Multiple Sclerosis - A Practical Guide to Rehabilitation - 33

A Practical Guide to Rehabilitation
in
A PRACTICAL GUIDE TO IDIOPATHIC

MULTIPLE SCLEROSIS

SLP treatment of dysarthria has been shown
effective and should focus on improvement
and/or use of compensatory strategies.124
Interventions should be individually tailored and
typically involve exercises to increase strength and
control of muscles used for speech and
modifications to the rate of speech and/or
loudness to enhance intelligibility.
The American Speech-Language-Hearing
Association (ASHA) provides the practical
suggestions for persons with dysarthria and for
listeners.125
Tips for the Person with Dysarthria
* Introduce your topic with a single word or
short phrase before beginning to speak in more
complete sentences
* Check with your listeners to make sure that
they understand you
* Speak slowly and as loudly as you can and
pause frequently
* Try to limit conversations when you feel tired
(when your speech will be harder to
understand)
* If you become frustrated, try to use other
methods, such as pointing or gesturing, to get
your message across or take a rest and try again
later
Tips for the Listener
* Reduce distractions and background noise
* Pay attention to the speaker
* Watch as he or she talks
* Let the speaker know when you have difficulty
understanding him or her
* Repeat the part of the message that you
understood, so that the speaker does not have
to repeat the entire message
* If you still don't understand the message, ask
yes and no questions or have the speaker write
the message
Recovering speech function and maintaining
communication is essential for the well-being of
the patient and family, and for maximizing quality
of life.126

Augmentative and alternative communication
(AAC) strategies can be helpful when speech
alone is insufficient. AAC is a system comprised
of symbols, aids (books, devices, apps), strategies,
and techniques. The goal of AAC is to supplement
existing speech or replace speech that is not
adequate for functional purposes. The most
effective AAC systems allow the user to initiate,
maintain, and terminate the communication
process. In addition to basic needs, AAC should
help patients to connect and share ideas and
stories. Examples of low-tech options for ACC
include manual signs, natural gestures,
pictures/photos, alphabet, eye-gaze boards, and
buzzers (Figure 8, page 34). Fingers, other body
parts, pointers, or eye tracking can be used to
indicate selections.
High-tech AAC options include apps for mobile
devices, computer programs, and
speech-generating devices that provide
computerized voice output. Voice banking is
becoming increasingly popular, particularly
among individuals with neurodegenerative
diseases. Voice banking should be undertaken as
early as possible in order to preserve voice and
intelligibility. A popular provider is
ModelTalker,127 however other voice banking
services continue to emerge. ASHA provides links
to organizations with information on the range of
AAC devices and aids.128
With the increasing availability of
communication apps for tablets and smartphones,
clients may be keen to independently select and
program their own systems. However, some apps
may be too complex for patients with cognitive
challenges. Assistance with device selection and
programming from an experienced professional
can improve the usefulness of these tools and
associated outcomes.
Selection and use of AAC strategies and devices
should be individualized and practical. AAC users
and their caregivers should have the final decision
when choosing a device or system. Devices should
be selected with consideration of both current and

Speech, Swallowing Issues, and Oral Health

33



Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
Multiple Sclerosis - A Practical Guide to Rehabilitation - 5
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Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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