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Early Stage Parkinson’s Disease PWPD & SLP

Early Stage Parkinson’s Disease PWPD & SLP. Brenda Warren, M.A.,CCC-SLP Speech-Language Pathologist UNC Hospitals Chapel Hill, NC. Four Main Areas of Focus. Swallowing ( Dysphagia ) Voice - Speech & Oral-Motor Function Communication (verbal & non-verbal)

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Early Stage Parkinson’s Disease PWPD & SLP

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  1. Early Stage Parkinson’s Disease PWPD & SLP Brenda Warren, M.A.,CCC-SLP Speech-Language Pathologist UNC Hospitals Chapel Hill, NC

  2. Four Main Areas of Focus • Swallowing (Dysphagia) • Voice - Speech & Oral-Motor Function • Communication (verbal & non-verbal) • Cognition (Attention, Memory, Verbal Fluency,Visuospatial Skills, Executive Function)

  3. Swallowing(Dysphagia) • 50% incidence rate • Generally emerges in later stages • Early indications • Nighttime drooling • Difficulty swallowing pills • Decreased saliva production(medications) • Sensation of food getting “stuck” • Reflux

  4. Quick Tips • Screening by SLP to obtain “baseline” • Nighttime Drooling • Elevate head slightly during sleep to restore gravitational pull • Use absorbent pillow case (terrycloth,etc.) to keep moisture away from face

  5. Quick Tips • Swallowing medications • Coat pills with olive oil • Tip head slightly forward • Sip water BEFORE attempting pill • Take with a thicker liquid or semi-liquid • Tomato juice, applesauce, etc.

  6. Voice-Speech & Oral-Motor Function • 75-85% incidence rate over course of disease • Often an early symptom related to PD • Decreases in • Volume • Intonation (prosody) • Clarity (articulation) • Increases in • Rate (hypokineticdysarthria)

  7. Quick Tips • Screening by SLP • Amplication Device • Lee Silverman Voice Training (LSVT) • Yacker Tracker or other objective feedback device • Be sensitive to feedback from spouse, family, friends, and colleagues • Phone • Noisy background *Consider hearing testing for both PD pt. and partner

  8. Communication(verbal & non-verbal) • Frequently these symptoms emerge subtly in the early stages of PD and may increase in later stages • Difficulty with word finding • Masked face • Reduced eye-blink

  9. Quick Tips • Screening by SLP • Keep distractions to a minimum during conversation; give your full attention • Intentionally use words to describe your feelings rather than relying on facial expression • Alert your conversational partner to the fact that you are aware that your face is sending an “uninterested” signal

  10. Cognition • 40-60% incidence rate of impairment in at least 3 domains of cognitive function (not dementia) • Attention • Executive function • Visuospatial skills • Verbal fluency • Free recall • Personality change

  11. Quick Tips • Talk with MD/neurologist-referral for neuropsychological evaluation • Baseline data • Recommendations • SLP for cognitive-linguistic therapy • Compensatory strategies

  12. Questions

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