Freezing of gait is a common symptom for those with Parkinson's Disease (PD). When this occurs, you may feel like your feet are super glued to the floor when you are trying to walk. Over this past month, you have learned more about what freezing is, why it happens, and some strategies on how to get moving after a freeze. Today we will discuss another phenomenon of PD, which is freezing of speech.
The first speech/voice symptom typically noticed in PD is reduced volume, however as the disease progresses, some people may experience freezing of speech. This may include freezing of your speech muscles involved in articulation (i.e.,tongue, jaw, and lips), difficulty initiating speech/freezing of thought, hesitations when getting started, and/or sound/word repetitions. Research suggests that freezing of speech and repetitive speech disorders (speech dysfluencies) are associated with freezing of gait, and likely share the same pathophysiological mechanisms.
Unfortunately, freezing of speech does not usually improve with medical management (e.g., medications and/or DBS) and speech therapy programs for PD only indirectly target this symptom. However, there are some strategies that you can implement to try to reduce the negative effect this has on your quality of life and ability to effectively communicate.
Set yourself up for success by reducing external distractions when having conversations (e.g., turn off radio or television in the background, etc).
Focus on the conversation instead of attempting to multitask. Freezing is more likely to occur when cognitively challenged/overloaded. For example, find a nice place to sit instead of talking while walking.
Time social gatherings and phone calls around peak times of day, especially if you notice increased freezing during off periods.
Reduce overall stress, as increased stress can increase the frequency of freezing.
Advocate for yourself by asking family and friends to give you extra time to respond.
Use gestures and filler words to communicate that you have more to say, to prevent others from interrupting you before you have finished your thought.
Write scripts before making phone calls. This will help you organize your thoughts in advance, and the more you practice the script, the more automatic it will become. While on the phone, no one can see that you are reading, so you can use your finger to help you pace yourself.
In conversation, you can also try pacing yourself by tapping your finger like a metronome. This may help you move through a freeze.
Write a list of functional phrases that you use frequently throughout your day (as done in LSVT), and practice these daily.
If noticing increased freezing, try using shorter sentences/responses, as increased freezing is more likely to occur as the complexity increases. As a conversational partner, restructure your questions to yes/no questions, instead of requiring a more complex response.
Lastly, make sure you are checking in with your SLP regularly, to see if further skilled speech therapy is warranted.