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The Role of the Speech Pathologist in the Treatment of MS
Angie Lehmann, MA,CCC/SLP
Supervisor Rehab Therapies
ScrippsMemorial Hospital
Encinitas, CA
The speech pathologist is an important member of the therapy team in the treatment of MS Various research studies show that up to 70% of patients with MS will experience mild to moderate cognitive changes; up to 41% may develop dysarthria (difficulty with speech production ) or dysphagia (difficulty with swallowing). The primary role of the speech pathologist is to provide the patient with education about the disease process and to teach strategies to maintain function.
It is important for the MS patient to receive education early in the disease process in order to become familiar with strategies that will maintain function as well as possible. The common cognitive symptoms of MS patients include deficits in attention, mental processing speed, organization and memory. These deficits may negatively affect many aspects of daily life, such as the ability to run a household and maintain employment. The speech pathologist and the MS patient can work together to establish a memory and organizational aid that will suit the patient's abilities and lifestyle. Additionally, the speech pathologist can provide the patient with information on ways to alter their environment, either at home or at work, to reduce distraction and to focus on only one task at a time. The speech pathologist can provide training to the patient on ways to reduce time pressure to maximize performance in challenging situations. These strategies will not restore the lost neuropsychological process but will allow the patient to function more effectively and independently. The speech pathologist will assure the patient that a decline in a certain cognitive function does not necessarily indicate diminished intelligence or the ability to learn. The brain may simply need more time to recall or learn new information. The speech pathologist will also provide the patient with a cognitive home exercise program that includes activities that the patient enjoys, such as reading, writing, playing games with family, friends or on the computer. A recent study published in Brain, 20101 showed that patients with MS who participated in an intellectually rich life experienced less decline in their cognitive skills compared to controls.
Patients who develop dysarthria will benefit from training on ways to maintain the intelligibility of their speech. These strategies may include optimal use of breath support for speech, maintenance of vocal volume, reduction in rate of speech production and exaggerated articulation of individual sounds. The patient with dysphagia may need to alter their diet consistency or utilize compensatory strategies while eating to prevent risk for development of aspiration pneumonia. The speech pathologist may assess the swallowing function through video fluoroscopy or a fiberoptic endoscopy of the swallowing in order to determine the best diet consistencies and strategies needed for safe swallowing.
Angie Lehmann is a Speech Pathologist working at Scripps Memorial Hospital in Encinitas, California. The hospital holds a clinic on the first Saturday of each month that provides a comprehensive evaluation by Physical, Occupational and Speech Therapies and follow up treatment as needed.
1Brain. 2010 February; 133(2): 362–374.
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