Speech Therapy for Motor Neurone Disease 

The team at Speak and Swallow Speech Therapy have a special place in their hearts for individuals living with Motor Neurone Disease (MND). We even took part in a Pickleball Tournament to raise funds for our local charity, MND and Me! It’s safe to say it is a passion of ours to provide timely and meaningful speech therapy for people with Motor Neurone Disease. 

In this article, we’ll explore what MND is and how Speech Pathologists can help address the changes in talking and swallowing associated with the condition.  

Motor Neurone Disease and Speech Pathology 

What is Motor Neurone Disease? 

Motor Neurone Disease (MND) is a term used to describe a group of diseases that affect nerve cells called motor neurons. You may have heard of the condition also referred to as Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s disease. The different types of MND are classified by which motor neurones are affected (upper, lower or both) and how quickly the disease progresses. 

MND is a progressive neurological condition that affects the nerve cells located in the brain and spinal cord responsible for controlling voluntary muscles. As these cells degenerate and eventually die, the brain loses its ability to initiate and control muscle movements. These movements include things like walking, swallowing, talking, and breathing. 

Over time, this degeneration of motor nerve cells leads to muscle weakness, paralysis, and wasting, ultimately leading to respiratory failure. The speed at which MND progresses varies for each person and is usually dependent upon the type of MND. In Australia, two people are diagnosed with MND every day. Around 2,752 Australians are thought to be living with MND at any one time. 

A multidisciplinary care approach, involving a team of health professionals including Speech Pathologists, can help people with MND live with a better quality of life for longer.   

Speech Therapy for Motor Neurone Disease 

Communication Changes in Motor Neurone Disease 

People with Motor Neurone Disease experience changes in their ability to communicate using verbal speech. This is because the muscles used for speech are weakened over time, first leading to quieter, slurred speech that can be difficult to understand. As the muscles weaken, people with MND can often lose the ability to produce verbal communication as they are unable to effectively control the muscles of the face, mouth, and tongue.  

This is why it is so important for people diagnosed with MND to seek the support of a Speech Pathologist early. Following a diagnosis of MND, it is often a good idea to start thinking about getting your team of health professionals in place. Accessing Speech Pathology services early in the disease may allow the individual to start the process of voice banking.

Voice Banking for MND 

Voice Banking is a technology-supported way to prolong meaningful communication and improve quality of life for people living with MND. Voice banking is a process where a person with MND records phrases and words and has them organised into a digital communication system (essentially allowing them to continue to use a version of their own voice). This way, as they experience changes to their voice, they can use the support of their own customised communication system to express themselves using a voice that is a true representation of them. Many people enjoy the benefits of voice banking because it allows them to record specific phrases and different tones of voice that the person may be known for – we all have little inside jokes and idiosyncrasies that can be meaningful to draw on in conversation with our loved ones.  

If you have not used voice banking and have already experienced significant changes in your communication, there are still options available. Assistive technology has come a long way in recent years, and there are great options to support access to digital communication tools that enable people with MND to express themselves in their everyday life.

A Speech Pathologist can help you to select a digital communication device (also known as Alternative Augmentative Communication or AAC) that is right for you. They will organise device trials so you can find what works best for you and your lifestyle. For some, the Speech Pathologist will need to work with an Occupational Therapist to find the most suitable access method to this device, this may include touch, switches/buttons, eye gaze or even technology known as the neuronode, among others.   

For people living with MND, maintaining reliable methods of communication matter – it’s about quality of life, self-advocacy, and the right to communication. We all want to be active participants in our lives, and by prioritising communication therapy, a person with MND, can retain choice and control over how they live their life as their condition progresses. 

Swallowing Changes in Motor Neurone Disease 

Many of the muscles involved in speaking are used for swallowing, so it makes sense that people with MND often experience changes in their swallowing and secretion management (e.g. saliva) as well as communication. 

Speech Pathologists play an important role in an MND care team, helping to monitor changes in swallowing and secretion management. This also involves updating mealtime management plans to ensure that the individual continues to eat and drink safely and feels comfortable in managing oral intake and clearing or managing their secretions. Speech Pathologists can also provide training to support workers and carers to ensure they feel well equipped and confident to modify meals and support safe and enjoyable mealtime experiences for the person living with MND. 

Quality of life is an important factor when it comes to managing swallowing changes in MND. While some individuals feel more comfortable with certain diet textures, others prefer to continue to consume food and/or fluids that bring them joy, for example, continuing to have their favourite glass of wine or eating their favourite chocolate. This can be known as eating and drinking with acknowledged risk and is something Speech Pathologists can work with the person living with MND and their family to explore if it is a priority.  

If you are at the beginning of your journey with MND or would simply like to connect with a local Speech Pathologist with experience in this area, we would love to help. Speak and Swallow Speech Therapy provide supports for individuals living with MND in North Brisbane and the Sunshine Coast. Visit our contact page or give our friendly team a call to find out how we can help you.