Coping With Speech Problems in Multiple Sclerosis

Scanning Speech, Mumbling, and Other Communication Challenges

Among the most frustrating complications of multiple sclerosis (MS) are disorders that interfere with the ability to speak clearly. One of these is dysarthria, a motor disorder that makes it hard to control the muscles used for speaking, including (or those involving) the lips, tongue, jaw, soft palate, vocal cords, and diaphragm.

According to the National Multiple Sclerosis Society (NMSS), between 41 percent and 51 percent of those living with MS are affected by dysarthria.

Dysarthria manifests itself by interfering with clear speech in a variety of ways, including:

  • Scanning speech, in which words come out very slowly or in strange rhythms with the syllables between them separated by long pauses, slurred speech, mumbling, very slow speech, and limited movement of the tongue, lip, and jaw
  • Rapid speech that is difficult to understand
  • Uneven or abnormal speech rhythm
  • Uneven speech volume
  • Monotone speech
  • Difficulty moving the tongue or facial muscles

Dysarthria often goes hand-in-hand with a separate disorder called dysphonia, which affects voice quality, pitch, and volume.

If your speech has been affected by MS, there are ways to help make yourself more easily understood.

Inform Others of Your Challenges

If you've ever heard a recording of yourself speaking, you know how different your voice can sound on tape from what you hear in your head. It's the same thing when you talk to other people—they may find your speech to be much clearer than you think it is.

If you are concerned about how you sound, don't hesitate to give your listener a heads-up and tell them you sometimes struggle to express yourself clearly.

Take a Break

In the heat of a moment of frustration, communicating clearly can be difficult for anyone. You may find it particularly challenging.

Take a few minutes to regroup. Breathe in deeply until you feel ready to go back to your conversation. When you do, keep your sentences short and speak slowly.

Try Speech Therapy

Getting help from a speech-language pathologist (SLP) can be an effective way to deal with communication problems caused by MS.

This specialist will first evaluate your speech to figure out exactly what to focus on in your treatment. He or she will then meet with you one-on-one in therapy sessions and give you exercises to do on your own.

Your SLP may help you work on strengthening your speech muscles and increasing your tongue and lip movements, learn to speak more slowly, and teach you to use your breath more effectively when you talk.

Different technologies are available for self-monitoring, including recording devices and computer speech-analysis software. This may be an especially important step to take if you're worried your speech problem is impacting your work or your social life. Ask your speech pathologist more about these if you think they may be useful to you.

Consider Medication

Speech problems in MS occur as a result of nerve damage and underlying MS-related neuromuscular impairments, including spasticity, tremor, and fatigue.

Medications used to treat spasticity, including Lioresal (baclofen) and Zanaflex (tizanidine), may be useful in cases where spasticity is affecting muscle tone in the vocal cords, tongue, lips, soft palate, or the diaphragm.

Tremors can affect voice quality and vocal muscles directly or indirectly. Medications to treat tremor include Klonopin (clonazepam), Inderal (propranolol), Mysoline (primidone), and Doriden (glutethimide).

Fatigue can affect the muscular coordination and strength necessary for vocal production; medications that can be helpful in this regard include Symmetrel (amantadine), Provigil (modafinil), and Nuvigil (armodafinil). Getting enough sleep when you have MS is also critical in general and may also help to reduce speech-related symptoms.

Communicate in a New Way

Very rarely, dysarthria caused by MS can leave a person unable to be understood—or even speak—at all. In that case, there are various workarounds to try, including alphabet boards, note pads, hand gestures, sign language, and electronic or computer-based aids.

A Word From Verywell

Scanning speech and other symptoms of dysarthria don't create physical pain, but they can lead to anxiety, frustration, and a lack of self-confidence. Don't be hesitant to seek help so you don't suffer silently.

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Article Sources
  • American Speech-Language-Hearing Association. Dysarthria. http://www.asha.org/public/speech/disorders/dysarthria/

  • National Multiple Sclerosis Society. Speech Problems. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Speech-Disorders