Path to Dysphagia Diagnosis
  • Carinda Stout, MS CCC/SLP

May is Huntington’s Disease Awareness Month

Huntington’s disease (HD) is a brain disorder in which there is progressive neurodegeneration leading to motor, cognitive, and psychiatric symptoms. Problems may develop in the following three areas: motor control (movement); cognition (thinking); and behavior often causing speech difficulties and swallowing problems. Dysphagia (difficulty or discomfort in swallowing) is a common symptom in HD. The automatic coordination of bringing food to the mouth, chewing, forming a bolus and swallowing, while simultaneously inhibiting breathing, breaks down. Food may spill from the mouth. People with HD may inadequately chew foods, and commonly add more mouthfuls of food before swallowing. Poor coordination may lead to frequent choking on liquids and on solid food.


The automatic coordination of bringing food to the mouth, chewing, forming a bolus and swallowing, while simultaneously inhibiting breathing, breaks down.


Communication problems in Huntington's Disease may include:

  • Slurred, imprecise or slower speech

  • Low volume or weak voice due to respiratory problems

  • Difficulty with resonance and pitch control

  • The appearance of speaking through the nose

  • Abnormally long pauses between words or syllables of words – this is called ‘scanned speech’

  • Dysarthia, in which the capability to understand, remember words, and construct sentences is not lost but the ability to speak clearly becomes affected

  • Aphasia, in which there is a lack of understanding of what is being said and an inability to recall the vocabulary and grammar necessary to build a sentence and the annoyance of losing a word mid-sentence

Early intervention and involvement with a speech-language pathologist can help preserve and maintain the person’s highest level of communication and swallowing for as long as possible. As the disease progresses speech and language therapy for Huntington’s disease focuses on using compensatory strategies for loss of function in communication and swallowing.