Acquired neurological disorders: a complete guide for speech therapists
Beyond post-stroke aphasia, many acquired neurological conditions can affect communication, language, speech, and swallowing. Neurodegenerative diseases, traumatic brain injuries, brain tumors: the speech therapist intervenes to assess, rehabilitate, or adapt care according to the progression of the disease.
🧠 Adult neurology resources
Communication tools, cognitive supports, adapted exercises
Access the tools →📋 Table of contents
Parkinson's disease
🔵 Characteristics
Neurodegenerative disease affecting the basal ganglia. Motor triad: resting tremor, rigidity, bradykinesia (slowness of movement).
Communication disorders
- Hypokinetic dysarthria: weak voice (hypophonia), monotone, arctic
- Prosody disorders: loss of melodic variations
- Fluency disorders: palilalia (repetition of syllables/words)
- Micrographia: writing that shrinks
- Dysphagia: common in advanced stages
Speech therapy management
- LSVT LOUD®: intensive method to increase vocal intensity
- Work on prosody and articulation
- Breathing and phonatory coordination exercises
- Monitoring and rehabilitation of swallowing
Amyotrophic Lateral Sclerosis (ALS)
🔴 Characteristics
Neurodegenerative disease of motor neurons, progressive and fatal. Progressive impairment of voluntary muscles including those of speech and swallowing.
Communication disorders
- Dysarthria: mixed (spastic + flaccid), progressive towards anarthria
- Dysphagia: early in bulbar forms, life-threatening
- Progressive loss of intelligibility
Management
- Palliative and adaptive approach: accompany the progressive loss
- Early implementation of AAC (alternative communication)
- Vocal banking: recording the voice for future speech synthesis
- Adaptation of food textures, swallowing guidance
Multiple Sclerosis (MS)
🟣 Characteristics
Autoimmune inflammatory disease of the central nervous system. Progresses in relapses or progressively. Variable impairments depending on the location of the lesions.
Possible disorders
- Dysarthria: often cerebellar or mixed, speech is scanned
- Cognitive disorders: attention, working memory, processing speed
- Dysphagia: in advanced forms
- Severe fatigue impacting communication
Traumatic brain injury
🟡 Characteristics
Brain injuries due to a shock: road accidents, falls, assaults. Variable impairments depending on severity and location.
Communication disorders
- Aphasia: if focal lesion in the left hemisphere
- Dysarthria: common, variable depending on lesions
- Cognitive-communicative disorders: disorganized speech, pragmatic difficulties, digressions
- Executive function disorders: impacting speech planning
Dementias and neurocognitive disorders
Alzheimer's disease
- Progressive word-finding difficulty (anomia)
- Speech impoverishment
- Comprehension disorders (advanced stages)
- Disorientation, memory disorders
Frontotemporal dementia
- Behavioral variant: disinhibition, apathy, pragmatic disorders
- Primary progressive aphasia: isolated and progressive language impairment
Role of the speech therapist
- Maintain communication abilities as long as possible
- Adapt the environment and train caregivers
- Offer suitable communication supports
- Cognitive stimulation adapted to the stage
Dysarthrias
Dysarthria is a motor speech disorder (and not a language disorder) due to a neurological impairment. It affects articulation, phonation, prosody, and/or breathing.
| Type | Location | Characteristics | Etiologies |
|---|---|---|---|
| Flaccid | Lower motor neuron | Breathy voice, nasal quality, weakness | ALS, myasthenia |
| Spastic | Upper motor neuron | Strangled voice, effort, slowness | Bilaterally stroke, MS |
| Ataxic | Cerebellum | Scanned, irregular speech | MS, TBI |
| Hypokinetic | Basal ganglia | Weak, monotone, fast voice | Parkinson's |
| Hyperkinetic | Basal ganglia | Involuntary movements | Chorea, dystonia |
Our downloadable tools
💬 Communication boards
For individuals who have lost the ability to speak.
Download🧠 Working memory games
Adapted cognitive stimulation.
Download📊 Texture chart
To adapt diet in case of dysphagia.
Download🌬️ Breathing exercises
For dysarthria and breath control.
DownloadFrequently asked questions
Yes, absolutely. Even if the disease progresses, speech therapy helps maintain abilities longer, compensate for deficits, adapt the environment, and preserve quality of life. The approach is adaptive rather than curative: accompany the evolution, anticipate needs (AAC), train the entourage.
Aphasia is a language disorder: the person has difficulty finding words, constructing sentences, and understanding. Dysarthria is a speech disorder: language is intact but motor execution is impaired (articulation, voice). A dysarthric person can write correctly what they cannot say.
🧠 Supporting neurological disorders
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