A frequent symptom of motor dysfunction in HD, dysarthria is a condition where speech is slurred, slow, and difficult to understand. Dysarthria is caused by paralysis, weakness, or inability to coordinate the muscles of the mouth. The rhythm and speed of speech changes with bursts of words alternating with pauses. Speech becomes slower, and with disease progression, the voice may become hypophonic or explosive. Articulation of speech becomes impaired when voluntary control of lips, tongue and mouth declines. The coordination of speaking and breathing declines, and the intelligibility of speech deteriorates. Delays in initiation of speech, paucity of speech, and finally mutism occur. Referral to a speech-language pathologist may be indicated when articulation or intelligibility is affected. Motor dyscontrol or cognitive dysfunction often prevents the person with HD from using keyboard-or computer-based augmentative communication devices successfully. However, simple “word boards” placed on the lap can help some people with HD to communicate simple ideas and questions. Caregivers should be educated about behavioral strategies to improve communication.

Further Reading

HDSA Family Guide Series: Speech-Language and Swallowing Difficulties
This guide covers speech characteristics associated with Huntington’s disease, impairment in speech, swallowing problems and strategies to improve verbal communication.