Many people, but not all, may have trouble with speech. This is often referred to as dysarthria. Having difficulty with speech has psychological aspects to it. Our speech in an integral part of who we are, as part of communication it conveys our personality, sense of humour, our views and opinions. Impairment of speech may begin with slurring, hoarseness or weak voice. Weakness of the muscles of respiration will also affect speech volume. For some people it may progress to total loss of speech. Difficulties with communication can lead to decreased social interaction and feelings of isolation.
Early referral to the speech and language therapist (SLT) for advice on communication support strategies is advised. The goal is to optimise the communication both for the person with MND and their caregiver. It may help to create a relaxed atmosphere, not to rush the person, and not to interrupt or finish their sentences. It is better not to pretend to understand, this is very frustrating for the person as they can usually tell. It is best to check which method the person prefers to use to communicate (e.g. do they prefer to write or use a tablet or text on their phone). Try to identify key words and have a signal for yes and no.
The SLT will regularly review the person to ensure assessment and provision of communication aids and training in their use. Augmentative and Alternative Communication (AAC) devices can be used. Low-tech AAC may include pen and paper, white board and marker, alphabet charts and picture communication aids. The high-tech AAC options may include a voice amplifier, light writer, tablet or smart phone or an eye gaze device. The SLT will advise the most appropriate device based on the specific needs of the person.