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How Does Motor Neurone Disease Affect Speech & Swallowing? 

Difficulty with speech and communication is an unfortunate reality for many people with Motor Neurone Disease. In the earlier stages, techniques such as speech pacing can help you improve your intelligibility (where appropriate). Advance planning is important as there may be a need to use alternative communication methods in the future e.g. a text to speech app on a tablet. 

MND can make it more difficult to swallow effectively and handle saliva in your mouth. Swallowing problems may start at a fairly early stage in the disease if you have the form of MND called Progressive Bulbar Palsy. Swallowing problems can also occur in other types of MND, but usually at a later stage.

Speech Pacing

Motor Neurone Disease can cause speech to become slurred and unclear. Learning to pace your speech and over-articulate words can help improve your speech intelligibility in the earlier stages of the condition.

Text to Speech Apps

If your speech intelligibility is deteriorating and it is becoming hard for you to make yourself understood, it may be time to begin using a text to speech app.  There are many excellent text to speech apps available.

While you may not wish to use a text to speech app at present, it often helps to choose one and get familiar with it before you need to start using it for communication. 

Voice Banking

There may come a time when you are no longer able to use your voice. It is therefore advisable to bank your voice for future use.


Voice banking is a process that allows you to record a set list of sentences with your own voice. The recording is then converted to create a synthetic voice. A banked voice (although synthetic) will sound like your natural voice although it won't be a perfect replica. The voice can later be imported into a text to speech app. There is no limit to the words, phrases and sentences that the text to speech can read aloud in the banked voice. In other words, what you type will be spoken aloud using the banked voice. 

Our voice is our identity. Therefore, people with Motor Neurone Disease who don't bank their voice and who need to use a text to speech app at a later stage often regret not doing so. 


Voice banking is ideally done at diagnosis when your voice quality and speech intelligibility have not changed very much. In the video below Helen talks about voice banking and encourages everyone who has been diagnosed with MND to bank their voice early. 


Message Banking

Message Banking is a process that enables you to record and save messages in your own voice. These recordings can later be imported into a text to speech app, providing a more personal communication experience for you and those you love.


You may wish to bank your laughter, words of affection, gratitude and praise, pet commands, or other common phrases that are unique to you. Message Banking requires only a short time commitment of a less than an hour. 















Expiratory Muscle Strength Training (EMST)

EMST is a treatment method that has been used to improve cough function and swallowing in Motor Neurone Disease.  


The ability to swallow food and drink safely can decline in Motor Neurone Disease. Due to the progressive nature of the disease, regular reviews are advised. 

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