The speech exercises to still be able to communicate to some extent by correctly applying the breath support while speaking are of great importance if the voice sound temporarily decreases due to the "hoarseness". This is because I often lack the energy caused by the overall fatigue. Since 2005 my palate no longer closes the trachea from the throat to the nose sufficiently. 30% of the air disappears through the nose when speaking. This makes my speech sound nasal and often weak and this is very tiring.
When PLS affects and partially paralyzes the muscles involved in talking, it becomes more difficult to make yourself understood. The speech therapist can inform and support you with speech problems. She / he informs, advises and guides the patient and his immediate environment in the changing language and communication. She / he will also look at adjustments that are necessary (such as communication aids) to keep communication going, even if speaking is no longer or hardly successful.
If there is a reduced function of the muscles involved in speech, such as the lip, tongue and palate muscles, speech can decrease in quality and intelligibility. We call this dysarthria (= disorder in pronunciation).
Speech becomes slurred and slower. Misunderstandings arise because the interlocutor did not understand the patient and therefore did not understand it properly. Raising voice and calling from a distance becomes more difficult. It is more difficult to speak intelligibly in noisy rooms. Making calls takes effort or no longer works. Speaking in groups takes more effort. Expressing emotions verbally changes. Sometimes this is accompanied by a reduced mimic expression (mimic muscles stiffen or become limp). All of this changes not only speech, but also the social role. There is a danger of social isolation. The (conversation) partner is very important in the application of voice, speech and communication techniques. These techniques are discussed by the speech therapist with the patient and his immediate environment.
Making eye contact
Taking more time for a conversation
Alternate speaking with rest
Speak word by word
When the speech becomes really unintelligible, communication support is needed. There are several choices and options. It is very simple and obvious to use pen and paper. In addition, there are communication cards (custom) or letter cards. In many cases, more advanced equipment is used. A distinction is made here between the devices with speech output and the dynamic communication aids. The speech therapist can help make the choice based on the patient's affinity, capabilities and limitations.