Motor speech impairments are quite typical in HD. Persons with HD have even
been accused of being drunk due to their sluggish speech articulation. A lack of motor coordination causes difficulties with
enunciation and the breath control underlying speech.
Impaired Initiation of Speech
Word finding is often impaired, while knowledge of vocabulary is retained, because it takes
the brain much longer to search and retrieve the desired object. Listeners sometimes fail to wait long enough for the brain
to do its job.
In addition to speed limitations, the brain fails to regulate the sequence and amount of
traveling information, resulting in impairments in starting and stopping.
When language initiation is compromised by HD, techniques such as phrasing questions with
alternate choice answers (e.g., yes or no; lasagna or spaghetti) may help someone get started or retrieve the desired response.
|Disorganization of Language Content
In contrast to the basic impairments in language output, the basic capacity to understand
language remains relatively intact in HD.
Even in later stages of the disease, language comprehension may remain when the ability
to speak is significantly diminished.
This fact is important to communicate to family members, staff at care facilities and other
professionals involved. Even if a patient cannot express herself, it is likely
that she can understand what is being said.
Difficulties with word usage are rare in persons with HD, as are frank aphasia or impairments
in semantic memory.
The trouble that occurs in persons with HD is an inability to organize the outgoing and
incoming language, resulting in mis-communication.
To aid the person with HD in organizing language output and input it is best to
rely on short simple sentences and to assess understanding frequently during important conversations.