Individuals with multiple sclerosis typically benefit from speech therapy throughout the progression of their disease for a variety of different reasons.
The general public often hears the term "speech therapy" and automatically says to themselves, "My speech is fine.
I don't need a speech therapist.
" This is because most people do not realize that a speech therapist/pathologist can also address problems with cognition and swallowing.
The incidence of cognitive dysfunction can be as high as 65% in patients with multiple sclerosis and may go unnoticed unless formal testing is done.
It is important to get baseline information regarding cognitive functioning as soon as a diagnosis is made.
It is equally important to track this information as the disease progresses so that appropriate interventions can be put into place as they are needed.
Treatment can involve medication, use of compensatory strategies to make up for deficits with memory and problem-solving, changes in the physical environment, and changes in caregiver approaches.
A speech therapist can help by completing initial assessments of cognition, providing feedback to physicians regarding effects of medication, and providing instruction in the use of compensatory strategies to make up for cognitive deficits.
A speech therapist may also educate caregivers about changes that they can make to their approaches and/or physical environment.
Cognitive changes can be caused by several factors.
Most often they occur because multiple sclerosis damages both myelin and the nerve cells.
This can impair a number of different brain functions:

• Processing of information
• Sequencing and problem-solving skills
• Planning and prioritizing activities
• Attention and concentration
• Abstract reasoning

Other factors that are related to multiple sclerosis (fatigue, depression, anxiety) can also contribute to diminished cognitive functioning.
Along with addressing cognitive issues, speech therapy can also help improve the communication skills of individuals with multiple sclerosis.
A variety of speech deficits may appear during the course of multiple sclerosis because speech is controlled in many different areas of the brain.
The most common speech production problems are as follows:

• Dysarthia - disturbed motor speech patterns accompanied by facial grimaces, head jerking, tremors, etc.
  
• Slurred speech - distorted speech as the result of weak and poorly coordinated lip and tongue movements
• Scanning speech - normal speech with long pauses between words or syllables

A speech therapist may also address swallowing problems, referred to as dysphagia.
Many of the same muscles involved in speech production are also involved in the process of swallowing.
Individuals with multiple sclerosis are more likely to experience dysphagia than the normal population.
This is caused by muscle weakness, poor coordination, poor breath support, and sometimes cognitive deficits.
Any signs and/or symptoms of dysphagia should be addressed immediately to prevent further complications.
During the progression of multiple sclerosis, a speech therapist may provide training in any or all of the following areas:

• Breath support for speech and eating
• Dysphagia (swallowing problems) and alternative means of nutrition
• Dysarthria (inability to produce clear speech)
• Dysphonia (inability to produce a strong and consistent voice)
• Cognition (orientation, problem-solving, etc.
  )
• Augmentative communication (alternative means of communication)
• Environmental adaptations
• Adaptations to caregiver approaches

It is important to involve a speech therapist shortly after diagnosis so that baseline information can be obtained.
This allows for prompt and comprehensive treatment throughout the course of the disease.