Communication Problems in Multiple Sclerosis: 9-Year Follow-Up

The speech of 18 individuals with a long history of multiple sclerosis (MS), assessed 9–10 years earlier, was reinvestigated. The individuals were also interviewed about their experiences of living with MS and how they have handled communication problems and symptoms in general. Findings were related to the degree of neurological deficit. The results showed that neurological deficits increased and certain speech parameters (sustained vowel phonation and speech rate) decreased significantly during this period. Speech intelligibility was not significantly changed (>90% at follow-up). Consequently, speech problems were generally mild. Nevertheless, analysis of the interviews showed that participation in communication and interpersonal relationships was affected by other disease-related (mobility, vision, cognition, and fatigue) and age-related problems. Strategies to reduce the effect of communication and disease-related problems were found to be active rather than adjustment or avoidance, both in specific situations and as an approach to life. In conclusion, the importance of a broader perspective on communication difficulties and a more individual approach to intervention should be emphasized, taking the patient's perceived barriers and self-generated strategies into account.