits in MS. 
Cognitive disorder
Cognitive disorder 
Cognitive deficits affect approximately 
40–65 percent of persons with MS, leading 
to difficulties with memory, attention, 
processing speed, and executive function. 
These impairments can significantly affect 
communication. Individuals may struggle 
with their speed of understanding information 
and may report “brain fog.” Another common 
area of cognitive challenge is memory. 
Impairments in short term or working memory 
may present with challenges in your daily 
routine such as remembering a list of items 
at the grocery store. In the area of attention, 
persons with MS may have difficulty with 
sustaining attention or multitasking. Finally, 
areas of executive function, such as problem 
solving, organization, and decision making, 
may be challenging, particularly in situations 
of disease exacerbation and fatigue.  
The role of the
The role of the 
speech-language pathologist
speech-language pathologist 
Persons with MS are at risk for a variety 
of communication, swallowing, and cognitive 
challenges throughout the disease progression. 
SLPs are there, every step of the way, to provide 
critical assessment, treatment, and education 
to help individuals maintain their best quality 
of life. SLPs use standardized and functional 
assessments to evaluate communication, 
swallowing, and cognition. Early assessment 
and treatment are essential, to closely track 
changes in function over time, which is 
important when applying for disability or 
workplace accommodations. 
SLPs provide fundamental treatment to 
improve quality of life. These include:  
1) Speech treatment to address dysarthria, 
such as articulation, speech intelligibility 
training, breath support training, and/or 
voice therapy to improve loudness, vocal 
control, and speech intelligibility, such as Lee 
Silverman Voice Treatment. In severe cases, 
SLPs 
may 
recommend 
augmentative 
 
alternative communication systems to  
support functional communication skills.  
2) Swallowing therapy to address dysphagia by 
using a combination of compensatory and  
therapeutic strategies to reduce the risk of  
aspiration and maintain overall nutrition and 

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