If you have multiple sclerosis (MS), you may have found yourself struggling to find the right words or stuttering in conversation. Some people with MS avoid certain social situations because they have trouble eating or drinking without coughing or choking. If you have these symptoms, a speech-language pathologist (SLP) may be able to help.

Speech-language pathologists are therapists who specialize in evaluating, diagnosing, and treating speech disorders and swallowing problems that prevent healthy communication.

One MyMSTeam member shared how an SLP helped them improve their speech problems: “Since I had a relapse in 2013 which weakened my tongue muscle, I have had speech problems where my voice sounded raspy at times. This same exact problem happened once before. I did work with my speech pathologist on both occasions and learned that what happens with me is not weakness, but vocal cords tightening. Every morning I massage my neck muscles and windpipe to try to loosen them up.”

According to the National Multiple Sclerosis Society, about 25 percent to 40 percent of people with MS experience speech problems, including:

• Dysarthria (slurring)
• Dysphonia (changes in voice quality)
• Disrupted rhythm and intonation
• Nasal speech
• Stuttering

Around 45 percent of people with MS experience dysphagia (difficulty swallowing), resulting in coughing or choking when eating or drinking, having difficulty chewing food, and drooling.

These symptoms are caused by MS lesions (damage) in parts of the brain that control the muscles involved in speech and swallowing. Issues like these should be addressed because they can lead to lower quality of life for people with MS.

If these issues affect you, it’s important to have a personalized treatment plan from your care team, which may include visits to a speech-language pathologist. Here are eight ways an SLP can help.

1. Your Speech-Language Pathologist Can Identify Problematic Muscles

During your initial meeting, an SLP will listen to you during conversations and give you a set of tasks so they can determine which part of your speech is affected. They’ll also review the articulation and clarity of your speech to identify the muscles that are causing your issues. During these evaluations, the SLP will determine whether you’re struggling to find words or keep up with the conversation.

For people with swallowing difficulties, the SLP will evaluate the strength of the muscles in your head and neck. They may also ask you to try food and liquid with different textures to figure out ways to improve swallowing. Often, the SLP will refer you for a barium swallow study and an endoscopy to assess how your condition affects your ability to swallow.

2. Your Speech-Language Pathologist Will Assess Your Communication Barriers

In addition to mapping out the mechanics of your speech that may be affected, your SLP will also observe how your speech issues are affecting your communication with family, friends, and colleagues to identify factors that can be improved to help you communicate better. Sharing this type of information with the SLP will allow them to ensure these communication barriers are addressed in their treatment plan.

3. Your Speech-Language Pathologist Will Create a Treatment Plan

Based on their assessment findings, your SLP will create a treatment plan to address the specific aspects of speech you should work to improve. There are three main treatment approaches to speech therapy for people with MS-related speech problems:

• Restorative rehabilitation — Restoring muscle strength and training mechanics of speech
• Adaptive rehabilitation — Learning behavioral techniques to improve communication
• Compensatory rehabilitation — Finding alternative methods to support communication

For people with swallowing problems, an SLP will create a treatment plan to enable safe and efficient swallowing by focusing on the following:

• Changing posture to improve control of your head and neck
• Building muscle strength and control to make swallowing more efficient
• Adjusting food textures to make swallowing easier
• Educating you and your caregivers about proper swallowing function to promote safety

4. Your Speech-Language Pathologist Will Recommend Exercises

After your SLP identifies the muscles affected, they’ll recommend a set of exercises to strengthen and train those muscles, which may include the following:

• Exercises to strengthen and coordinate the muscles in the mouth, throat, tongue, soft palate, lips, and diaphragm
• Exercises to improve vocal cord control to restore vocal quality
• Exercises to improve movements of the jaw, tongue, and lips for clear articulation and pronunciation
• Voice-training exercises to improve articulation
• Breathing exercises to aid in phrasing and rate of speech

For people with swallowing problems, the SLP may recommend a series of maneuvers and exercises that strengthen the muscles involved in swallowing. These exercises can also help improve coordination of the nerves and muscles in the throat, jaw, lips, and cheek to make swallowing safe and efficient.

5. Your Speech-Language Pathologist Will Provide Communication Strategies

In addition to working on improving the mechanics of speech through exercises, your SLP can help you find ways to make communicating with others less challenging and more effective. Some of those strategies may include:

• Timing important conversations to avoid being tired
• Using facial expressions, gestures, media, or objects to convey your message
• Using prepared notes for reference
• Checking with conversation partners if they are following the conversation
• Using other modes of communication, such as email or texts
• Speaking in short sentences and slowly

6. Your Speech-Language Pathologist May Give Caregivers Communication Tips

Often, there are things your conversation partners can do to help you have effective communication. Your SLP can provide your family members and friends with some tips, including:

• Giving you their full attention during the conversation
• Reducing background noise coming from sources like TV, radio, and traffic
• Repeating back what they heard to let you know they are following the conversation

7. Your Speech-Language Pathologist Can Suggest Tech Tools

There are a variety of technology-based methods you can use to enhance your communication, including:

• Text-to-speech apps
• Voice amplifiers
• Communication boards
• Pictures of words and phrases

Your SLP will work with you to find the right tools for your situation and lifestyle.

8. Your Speech-Language Pathologist Will Work With Your MS Care Team

For many people with MS, issues like fatigue and decline in cognition can affect speech and swallowing. Your SLP will work with other members of your health care team to help you manage the MS issues that affect your speech and swallowing.

If you have MS and are experiencing speech, language, or swallowing difficulties, ask your neurologist whether a referral to a speech-language pathology specialist can help you navigate them.

Talk With Others Who Understand

MyMSTeam is the online social network for people diagnosed with MS and those who love them. Here, more than 199,000 members have found a place where they can safely share about the condition and meet others who live with it every day.

Have you worked with a speech therapist on language therapy or swallowing skills? Share your experience in the comments below or by posting on MyMSTeam.