A number of dystonias can affect speech. Where speech difficulties occur a speech and language therapist (SALT) can sometimes be helpful:
Voice dystonia (Spasmodic dysphonia)
Speech therapy offered by a speech and language therapist (SALT) involves training the person to alter voicing techniques. The SALT can support with voice and breathing exercises that can help speech. They can also help by exploring ways to make best use of the voice and sound the person with dystonia has. For instance, they may point out that the patient is producing his or her voice with poor breath support or poor tongue placement in the mouth. Through exercises and practice, the patient can gain better insight into how to speak more efficiently and effectively.
Unfortunately, this approach often produces only limited benefit for voice dystonia patients since voice dystonia is a neurological condition over which the patient has little or no control. Speech therapy is generally seen as a possibly helpful adjunct to other therapies such as botulinum toxin injections and to help voice dystonia patients who have excess voice strain to reduce some vocal muscle tension.
Dystonia affecting the mouth
For those with dystonia which affects the mouth, the SALT can give mouth and swallowing exercises to help them reduce the risk of choking by chewing and swallowing safely.
Dystonic cerebral palsy
Speech and language therapy can provide treatment and management options for children with dystonia where there are issues with communication as well as difficulties with eating drinking and swallowing, and saliva control. The focus will be on optimising each child’s communication abilities; speech and language therapists will also work with the multi-professional team and families to ensure their child’s mealtimes are safe and comfortable, and that each child eats and drinks enough to grow and stay healthy. A child can be helped to improve their saliva control through the use of oral skills programmes, attention to posture and effective oral and dental hygiene. An early assessment by a specialist team including Ear, Nose and Throat (ENT) specialist, paediatrician and a Speech and Language therapist would support the use of these more conservative treatment options before considering the use of medication or surgery to promote better saliva control.
Last reviewed January 2014
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