Many people who are diagnosed with MS may at some point have
difficulty with their speech because of the movement problems
they experience. This speech disorder, called "Dysarthria"
happens when muscles are weak and do not move as far,
as fast, or with the coordination that is needed
for precise speech. Dysarthria typically involves many
parts of the system used to produce speech, including the tongue,
lips, jaw, and soft palate (back part of the roof
of the mouth). Because many parts of the brain may
be affected in MS, the pattern of speech difficulties
is likely to differ from person to person-or may
change over time for any one person. Several speech
symptoms are commonly seen in MS. It may be difficult
to control the loudness of your voice, and you volume
may change at inappropritae times without your control. Similar
problems may happen to the pitch of your voice. Your
consonants may not sound "quite right" because of
weakness or incoordination of the muscles used to move
the lips, tongue or soft palate. Your speech may sound slurred or
concoordinated. Hypernasality (too much air going through the nose) is
also possible. Your voice may also sound hoarse or harsh.
Some people have what is called "scanning speech," in which
they speak very slowly and seem to pause after every syllable.

Because the disease may get worse and then better for awhile
and because so many different parts of the brain may be involved,
it is difficult to describe how speech changes as MS
progresses. If the disease worsens, however, some changes in
speech are typical. For example, as muscles become weaker or
movement becomes less coordinated, speech sounds will be
harder to make. they will sound more and more distored.
Voice changes are also common as the disease gets worse.
The voice may sound incrasingly hoarse or harsh and the
pitch may be too high or too low. The voice
may also sound "shaky." That is, it may sound wavering due
to tremor. Sometimes, these speech changes make it
harder for other to understand you. There are
some things that can be done to help you be
more easily understood or to provide other ways
for you to communicate.

Speech therapy can often be helpful for people who have
dysarthria. The type of therapy that is best depends on whether
the speech problem is mild, moderate, or severe. If
your speech is only midly affected, therapy might help
you conserve your energy and control your pitch and loudness
to make your speech sound more natural.

Many people with moderate dysarthria due to MS will
have difficulty coordinating respiration (breathing)
with voice and articulation (making consonant
and vowel sounds). There are many ways therapists
can help you control your use of the outgoing
airstream for speech. Work on controlling rate is also
often helpful. Helping you adjust your phrasing and breath
patterns can often help to improve intelligibility.
For people with severe dysarthria, augmentative communication
is often recommended. Augmentative communication means any
system such as a picture of word board, a computer,
or gestures that you can use with speech or
instead of speech.