Characteristics of multiple sclerosis as a function of the severity of speech disorders.

Although previous studies of the speech problems associated with multiple sclerosis (MS) report general prevalence information, they do not describe the full range of patient characteristics necessary for appropriate clinical management. This study reports data from a community-based survey of 739 individuals with MS. Of this sample, 31% (n = 229) reported mild speech problems, and 9% (n = 67) reported moderate or severe speech problems. The relationship between level of speech problem (none to severe) is examined for a variety of variables including the following: demographics (age, gender, time since onset, level of education, employment), disease status (overall health, EDSS-S, and type of MS), physical function (arm strength and coordination, and walking), sensory and other symptoms (vision, hearing, heat sensitivity, pain, fatigue, depression), and speech-related symptoms (thinking, reading, writing, swallowing). Results indicated that moderate or severe speech disorders do not occur in isolation; rather, they usually occur along with a complex constellation of other physical, cognitive, and psychosocial changes. Further, individuals with moderate or severe speech disorders are more likely to exhibit a progressive (either primary or secondary progressive) rather than a relapsing remitting type of MS. Appropriate type and timing of speech intervention is described.