Several medical issues can cause slow, slurred speech. Speech-language pathologists can help identify the cause and use appropriate therapies so the patient can communicate more clearly.
Johnna Johnson is a speech-language pathologist at Regional One Health’s East Campus Center for Rehabilitative Medicine. She literally teaches patients to form sounds and words so they can speak more clearly.
“I can cue every movement of a patient’s lips and mouth to make a sound. I can get a non-verbal person to produce words and phrases in the therapy room because I know the articulatory placements of the tongue and lips to be able to produce sounds,” Johnson said.
Johnson said garbled speech typically falls into two categories.
Dysarthria is weak muscles due to brain damage. Patients have a hard time controlling the muscles used in speech. Muscles in the face, lips, tongue and throat are affected.
Apraxia is a motor disorder. Patients find it hard to move their mouth and tongue to speak. This occurs even though the muscles are fine and the patient wants to speak.
Dysarthria and apraxia often have the same causes:
- Brain injury
- Brain tumor
- Neurological disorders
Johnson said speech therapists help by physically showing patients how to form sounds. They focus on constant repetition to engage neural plasticity.
“The patients can’t control their tongue and lips, so I give them a visual of what I want them to do,” she said. “I show them how they should manipulate their lips, tongue, etc. to make specific sounds and say specific words.”
Johnson gave some examples:
- To make a P, B or M sound, she tells patients to start with a closed mouth.
- T, D, L and N start with the tongue behind the front teeth.
- To say words like slice, you smile then move your tongue up.
Johnson said tongue and lip placement and repetition are key. That’s why words like “spaghetti” are so hard to teach. The word involves quickly changing between several mouth positions.
Practice can help patients overcome or improve dysarthria and apraxia. Johnson starts by helping them memorize key functional phrases they use every day. For example, one of her patients has young kids. She helped her learn to give simple directions like “get dressed” or “clean up.”
Johnson said patients can relearn words and phrases. It requires dedication. “Repetition is key,” she said. “Apps and iPads are helpful because they allow for more practice.”
It’s called neuroplasticity. The brain is a living organ. If you repeat a motor sequence you can make connections to relearn it.
Johnson recommends videos and apps patients can use to practice at home.
She also encourages family members to attend therapy sessions with the patient. That way they can learn how to help coach the patient to form sounds, words and phrases.
“Too often a patient can speak while they’re in my office, but once they leave me they go back into the silent world,” she said. “The way to have success is that it takes a village. The family has to go to therapy and learn how to cue the patient, and they have to practice every day.”