Managing speech problems

The first step in managing speech difficulties is to identify the specific problem, or problems, you are having.

This page covers:

There's more detailed information in our booklet on Speech difficulties.

Assessment

Man undergoing an assessment with his speech therapist

Your doctor or MS nurse can refer you to a speech and language therapist.

They will:

  • Carry out different tests with you, to see exactly which parts of the complicated speech process are affected.
  • Assess your needs over time, to see if your situation has changed, and if treatments are still effective.

If your speech difficulties are caused by muscle stiffness or spasms there might be drug treatments to help relieve them. But in most cases, you will need to learn how to compensate for problems, and find ways to make communication and speech as easy as possible.

Things you can try with the help of a speech and language therapist include:

  • Exercises that strengthen or relax the muscles controlling the vocal cords. This is a sort of ‘speech physiotherapy’ – either helping the cords to stay closer together, or keeping them separated and more relaxed.
  • Other exercises, to help with the movement of the jaw, the tongue and the lips, can help with clear articulation and pronunciation.
  • You might find it useful to put the emphasis on communicating, rather than accuracy of the sounds. This is sometimes called 'functional communication therapy'. This could involve, for example, choosing to phrase things in the shortest, most concise way, and clarifying things with the listener to be confident they have understood. It could also include developing techniques to simplify sounds, words or sentences in a way that ensures you still get the message across.
  • Breath control: a speech and language therapist may encourage you to practise breathing in and out in a controlled way – so that you can make longer sentences in one breath. Other exercises can help with accenting certain words in a sentence and with catching quick breaths between thoughts. They can also show you how to monitor your own breathing and be sure you are doing it in the most effective way.

They’ll also look at the emotional side of speech difficulties - stress and anxiety, for example, may make difficulties worse.

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Adjustments, aids and equipment

If you have difficulty making yourself heard, something as simple as raising the volume control on your telephone might help. Specialist gadgets could also be helpful.

For example, a textphone could give you the option of speaking when you feel able to, or typing when not. If you are able to use the text function on a mobile phone, or email instead of telephone, this could also be helpful.

The Disabled Living Foundation has more information about telephones and other useful aids and equipment.

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Tips for managing speech difficulties

  • When you need to communicate, don't try to compete with other noises, such as TVs and radios.
  • Make sure you have someone's full attention before starting to tell them important information, and be prepared to repeat things if necessary.
  • Whenever you can, try to communicate face-to-face. Your facial expression and other forms of non-verbal communication can help the listener to understand what you are trying to say.
  • If a conversation goes on for a long time, you may find that your speech can sometimes become less clear. If this happens you may want to explain that you need a break before starting a conversation again.
  • If you have problems finding the right word, or remembering what you are trying to say, take your time and use notes if necessary.
  • Try to remain relaxed. Take regular pauses for breath when you’re speaking, and avoid rushing.
  • If you can laugh or smile about things, both you and the person you’re talking to may feel less anxious about not understanding or being understood.

Good posture: pillows and foam supports might be useful to support good posture when sitting or lying down and help you speak more easily. A physiotherapist can help with posture. For more on posture, see our factsheets on Posture and movement 1 - an introduction and Posture and movement 2 - moving well with MS.

Tips for others

  • Most people who have MS speech difficulties have problems with the physical process of creating speech. Don't assume that someone has trouble finding words or understanding what you are saying.
  • When speaking with someone who has speech difficulties, remember that it can be frustrating and tiring for them to talk.
  • Be honest when you really have not understood something.
  • It may help to ask ‘closed questions’ to clarify things and be sure you have understood (“Do you mean ...?”, for example).
  • Try to be patient, and not’ always finish their sentences for them.
  • If someone becomes upset or frustrated about not finding the right words or being understood properly, it will often make them anxious and their speech may become more difficult. Try to keep calm and understanding, and reassure them if necessary.

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Communication aids

If your speech is affected more severely, and it becomes very difficult for you to communicate in this way, a communication aid might be helpful.

There is a range of devices available, sometimes known as ‘augmentative and alternative communication’ devices. They can help by, for example, translating written words into speech.

Finding the right one for you depends on your overall situation, not just how your speech is affected. Certain symptoms, such as tremor or weakness in your hands, vision problems or cognitive difficulties may mean that you are unable to use some aids.

A speech and language therapist can suggest options and work with you to learn how to use them.

Find out about MS Society grants for equipment.

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