Internet Advice: Swallowing and Voice in PD

Girl screaming at boy

I know I’ve offered A Word of Caution already. At the risk of crossing a line into annoying, I’m going to say this just one more time: be careful with advice from people on the Internet! Some are qualified to give it; others could inadvertently cause you harm. Online advice regarding voice and swallowing disorders is a topic that is currently of great concern to me as a Speech-Language Pathologist. Both voice production and safe swallowing functions rely upon healthy function/vibration of the vocal folds (cords).

A few facts:

The vocal cords…trendy singer
…primarily function as protection of the airway during the swallow.
…are prone to bowing in people with Parkinson’s Disease.
…do not close completely when bowing is present, increasing the risk of food/drink/saliva entering the airway.
…require adequate breath support to vibrate efficiently — and generalized weakness/fatigue/decreasing activity in PD contributes to reduced breath support.
…may be damaged or existing damage exacerbated by some of the hyperfunctional vocal techniques I have recently seen recommended for people with Parkinson’s. For example, there is a good LOUD and a bad LOUD. LSVT LOUD is good because you are trained by certified Speech-Language Pathologists to produce a good quality, relaxed voice at a normal loudness. LSVT LOUD has a strong body of evidence supporting it. BAD loudness is produced in the presence of excessive tension and may cause the development of vocal nodules or other pathologies. These pathologies interfere with closure of the vocal folds during vibration and swallowing.

Swallowing…Businesswoman drinking a cocktail
…is dependent upon the integrity of the oral, pharyngeal (throat), and laryngeal (voice box) system and reflexes as well as coordination with the respiratory system.
…problems may place the person with PD at risk of developing aspiration pneumonia, which is no fun at best and life threatening at worst.
…is assessed and treated by Speech-Language Pathologists who have received extensive education, training, experience, and in some cases advanced certifications in dysphagia management.

This is the proverbial tip of the iceberg! Voice and swallowing functions are complex! Again, please be cautious about following advice from people on the Internet. I have no doubt that they mean well, but voice and swallowing disorders require the services of people who are educated, trained, experienced, and credentialed in their management.

Container of soap


Cynthia Williams Bowen, MS, CCC-SLP owns Bowen Speech-Language Therapy, LLC in Clearwater, FL. Cyndee provides quality, creative, collaborative treatment to adults and adolescents with communication, swallowing, Parkinson’s, and related disorders.

2 thoughts on “Internet Advice: Swallowing and Voice in PD

  1. You’re so interesting! I don’t believe I’ve read through anything like
    this before. So nice to find somebody with genuine thoughts on this subject.

    Really.. thank you for starting this up.

    This site is one thing that’s needed on the web, someone with
    some originality!

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