Speech & Swallowing in Parkinson’s

Speech and swallowing challenges are common in Parkinson’s disease (PD) and can impact important parts of life, such as enjoying favorite foods or participating in conversations with family and friends.

Seeing a speech therapist and starting treatment early can improve your quality of life and help prevent more serious problems later on.

Quick Facts

PD causes movements to become smaller and slower over time, which can affect how the face, mouth, throat and chest move during speaking and swallowing.
PD can disrupt communication between the brain and the body, which may make it difficult to notice changes in speech and swallowing.
Speech therapists are trained to support speech, communication and swallowing challenges in PD.

Speech Issues in Parkinson's

Voice and speech changes can be among the early signs of PD. Common examples include soft speech, monotone voice, slurred words and trouble finding the right words or starting sentences. Limited facial expression may cause others to misread emotions.

Speech Self-Check

Do others have trouble hearing or understanding me?
Do I avoid phone calls?
Is my voice weak or does it tire easily?
Do I struggle to find words or lose my train of thought?
Do I feel left out of conversations?

Swallowing Issues in Parkinson's

Many people with PD experience swallowing difficulty (dysphagia). These can range from mild problems, such as taking longer to eat, to serious issues like weight loss, choking or aspiration pneumonia — a life-threatening infection caused by food or liquid entering the lungs.

Another common concern is excess saliva. This happens not because the body produces too much saliva, but because PD can make swallowing less automatic.

Swallowing Self-Check

• Do food or pills feel stuck in my throat?

• Do I clear my throat often when eating or drinking?

• Does it take longer to eat than others?

• Have I lost weight without trying?

• Do I have excess saliva?

• Do I often have heartburn or a sore throat?

Addressing Speech and Swallowing Issues

The main treatment for speech and swallowing issues is working with a speech therapist (also called a speech-language pathologist). Many speech therapists specialize in neurological conditions.

Adjusting PD medications may also help, especially if symptoms happen during “off” times.

Evaluating Speech and Swallowing Issues

A speech therapist will review your medical history and evaluate how your face, lips, tongue and jaw move, along with your speech and swallowing. If there are concerns about swallowing, the therapist might recommend tests like a video X-ray or a fiberoptic endoscopic evaluation (a test that uses a small camera to check swallowing).

What to Expect in Speech and Swallowing Therapy

Parkinson’s affects everyone differently, so your therapy plan should be tailored to your specific symptoms and goals. Typical therapy includes:

Exercises, strategies and tools to improve speech clarity, strengthen muscles and enhance communication.
Swallowing therapy to strengthen muscles for breathing, coughing and swallowing.
Diet tips and safer mealtime strategies, if needed.
Regular re-evaluations and “tune-ups” every few years.

Consistency is important for progress, so practicing at home is key. Singing can also help with breath control and vocal strength. Some local PD support groups and community centers offer choir opportunities.

Finding a Speech Therapist

Ask your doctor for a referral or contact our Helpline. Programs like Lee Silverman Voice Treatment (LSVT LOUD) and Parkinson Voice Project SPEAK OUT! focus on Parkinson’s speech challenges and offer online directories to help you find specialized speech therapists.