Multiple sclerosis (MS) may cause problems with speech and communication because it affects various parts of the brain. A speech therapist can help identify specific speech issues and determine suitable treatment strategies.

Speaking is a complex process that involves the coordination of muscles, breathing, and hearing, all controlled by the brain. These processes occur in a fraction of a second, so people are unaware that they take place.

The brain identifies the language for what a person wants to say. It then sends the messages to the muscles that control speech, informing them how to form the correct words and sentences. As a person talks, the brain sends messages to the different muscles, producing volume, accent, tone, rhythm, and word precision.

MS damages the myelin sheath, a protective membrane that surrounds nerve cells and allows signals to travel efficiently between them. The damage changes how the signals, or nerve impulses, travel to and from the brain, disrupting typical body functioning and causing difficulties with speech and swallowing.

These difficulties may come and go. They may also be a symptom that occurs during MS relapses.

This article will discuss how MS affects communication and whether speech therapy can help. We will also examine what a person can expect during speech therapy and look at speech therapy exercises.

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Speech therapy can help people with MS manage speech disorders. Speech-language pathologists are trained in diagnostic and exercise-based techniques to diagnose speech, language, cognitive, and swallowing disorders.

Generally, speech-language pathologists work closely with doctors who specialize in the following areas to help support people with MS:

  • brain, spine, and nervous system conditions (neurologists)
  • ear, nose, and throat conditions (otolaryngologists)
  • physical medicine and rehabilitation

MS can affect speech in different ways. It may affect the physical aspects of speech production and the sound of the voice. It may also change a person’s understanding of language and the thought processes that help a person decide what to say.

MS may cause the following speech disorders.


Dysarthria occurs when a person has difficulty speaking due to weakness or impaired coordination in the muscles involved in speech. Areas of MS damage in the central nervous system prevent a person from fully controlling the parts of the body involved in speech, such as the:

  • lips
  • tongue
  • voice box (larynx)
  • soft palate
  • diaphragm
  • jaw

The lack of coordination of these body parts affects articulation, speaking rate, and the natural flow of speech. This can make it challenging for others to understand the person.


Dysphonia is an impairment of voice production. It may occur when MS affects the brain areas that control the larynx. It can affect a person’s ability to control volume and pitch. It may also cause a person’s voice to sound hoarse.

Cognitive-related speech difficulties

MS may result in changes in thinking and memory (cognitive difficulties). These difficulties may change how a person speaks and uses language and cause them to have trouble understanding concepts, putting together their thoughts, and thinking of words to use and how to express what they want to say.


Aphasia results from damage to the areas of the brain responsible for understanding and communicating language. It can affect people’s ability to express themselves and understand others. This condition is not common in MS, as demyelination is less likely to affect language areas of the brain.

People with aphasia may speak in short phrases or long sentences with no meaning. They may also find reading and writing challenging.

Learn more about the differences between aphasia and dysarthria.

People who are experiencing speech and communication difficulties resulting from MS can have an initial assessment with a speech-language pathologist to determine their needs and the most suitable treatment.

A speech-language pathologist develops an individual plan of speech therapy exercises to help with speech, language, and cognitive communication.

People with MS may also experience problems with swallowing (dysphagia). A speech-language pathologist can help a person improve dysphagia using the following strategies:

  • practicing safer eating and swallowing
  • making dietary changes
  • using exercises or stimulation

The type of speech therapy a person needs will depend on several factors, including their specific speech challenges and the severity of the speech disorder.

Pathologists use several types of speech therapy and techniques for MS, including:

  • oral motor exercises
  • dietary changes
  • specialized communication devices

A speech-language pathologist will determine the most suitable therapies for a person’s circumstances.

Goal of treatment

According to the American Speech-Language-Hearing Association, speech therapy for MS aims to meet goals such as:

  • slowing down speech
  • strengthening mouth muscles
  • moving the lips and tongue more
  • using more breath to speak louder
  • saying sounds in words and sentences clearly
  • developing other ways of communicating, such as using gestures, writing, or using technology

Learn more about speech therapy.

In addition to helping the person who is experiencing speech difficulties, a speech-language pathologist can help family and friends of the person learn different strategies to enable communication.

People with speech difficulties can try the following when communicating:

  • Start a conversation with one word before speaking in sentences. This lets the person listening know the conversation’s topic and helps them understand the rest of the sentence. For example, a person could say “breakfast” before discussing what they want to eat.
  • Frequently check with the listener that they understand.
  • Speak slowly and loudly with pauses to ensure that the other person can absorb the information and respond.
  • Try to avoid having long conversations when feeling tired. Speech can often be more challenging to understand when a person is tired.
  • Try writing, drawing, or pointing to communicate when having difficulty speaking.

To help a person with a speech disorder communicate their thoughts, individuals could try the following:

  • Give the person time to speak and respond.
  • Observe body language and gestures to aid communication.
  • Try not to finish their sentences.
  • Ask the person to write, point, or gesture if they are having trouble talking.
  • Let them make mistakes and try to do things for themselves. Help them when they ask for help.
  • Remove distractions, such as by turning off the TV, to help the person communicate and understand better.

To help a person with a language disorder understand, another person can do the following:

  • Get the person’s attention before talking.
  • Keep voice volume at a typical level. If the person needs others to speak louder, they will ask.
  • Use simple words without talking down to the person.
  • Use short sentences. Repeat key words that the person needs to understand.
  • Try using writing, pictures, and facial expressions. The person may sometimes understand these better than words.
  • Use “yes” and “no” questions for a straightforward conversation response.
  • Give choices when asking a question instead of asking an open-ended question.

MS can cause speech disorders such as:

  • dysarthria
  • dysphonia
  • cognitive-related speech difficulties
  • aphasia

People with speech and communication difficulties resulting from MS can have speech therapy sessions with a speech-language pathologist to help them manage their symptoms.

A speech-language pathologist will recommend communication strategies and develop speech therapy exercises that enable people to speak effectively with others. The techniques they recommend depend on an individual’s challenges and the severity of their speech disorder.