Let's talk: Parkinson's disease, speech changes + communication issues

Parkinson's disease can cause your voice to become raspy, quiet or unsteady, and motor symptoms can make writing and typing more difficult. Have you experienced communication issues like these? See what others have tried — from Lee Silverman Voice Treatment and voice-activated "smart" devices to (drumroll please...) singing classes. How PD can impact communication Parkinson's affects the part of the brain and nerves that control speech and oral/facial movement. ParkinsonsDisease.net says PD may cause:

• Softer, breathy, or hoarse voice
• Slurred speech
• Mumbling or rapid speech
• Monotone voice, lacking the normal ups and downs
• Slower speech because of difficulty finding the right words
• Trouble participating in fast-paced conversations.

They also break down the medical terms related to these speech symptoms:

• Dysarthria — A motor speech disorder or impairment in speaking due to PD affecting the muscles required for speech
• Hypophonia — Soft speech or an abnormally weak voice caused by the weakening muscles
• Tachyphemia — Also known as "cluttering," this is characterized by excessively fast talking and rapid stammering that can be difficult to understand

In addition, people with PD may experience tremor, rigidity and dystonia or cramping, which can make writing and typing difficult. Research has shown that about half of people with PD have micrographia (small, cramped handwriting). Treatments and tools for communication In our recent roundup of products that help people live better with PD, some members said they use an adaptive pen (Ring-Pen) to help with handwriting, Dragon Naturally Speaking (speech recognition software) to help with typing and computer use, and "smart" speakers/home devices (such as Amazon Alexa or Google Assistant) to use voice commands to search the web or make a call. Here are some other therapies and tools mentioned on PatientsLikeMe and around the web to help manage PD communication issues:

• Speech-language therapy or SLT (which can also help with dysphagia/swallowing issues and saliva control)
• Lee Silverman Voice Treatment (LSVT®), which is a specific type of speech therapy first developed in the 1980s specifically for people with PD (see research on LSVT and join PatientsLikeMe for full access to members' evaluations of this treatment)
• Speech amplification devices, such as Spokeman, ChatterVox and Oticon (see a Canadian study on these devices for people with PD — jump to page 70 for patients' ratings). One person even shared on Reddit about hacking a collar-style microphone to work all day with an Echo/Alexa or smart home device (for his mom with PD)
• Free dictation software, which is now available on most Apple/iOS and Android phones/mobile devices — just look for the microphone icon next to your space bar on the keyboard where you write text messages (hint: this works for almost anywhere you can type on the PatientsLikeMe app — get the iOS app here and the Android app here!)
• Other dictation tricks for Apple devices as well as Android, Windows and other systems (many work with Google docs — a free alternative to dictation software)
• Voice banking with programs like VocaliD, Message Banking or ModelTalker (check out our recent roundup of communication tools for people with ALS)

And explore even more Apple and Android accessibility tools. Singing or music therapy for PD Researchers are studying the positive effects of singing in people with PD. Initial research from Iowa State University (which has a weekly singing class for people with PD) shows that regular singing and voice exercises may help the muscles involved in speaking, swallowing and respiratory control. Singing in a group may also help with symptoms like depression and tremor, and overall quality of life, researchers in Australia say. Choirs for people with PD have popped up across the U.S., from California to Georgia. (Add a comment below if you know of any in your area!) Which communication issues are you dealing with these days? What's been the most (or least) helpful? Join PatientsLikeMe today to check out or take part in this forum conversation with others living with PD. Share this post on Twitter and help spread the word.