Speech therapy for Huntington’s disease
Last updated June 13, 2025, by Susie Strachan
Fact-checked by Marta Figueiredo, PhD
Huntington’s disease is a progressive disease that can lead to involuntary movements (chorea), weak throat muscles, and cognitive decline, making communication and swallowing more difficult.
Speech therapy for Huntington’s disease can help with these communication issues and swallowing difficulties.
Speech therapists — also called speech language pathologists (SLP) — offer people with Huntington’s disease techniques and tools to improve speech clarity, support communication, and reduce risks associated with swallowing problems, all to help enhance quality of life.
Communication challenges in Huntington’s disease
Huntington’s symptoms can affect speech differently for each person. How these symptoms shape your ability to speak often depends on your overall health and the specific stage of the disease.
The most common Huntington’s-associated speech disorder is hyperkinetic dysarthria, a condition marked by involuntary movements in the muscles used for speaking. Dysarthria in Huntington’s disease can make your speech sound harsh, strained, overly nasal, or breathy, and the volume may vary unexpectedly.
Perhaps you speak quickly, trying to get your words out before a movement disturbance starts, or you run out of breath. This can be a common experience for people with Huntington’s, and it often requires effort to work around involuntary movements or breath control issues.
Your speech may also lose its natural rhythm and tone, sounding flat or without emphasis. When these changes occur, it can become harder for others to understand you, which can be frustrating and affect your social interactions.
However, remember that these changes don’t reflect your ability to think or understand. With patience and understanding from those around you, communication can still feel meaningful and supportive.
Swallowing and eating challenges
Swallowing difficulties, known as dysphagia, are common among people with Huntington’s disease, particularly in the later stages.
You might cough or choke when eating or drinking, which happens when food or liquid enters the airway “down the wrong pipe.”
Swallowing problems in Huntington’s can be caused by involuntary movements in the mouth, tongue, and throat that affect airway protection, delayed swallow reflexes, and loss of coordination between breathing and swallowing.
They can also result from:
- holding food or liquid in the mouth
- incomplete swallows
- difficulty chewing
- taking bites or sips too large to manage safely.
As Huntington’s progresses, swallowing difficulties and associated feeding problems can worsen. Mild issues in the early stages can become more serious over time.
Without treatment, swallowing problems can lead to malnutrition, dehydration, weight loss, or even more serious complications like aspiration pneumonia, which is an infection caused by inhaling food, saliva, or stomach acid into the lungs.
Speech therapy techniques for Huntington’s disease
Speech therapy can involve techniques and interventions to help you maintain your ability to speak and stay safe while eating.
Speech clarity
In the early stages of Huntington’s disease, an SLP can help you focus on speech rate and breathing patterns to help improve speech clarity.
Your treatment plan might include exercises to help reduce muscle tension around the voice and may involve relaxation techniques to improve speech. You may also be shown how to exaggerate certain mouth movements, so your words are easier to understand.
In the middle stages, an SLP can work with you on exercises to coordinate breathing and speaking. At this stage, your caregiver may wish to attend the treatment sessions to learn how to aid you in communication.
In the later stages of Huntington’s, you may find that you rely more on your caregivers and family members to help support your communication.
Your SLP can help your caregivers and family members learn strategies to assist with communication, such as using gestures, facial expressions, and written words when speech becomes difficult or impossible.
Alternative communication methods
Augmentative and alternative communication (AAC) devices can be helpful during the later stages of Huntington’s.
These tools range from simple word or picture boards to advanced systems, such as eye-tracking devices, that can be adapted over time to meet changing needs.
An SLP can recommend devices suitable for you, including those with features like predictive text, voice banking, or alternative access methods (e.g., switches or joysticks). These are particularly useful as motor symptoms progress.
Swallowing interventions
Swallowing difficulties in Huntington’s disease are typically assessed using a combination of patient questionnaires and clinical tests.
The tests can include a clinical swallow assessment, a modified barium swallow, and a fiberoptic endoscopic examination.
- A clinical swallow assessment is when an SLP observes you swallowing while eating.
- A modified barium swallow is a procedure that involves swallowing a chalky-tasting liquid that contains a contrasting agent, called barium, while X-rays capture its movement through your mouth, throat, and stomach.
- A fiberoptic endoscopic examination of swallowing is when an SLP uses a thin tube with a camera to view your airway and swallowing in real time.
Your speech therapist can work with you and your caregivers on strategies and exercises to make eating and drinking safer and more manageable. These might include:
- modifying food textures, such as softer foods or pureed options, to make swallowing easier
- taking small bites and sipping liquids slowly to avoid overwhelming the swallowing reflex
- using adaptive equipment such as specialized cups, spoons, or straws to make drinking and eating safer and easier
- sitting upright in a well-supported chair to reduce the risk of choking
- using a chin tuck position while swallowing for improved airway protection.
Benefits of early speech therapy intervention
After a Huntington’s diagnosis, seeing an SLP early can make a difference.
During your first visit, they can evaluate your speech and swallowing abilities to establish a baseline. This step helps track changes over time and provides insight into maintaining safe swallowing and strategies to improve communication.
Early intervention allows them to recommend exercises or techniques appropriate for your needs. Learning these strategies gives you and your caregivers time to practice and become comfortable with them before further difficulties arise.
In addition to working on current concerns, early speech therapy can introduce AAC devices, which can be helpful if speaking becomes harder in the future. Starting these tools earlier ensures that you can gradually adapt to them.
Involving caregivers and family
Caregivers and family members can support a person with Huntington’s who has speaking and swallowing difficulties by using strategies such as offering softer foods, using communication aids, and maintaining a calm mealtime environment.
As the disease progresses, your loved one may face increased difficulties. In the advanced stages of Huntington’s, changes to their motor and cognitive abilities can make it harder for them to use tools like writing, typing, or communication boards.
As a caregiver, familiarizing yourself with their preferences and gestures can help you aid them in expressing their thoughts and needs more clearly, providing essential support during these stages.
To help create a supportive communication environment at home, it can be helpful to:
- watch for body language, facial expressions, and gestures that may help convey messages
- reduce distractions during conversations by minimizing background noise
- offer simple yes/no or multiple-choice questions to make it easier for them to respond
- use visual supports such as pictures or symbols
- stay calm and support their communication efforts, even if it takes longer.
You can also work with an SLP to recognize the early signs of choking or aspiration. The therapist can teach you how to perform the Heimlich maneuver or other emergency choking interventions.
Additional ways you can help with mealtimes include:
- helping your loved one sit upright during meals to prevent food from entering the airway
- encouraging them to take smaller bites and sips, which can reduce the risk of choking
- creating a calm and distraction-free environment to help them focus on swallowing.
Resources for patients and families
To find the right SLP who has experience with Huntington’s and speech and swallowing difficulties, start by checking professional directories and looking for SLPs with experience in neurology or neurodegenerative diseases.
- The American Speech-Language-Hearing Association has a Find a Professional” tool to search for licensed and certified SLPs in your area.
- Speech-Language & Audiology Canada offers a directory of registered SLPs in Canada, which allows you to search by location and area of expertise.
You may want to consider an SLP who offers therapy covered by your health insurance and who offers telehealth therapy sessions. These can be especially useful if you have mobility or travel challenges.
You can also ask for recommendations from your healthcare professionals or connect with other people living with Huntington’s and their families through support groups.
Organizations such as the Huntington’s Disease Society of America and the Huntington Society of Canada may be able to direct you to experienced SLPs or provide links to local support networks.
Huntington’s Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
