Neurological conditions affect the brain, spinal cord and/or nerves. There are over 700 neurological conditions, however the ones most often associated with communication difficulties in adults are the following:
- Parkinson’s Disease
- Huntington’s Disease
- Alzheimer’s Disease
- Dementia
- Multiple Sclerosis
- Motor Neuron Disease
- Stroke
- Brain Tumour
- Traumatic Brain Injury
Communication changes can be sudden as in a brain injury or a stroke, or can be gradual as in a progressive neurological condition such as Parkinson’s Disease. Communication difficulties are prevalent in neurological conditions. About 90% of people with Parkinson’s Disease, and 30% of people who have a stroke, experiencing difficulty in some way.
Types of Communication Difficulties
Everyone experiences communication difficulties differently, however there are some common types of communication changes.
Aphasia is a difficulty with language which affects speaking, understanding, reading and writing. Symptoms and severity varies greatly. People may have difficulty finding words or saying them properly, or cannot speak at all. Some people lose the ability to understand language, or cannot read or write.
Dysarthria causes speech to be unclear as a result of weakness in muscles that control breathing, voicing, resonance and articulation. Speech may be very quiet, uneven or slurry. It can be very difficult to understand people who have dysarthria due to unclear speech.
Apraxia is a motor speech disorder which affects the ability to plan how to speak, resulting in speech that is incorrect and muddled. People with apraxia have trouble connecting their thoughts from their brain to the mouth.
Cognitive-communication challenges can result particularly from dementia or brain injury and affects the ability to focus in a conversation, stay on topic, remember information, respond appropriately, understand jokes, solve problems and make decisions.
Dysphagia. It is also important to mention that neurological conditions may also affect swallowing. This is known as Dysphagia. The nerves and muscles that control the mouth and throat that are responsible for safe swallowing can be impaired resulting in difficulty chewing, controlling the food or drink, protecting the airway and swallowing the material into the oesophagus. The risk of dysphagia is aspiration which is when food or drink enters the airway and can make people very unwell.
How do communication challenges impact people?
The impact of communication and swallowing difficulties for people with neurological conditions is immense, as well as the burden on families and carers. Depression and anxiety is very common for these people as their lives have been altered significantly. People may not be able to work or continue previous roles. Maintaining friendships and other relationships is challenging. They may not be able to participate in previous activities they enjoyed. They may become dependent on others, become socially isolated and their quality of life is often reduced.
There are many professionals and organisations that support people with neurological conditions, however it is important that anyone experiencing communication or swallowing changes, even just slight changes, be seen by a speech language therapist. Early intervention is key, especially for people with progressive conditions, and to help optimise recovery after a stroke/brain injury.
Speech Language Therapists can help with the following:
- identify strengths, abilities and skills
- diagnose communication or swallowing difficulty
- provide impairment based therapy to improve skill
- support the use of compensatory strategies to improve function
- help develop confidence to participate in communication activities
- educate communication partners about supportive communication
- identify and implement assistive or alternative communication if needed
- discuss feelings and thoughts about living with a communication difficulty
- refer to other professionals if needed
- recommend activities and groups for support.
Speech language therapists are skilled in communicating with people who struggle to communicate. They are able to talk to people to understand where they are at, what their thoughts and feelings are and what they would like to achieve and get better at.
If you are noticing changes with your communication or your swallowing as a result of a neurological condition, or you know someone who is, a speech language therapist can help.
Where to find a Speech Language Therapist
Your GP can refer you to see a community therapist usually based out of the hospital, or if you have an ACC claim, ask you recovery partner to refer you for speech language therapy. These services are funded by the government.
If you wish to look for a private therapist, search on the New Zealand Speech-language Therapists’ Association website to find someone close to where you live. You may be eligible for funding through your private insurer or through other sources so talk to your therapist about options.
I provide speech language therapy to people who have a claim through ACC and patients at Burwood Hospital. I also provide private therapy in Christchurch, or via tele-health for people who live outside of Christchurch.
If you’d like to talk to find to what you need to help your communication or swallowing, be in touch and I can point you in the right direction.