Parkinson’s disease and Communication

Parkinson’s disease is a progressive brain disease. It happens when the brain and nervous system lose dopamine-producing cells.  

Dopamine is a neurotransmitter. Our bodies use dopamine for everyday activities like walking and talking. Dopamine is also important for digestion and blood pressure regulation.  

Parkinson’s can affect all aspects of communication. This includes speaking, language and thinking, as well as non-verbal skills such as facial expressions, typing or writing. 

How Parkinson’s affects speech 

If you have Parkinson’s, you may make smaller, stiffer or slower movements.  

This can make it harder to produce speech. 

You may take smaller breaths, and make smaller movements with the muscles in your throat and mouth.  

Your voice may become quiet or hoarse. 

You may not articulate words well. 

Your speech may sound monotonous or flat. 

Parkinson’s can also affect the way you swallow food, drink or saliva.  

Signs and symptoms of Parkinson’s 

Every person with Parkinson’s is different. 

Changes usually happen gradually and are often not immediately obvious. 

Some people may not even know they are experiencing symptoms. 

Common signs and symptoms include: 

  • a softer voice 
  • a voice that sounds raspy or hoarse.
  • altered speaking rate – long pauses between words or accelerated speech 
  • frequent throat clearing or sensation of saliva build-up
  • unclear or mumbled speech due to the tongue and lip muscles moving too slowly
  • stiff facial muscles, which can make it harder for people to express their emotions
  • thinking and language changes – these can range from minor to significant and include difficulty with attention, planning, finding the right word or understanding complex language
  • micrographia – handwriting becomes smaller, cramped and less legible
  • reduced body language.

 Strategies to improve communication 

There are some things that can make it easier to communicate. 

  • Have face to face interactions – communication is easier when we can see (lip reading, facial expression, body language) as well as hear.  
  • Reduce background noise –background noise can make it harder to hear someone with Parkinson’s. 
  • Avoid multitasking or distractions – doing two things at once, like talking and walking, can be hard for people with Parkinson’s.
  • Give the person with Parkinson’s time to respond – patience and understanding are essential.

How to get help 

The earlier you get help, the more effective it can be. 

A speech pathologist can assess your speech and swallowing. This will give you strategies you can use to communicate effectively and swallow safely.  

Some other ways to get help include: 

  • Parkinson’s speech therapy programs, which help you improve communication, participation, and quality of life through tailored, goal-orientated therapy
  • augmentative and alternative communication (AAC), which can help you if your speech becomes too difficult to use on its own
  • intensive speech therapy programs such as the Lee Silverman Voice Treatment (LSVT LOUD) or SPEAK OUT!, which teach you to speak more loudly and clearly
  • ParkinSong, which is a peer-support group offering vocal exercise, group singing and social connection though opportunities to converse with other people living with Parkinson’s. 

The main thing is to keep communicating in as many different ways and places as you can. 

If you avoid communication, you can lose confidence and skills. 

You should also have regular reviews, because Parkinson’s changes over time.  

Speak to your doctor about any concerns and ask for a referral.  

Find out more 

More information on Parkinson’s and supports can be found at the Fight Parkinson’s website:

This fact sheet was produced in collaboration with: