Huntington’s disease damages nerve cells in the brain. This results in involuntary movements and a loss of coordination. As the disease progresses, patients gradually lose the ability to control the muscles in their mouth and throat; speaking, eating, and swallowing become difficult.

People with Huntington’s disease also may have trouble thinking and reasoning, which can make conversations more challenging. Mood changes, such as depression or apathy, may reduce the person’s interest in interacting with others.The inability to communicate may add to the patient’s feelings of frustration, depression, or isolation.

Swallowing problems may cause food to “go down the wrong way,” which can lead to choking or lung infections. Being able to eat and drink helps maintain the person’s quality of life.

One type of healthcare professional, known as a speech therapist or speech-language pathologist, may be able to help patients and their caregivers with speaking and swallowing issues.

When to see a speech-language pathologist?

According to some speech-language pathologists, seeing the Huntington’s patient earlier is better. That allows for advance planning on how to handle changes as the disease progresses. The therapist and patient also have more opportunity to get to know each other.

A therapist also may be consulted when the patient starts to show changes in the ability to speak or understand, or begins having trouble swallowing. Symptoms of swallowing problems include coughing or choking more often, causing the patient to change eating habits or lose weight.

What does the therapy involve?

Huntington’s disease develops differently in each patient. So, a speech-language pathologist’s course of therapy will vary according to the patient and may change over time.

The therapist likely will start by asking patients about their symptoms. For example, when and how often the swallowing difficulties occur, and whether they involve liquid or solid foods. One suggestion may be to keep a journal of swallowing problems. Other recommendations may be to try to eat at the same time each day, eat slowly, and choose softer foods.

Regarding speech difficulties, the therapist might recommend breathing exercises. They might show patients how to exaggerate certain mouth movements so their words are easier to understand. Caregivers might be advised to reduce distractions when talking to a Huntington’s patient. Speaking slowly and asking simple “yes” or “no” questions may help.

The therapist may recommend assistive devices to help with communication. These might include smartphones, tablets, or computers. “Low-tech” options are notebooks, calendars, or picture boards with images of objects and activities from everyday life.

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