Characteristics of Individuals with MS who Report Speech Problems.

TitleCharacteristics of Individuals with MS who Report Speech Problems.
Publication TypeJournal Article
AuthorsYorkston KM, Klasner ER, Johnson KL, Ehde DM, Gibbons LE, Kraft GH
JournalInternational Journal of MS Care

Self–report questionnaires about communication difficulties associated with MS indicate that approximately 25 to 45 percent of the respondents noted changes in speech. Although previous studies 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 758 individuals with MS. Of this sample, 39.7% (N=301) report either mild, moderate, or severe speech problems. The relationship between level of speech problem (none to severe) is examined for a variety of variables including: demographics (age, gender, and level of education), disease status (EDSS, overall health, type of MS, and time since onset), physical/sensory function (arm strength and coordination, sensation, vision, hearing, and swallowing), communication related function (thinking, reading and writing), psychosocial factors (living situations, depression, employment, quality of life), and fatigue. Results indicate the higher severity of speech problems is associated with higher impairment and functional limitation in other areas. One exception is the rating of fatigue that is uniform across severity groups. Clinical implications include the need for clinicians to anticipate greater levels of physical, sensory, and cognitive impairment in individuals with speech problems as compared to those without such problems. The greater physical, sensory, and cognitive impairments in individuals with moderate or severe speech disorders may substantially increase challenges in clinical management. Because important levels of fatigue must be anticipated in all individuals who endorse speech problems, including those who report only mild speech changes, intervention planning should incorporate strategies for reducing fatigue and for maintaining cognitive and communicative function in the face of fatigue.

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