What to Expect: Speech Therapy for Progressive Supranuclear Palsy
Progressive Supranuclear Palsy (PSP) is a degenerative brain disorder associated with deterioration of the cells in the brain responsible for controlling body movement and cognition (e.g. planning, thinking and reasoning). It’s important to note that while PSP is still classified as a rare disorder, PSP affects approximately 5-6 in every 100,000 people. However, due to misdiagnosis, the true number may be higher (Maher et al., 2017).
PSP is similar to Parkinson’s Disease, which is why it is often referred to as a “Parkinsons-Plus” syndrome – but it’s important to note that PSP is a different condition with its own set of symptoms, a faster progression, and a different response to medication than Parkinson’s Disease.
People with PSP are more likely to experience earlier onset of swallowing difficulties, known clinically as ‘Dysphagia’, than those with Parkinson’s Disease. Swallowing impairments are also present in over 80% of people with PSP (Stahl et al., 2013). Because of this, it’s important to involve a Speech Pathologist in your care from the early stages of PSP. Keep reading to find out what to expect from speech therapy for Progressive Supranuclear Palsy, and where to find a local Speech Pathologist.
Speech Pathology and Progressive Supranuclear Palsy
Swallowing Difficulties and Progressive Supranuclear Palsy
Progressive Supranuclear Palsy is associated with changes in the strength and coordination of body movements. This can affect the strength and coordination of smaller more precise movements, like those required of the mouth, tongue, and neck muscles during the swallowing process.
As you can imagine, if the strength and coordination of muscles like the tongue are impacted, it can make swallowing difficult. Research has shown that people with PSP are more likely to experience disruptions to the oral and pharyngeal phase of swallowing. Early assessment and management of swallowing difficulties are essential to reduce the risk of aspiration pneumonia, which is known to be one of the leading morbidity risks in PSP (Stahl et al., 2013).
Swallowing also requires coordination and timing with breathing to ensure that foods and drinks go down ‘the right way’, and not into your airway. Because of this, people with PSP are known to be more at risk for foods and drinks going down the wrong way, leading to heightened risk of aspiration pneumonia and choking.
Speech Pathologists work with people with Progressive Supranuclear Palsy to assess their swallowing difficulties, monitor changes in the strength and coordination of the muscles involved in swallowing, and prescribe swallowing exercises to maintain mealtime enjoyment and safety.
Communication Difficulties and Progressive Supranuclear Palsy
Progressive Supranuclear Palsy (PSP) is a complex neurological condition that can significantly impact both speech and communication. Up to 90% of people with PSP will develop a speech disorder known as ‘Dysarthria’ – resulting in slurred or unclear speech due to muscle weakness. This is also often accompanied by hypophonia (a quiet voice), making communication support from an experienced Speech Pathologist essential. As PSP progresses, many individuals experience changes in voice clarity, vocal loudness, and the ability to initiate or sustain conversation. These changes may be further compounded by difficulties in finding the right words or processing language efficiently.
Speech therapy for people with PSP focuses on maintaining communication function for as long as possible. Starting to work with a Speech Pathologist can help you preserve your voice quality and stay connected with the people and activities you care about.
One important area of therapy is breath support, which plays a crucial role in both speech and swallowing. Targeted exercises can help strengthen respiratory muscles and improve the coordination needed to produce clear speech. This can also support better endurance for communication – meaning that you’re less
As PSP progresses, communication aids can become a vital part of therapy. These may include:
- Low-tech tools such as communication books or alphabet boards
- High-tech solutions such as speech-generating devices or apps that support text-to-speech communication, or even voice banking
- Partner training, which helps family members or carers learn how to better support communication in daily life
By integrating these supports early, individuals with PSP can reduce communication breakdowns, preserve independence, and maintain participation in meaningful social interactions. It’s important to note that while there are many great communication aids that can support people with PSP, eye-gaze technology is not suitable for people with this condition due to known early and severe eye movement changes including difficulty focusing, tracking, and calibrating. Instead, Speech Pathologists and carers should consider AAC options that include switch access, touch access, or partner-assisted AAC options.
The combination of speech changes, cognitive challenges, and physical limitations in PSP can lead to frustration, social isolation, and a decline in overall quality of life. Speech Pathologists play an essential role in helping individuals adapt to these changes—supporting not just speech clarity, but also dignity, connection, and engagement in everyday life.
As we like to remind our clients with progressive conditions, “You may not be able to change the direction of the wind, but you can adjust your sails to reach your destination”.
Where to Find a Speech Pathologist for PSP
If you are looking for a Speech Pathologist in North Brisbane that offers both in-clinic and home visit appointments for adults with Progressive Supranuclear Palsy, you are in the right place. The friendly team at Speak and Swallow Speech Therapy are experienced in this area and look forward to supporting you with functional speech therapy that focuses on your quality of life.
If you are located outside of North Brisbane, but are still located in Australia, we’d recommend using the “Find a Speech Pathologist” register on the Speech Pathology Australia website to find a local clinician.