Speech and Swallowing in PD

People with Parkinson’s (PD) may notice changes in or difficulty chewing, eating, speaking or swallowing. These changes are more likely, and tend to worsen, as PD progresses and the muscles in the face, mouth and throat that are used in speaking and swallowing are affected.  Here are some resources to understand speech and swallowing issues in PD, how speech-language pathologists determine the extent of the changes, and what can be done to compensate or make swallowing safer to prevent aspiration.

Downloadable Documents | Online Articles | Podcasts & Webinars

Downloadable Documents (PDF)

Eating, Swallowing and Saliva Control in Parkinson's

Published by Parkinson's UK, 2013

This six-page information sheet (PDF) explains difficulties associated with eating and swallowing, as well as producing too much or too little saliva. Information and tips for family and friends are shared.

Make Your Voice Heard! Healthy Communication and Parkinson's Disease

Published by the American Parkinson Disease Association, 2019

This 17-page booklet (PDF) describes changes to the voice, speech, facial expression, and cognition due to Parkinson's disease, along with treatment options and things you can do right now to compensate for these changes.

Speech and Swallowing, a Body Guide to Parkinson's Disease

By Marjorie L. Johnson MA/CCC-SLP.  Published by the Parkinson's Foundation, 2019

This 48-page booklet (PDF) describes speech, swallowing, memory and thinking changes in PD as well as the anatomy of speech production and swallowing, swallowing challenges and getting the help you need.
En Español: Enfermedad de Parkinson: Dificultades con el Habla y la Deglución (tragar)

Speaking Effectively, A Strategic Guide For Speaking and Swallowing

Published by American Parkinson Disease Association, 2010

Booklet (PDF) includes self-evaluations and caregiver surveys to determine at what point professional help is needed. Professional examinations are described along with recommendations for both home and professional intervention to improve speech, make eating easier and safer, and reduce drooling. Maintaining communication to reduce isolation is encouraged.

Speech and Communication Problems in Parkinson's

Published by Parkinson's UK, 2019

A 9-page information sheet (PDF) looks at what difficulties you may have, what causes them and what you can do to manage them.

Speech and Language Therapy and Parkinson's

Published by Parkinson's UK, 2013

Short information sheet (PDF) looks at what difficulties associated with speech and communication, and how speech and language therapy can help.

Understanding Drooling in Parkinson's Disease

Published by American Parkinson Disease Association, March 2022

This 2-page fact sheet (PDF) provides a brief overview of sialorrhea (drooling) as a non-motor symptom of PD. It also offers solutions to drooling, including non-pharmacological and oral medication treatment options, and information about botulinum toxin injections.

What is Dysphagia?

Published by American Parkinson Disease Association, 2011

This educational supplement (PDF) describes the normal swallowing process. It offers seven swallowing exercises and a list of five other considerations that help with swallowing.

Online Articles

5 Speech Therapy Tools to to Improve Speech in Parkinson's Disease

Published by Aptus Speech Therapy, March 15, 2019

This list suggests five tools that may help some people with PD communicate when remediation therapy is insufficient or unsuccessful.

9 Ways to Improve Speech in Parkinson's Disease

By Megan S. Sutton, MS, CCC-SLP.  Published by Tactus Therapy

This short list includes four methods of remediation (addressing the underlying problem), three methods of compensation (tools to offset the problem), and two methods of participation (living life despite the problem).

10 Tips for Managing Drooling in Parkinson’s

By Maria De León, MD.  Published by defeatparkinsons.com, July 31, 2014

Sailorrhea, or drooling, refers to pooling of saliva in the mouth.  It occurs in around 50-80% of all Parkinson’s patients, particularly men.  This blog post explains the cause, risk of aspiration, anxiety, and social embarrassment, with 10 helpful tips & treatment options to help with this pesky problem.


Published by the Parkinson's Foundation

Excessive drooling, called sialorrhea, is a common non-motor symptom of PD and can cause awkwardness in social situations. Counterintuitively, the amount of saliva your body produces is usually normal, but swallowing issues – swallowing less often or not completely – lead to saliva pooling in the mouth. This page discusses both pharmaceutical and non-pharmaceutical options to manage drooling.

The IDDSI Framework

Published by the International Dysphagia Diet Standardization Initiative

The IDDSI framework consists of a continuum of 8 levels (0 - 7), where drinks are measured from Levels 0 – 4, while foods are measured from Levels 3 – 7, providing common terminology to describe food textures and drink thickness. IDDSI Testing Methods are intended to confirm the flow or textural characteristics of a particular product. These pages outline the IDDSI framework with detailed definitions as well as testing methods to determine where specific food and drinks fall on the IDDSI framework.

Let's Talk About Talking with Parkinson's Disease

Published by the American Parkinson Disease Association

In this short interview with a speech-language pathologist (SLP), the interviewer asks about common reasons someone with PD will see an SLP, what signs indicate it is time to see an SLP, what a typical SLP therapy session involves, reasons someone with mild PD symptoms may benefit from seeing and SLP, and thoughts about singing and choir programs for PD. There are tips for having a conversation in a loud room, and more tips and takeaways.

Oral Dysfunction in Parkinson's Disease: Swallowing Problems and Drooling

Published by American Parkinson Disease Association

This blog post explains the complexities of swallowing, why swallowing is affected by PD, and signs that may indicate someone with PD has difficulty swallowing. It also provides an overview of the two main types of swallowing evaluations and what can be done if a swallowing issue is found. Drooling is also briefly discussed, including solutions. 

Speech and Swallowing Problems

Published by National Parkinson Foundation (Now the Parkinson's Foundation)

Webpage with self-assessments to determine if professional evaluation is needed for speech or voice and swallowing problems. Additioinal links to information on treatment for speech problems and a stronger voice.

Saliva Control

Published by the MSA Trust, April 2016

This 4-page fact sheet is aimed at those experiencing difficulties with saliva control.  It provides information about the possible problems and advises on what can be done to manage these symptoms.  MSA is a form of parkinsonism, sometimes referred to as ‘Parkinson’s Plus.’  It shares many gait, balance, and non-motor symptoms, like sailorrhea (drooling).


Published by What-When-How, In Depth Tutorials and Information

This short webpage explains the typical sequence of movements that transport food and liquids from the mouth to the stomach.  PD often affects the function of these muscles,  causing swallowing problems or drooling.  Significant swallowing problems can be life threatening.  Speech-language pathology can help a person improve control of these muscles.

Podcasts & Webinars

Building Stronger Caregiving Partnerships Through Better Communication

By the Parkinson’s Foundation, December 1, 2018

In this one-hour talk, the speaker explains that diminished communication significantly impacts the social, emotional and physical burdens of caregiving.  The fourth speaker at the Parkinson’s Foundation Caregiver Summit, Angela Roberts, PhD, explains how changes in speech, cognition and hearing due to Parkinson’s disease (and normal aging) affects communication. She then offers specific strategies for optimizing communication. 
Presenter's slides   

Communication Strategies for Optimal Success

By the Parkinson’s Foundation, September 17, 2019

In this 1-hour webinar speech language pathologist Angela Roberts reviews the changes in speech, facial expressions, cognition, voice and hearing caused by PD (and aging) that can interfere with communication and meaningful connection with others.  These changes impact the social, emotional, physical and practical aspects of living with PD.  Communication strategies for optimizing successful conversation are shared.  Registration is required, but it is free.

Davis Phinney and Kelsey Phinney Practice Vocal Exercises for Parkinson's

By the Davis Phinney Foundation, April 15, 2020

In this 23-minute episode of The Parkinson's Podcast, Davis Phinney and his daughter and podcast host, Kelsey Phinney, practice and explain some vocal warmup exercises before Davis sings a few pop songs.  Davis's voice gets louder and clearer over the course of the session and is a good demonstration of the benefit of speech therapy and daily practice of speech exercises, including singing, for those with Parkinson's.

Down the Hatch

By Ianessa Humbert, PhD, and Alicia Vose, PhD

Down the Hatch (The Swallowing Podcast) hosted by Ianessa Humbert, Ph.D. and Alicia Vose Ph.D - two SLPs who love to gab about swallowing, started in 2016 and has more than 43 tracks available free on SoundCloud, Apple, and other platforms.

How Does Speech Therapy Help in Parkinson's Patients

By National Parkinson Foundation (Now the Parkinson's Foundation), August 2009

Four-minute video features Michael S. Okun, MD.

Language Impairment In Parkinson's Disease

By Parkinsons Society British Columbia, September 21, 2021

In this 1-hour webinar, speech language pathologist Jamie Russell discusses communication and swallowing challenges common in people with Parkinson's,  general interventions and self-management strategies for patients and caregivers, strategies for working through difficulties such as following complex commands, word retrieval, and organizing thought in conversation, as well as general swallowing strategies.
Webinar Notes on the Stanford PD Community Blog

Managing Swallowing Changes in PSP, CBD, and MSA

By CurePSP, June 27, 2022

In this one hour and fifteen-minute webinar speech language pathologist Julie Hicks has just one slide specific to PSP, CBD, and MSA.  The rest of her presentation provides general information about working with a SLP, what swallowing evaluation looks like, and what treatment might involve. In the question-and-answer time Julie talks about when to see an SLP, the use of feeding tubes, practical tips families can use to help people slow down and control impulsivity while eating, and how to find an SLP with experience treating those with parkinsonism disorders.
Webinar Notes on the Brain Support Network Blog

Movement & Speech

By the American Parkinson Disease Association, March 25, 2021

This 44-minute webinar is part of the series Let's Keep Moving With APDA. Speech-language pathology (SLP) services have been proven to be effective in improving functional, everyday communication.  Lisa Sommers, SLP, describes the sometimes subtle changes in breath support, voice production, speed and accuracy, inflection of voice, facial expressions and swallowing before explaining what to expect from SLP evaluation and treatment.
Webinar Notes on the Stanford PD Community Blog

My Parkinson's Story: Speech and Swallowing

By the Veteran's Administration

This 8-minute video alternates between an interview with a man and his wife and healthcare professionals. The man and his wife share how Parkinson's has affected his speech and swallowing. The healthcare professionals explain how Parkinson's affects speech and swallowing. Speech therapy can improve speech volume and enunciation as well as swallowing control and drooling. They also advise specific changes to eating habits and avoiding some types of foods to prevent choking.

Parkinson's and Speech

By PMD Alliance, December 11, 2020

In this very informative hour CCC-SLP, Nicole Herndon, spoke about why speech changes occur in PD as well as treatment options and strategies for both the speaker and listener to improve communication.

Patient Videos

By Ianessa Humbert, PhD

Dr. Humbert has created a free collection of eight very short, informative videos to help viewers understand normal swallowing, swallowing in older adults, aspiration, and residue, as well as how clinical swallowing evaluations, modified barium swallowing studies, and fiberoptic endoscopic evaluation of swallowing are done.  The last very short video is an overview of the types of swallowing therapies available with a focus on those offered by speech language pathologists.  

Saliva and Swallowing Challenges

By Parkinson Canada, December 16, 2021

In this 1-hour webinar Ianessa Humbert, PhD, discusses the normal swallowing changes that occur with aging, how swallowing issues are assessed, what happens when food goes the wrong way, and swallowing treatment options.  She also briefly talks about drooling and dry mouth assessment and treatments.

Swallowing and Saliva Management

By Parkinson Society British Columbia, February 4, 2020

This one-hour talk is in three parts.  What a speech language pathologist (SLP) is, how they can help someone with PD.  Why you should be concerned about swallowing problems, some indications you may have a swallowing issue, what a swallowing assessment by an SLP might look like, and recommendations an SLP might make to improve swallowing.  And, why you should be concerned about having either too much or too little saliva and how to manage either situation.

What is Aspiration?

By the Davis Phinney Foundation, August 17, 2018

This six-minute video uses slow motion animation to demonstrate how the body’s anatomy contributes to both normal swallowing and aspiration of material into the airway.

What Types of Tests and Techniques are there for Swallowing Problems?

By the National Parkinson Foundation (Now the Parkinson's Foundation)

Four-minute video features Michael S. Okun, MD.

Last updated November 2022 by Stanford Parkinson's Community Outreach.