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Communication Many conditions have associated communication difficulties. For example: • • • • • • • Stroke Parkinson’s Disease Dementia Head injury Motor Neurone Disease Multiple sclerosis Head and neck cancer, plus more In the UK: • • • • 2.5 million people in the UK have speech, language or communication needs (SLCN) 50,000 people who have a stroke every year have speech and language difficulties. 700,000 people with dementia experience SLCN About 70% of people with Parkinson’s disease will experience communication difficulties, largely with their voice There are three main types of communication difficulties: • • • Motor Speech Disorders e.g. dysarthria – difficulties with spoken output such as slurred speech Aphasia - difficulties with understanding or using language after a stroke or head injury Voice difficulties – such as muscle tension dysphonia or vocal fold nodules A communication difficulty can have a significant effect on a person’s quality of life. It could prevent them from being able to participate in everyday life. They may become unable to socialise with friends or family, or stop them from being able to use the telephone. This may result in them becoming isolated and/or depressed. MOTOR SPEECH DISORDERS Motor Speech Disorders is the umbrella term given to conditions which affect speech and voice quality. These include: dysarthria and apraxia of speech. Dysarthria – Ø describes changes to the voice and / or muscles used for articulation (speech sounds) Ø these difficulties can occur due to weak or tight muscles of the tongue, lips, soft palate, voice box (larynx) etc. Surgery which has had to remove part (or all) of a muscle (for example, with mouth cancer) can also result in dysarthria. Ø speech can sound slurred and can sometimes be very difficult to understand (unintelligible). Voices can be extremely quiet and very difficult to hear. Apraxia of Speech – Ø describes the difficulty a person may have with producing the correct speech sound they wish to say Ø they may be unable to say certain sounds or may say the incorrect sound in place of another Ø the person may be able to say many words which are very familiar, for example, counting, days of the week or ‘please’ and ‘thank you’, however when asking for a drink, cannot say the correct sounds in the word Conditions which may result in motor speech disorders include: • • • • Stroke Parkinson’s Disease Traumatic Brain Injury Brain Tumours Aphasia Aphasia is difficulty with language, which may affect a person’s ability to understand language or express what they wish to say. It can affect one or more of the following: o Understanding (words, sentences, instructions etc) o Speaking (single words, sentences, peoples names, places) o Thinking of the name of an object o Reading o Writing o Numbers Conditions which may result in aphasia include: • • • • • • • • Stroke Head Injury Brain tumour Brain infection e.g. encephalitis Neurological diseases e.g. Parkinson’s disease and epilepsy Dementia Drugs misuse Plus others Aphasia can be life changing depending upon the severity of the difficulties. Sometimes the person with aphasia can ‘regain’ some or most of their ability to understand and use language. However there are people who will continue to have severe aphasia for the rest of their lives – this is where SLT is essential in providing the right information, support and treatment to allow the person to communicate in the best possible way. Voice difficulties Voice difficulties can lead to changes in voice quality (dysphonia) and / or the complete loss of voice (aphonia). Conditions which may result in voice difficulties include: • Specific conditions which affect the voice, e.g. vocal fold nodules, polyps, muscle tension dysphonia and oesophageal reflux disease • • Neurological conditions, e.g. Multiple Sclerosis, Motor Neurone Disease and Parkinson’s disease Other disorders which can affect voice, e.g. asthma, HIV and AIDS How do Speech and Language Therapists assess and manage communication difficulties? Speech and Language Therapists (SLTs) are the experts in the assessment and management of communication difficulties. They will work closely with the service user, their family, other professionals and carers to ensure the person has the strategies they require to communicate as effectively as possible. Intervention may include: Assessment – • detailed assessment of an individual’s speech, language, voice and communication strengths and weaknesses Management – • • • • individual treatment plans based on the assessment treatment will either aim to rehabilitate speech/language/voice or compensate for the communication difficulties onward referral to local groups and support networks advice and information for other professionals, staff and family members