There are several causes of speech, language and swallow problems that would cause an adult to seek a speech-language pathologist. They include, but are not limited to the following:

Diseases that affect the brain may include Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, Huntington’s disease, or Lou Gehrig’s disease (ALS) are often non reversible. Fortunately there are compensatory strategies, methods, and exercises that can help slow down the rapid progression of disease along with improving the execution of daily activities and the quality of life. Disease of the brain can lead to problems with memory, reasoning, attention, weaknesses of the speech musculature, swallowing, and voice.

Traumatic Brain Injury/ Head injuries TBI(s) can be caused by insult to the brain from an accident (closed head injury) or external injury such as a gun shot wound (open head injury). TBIs can contribute to cognitive (thinking) communication disorders. Cognitive Communication Disorders affect the ability to use the executive portion of the brain that is responsible for reasoning, problem solving, judgment, attention, word finding, and explaining/ expressing ideas. Cognitive communication disorders may also cause difficulty with spelling, writing, and reading.

Along with the personality changes that may occur in a patient suffering from TBI, social communication may also be severely impacted. This can be very detrimental to the familial relationships established prior to the accident. Social communication includes turn taking during conversation, tone, sarcasm, appropriateness, maintaining a conversational topic, and picking up on the nonverbal language of their communication partner. (


Breathing Problems

Adults who suffer from COPD, CHF, ALS, Parkinson’s disease, and other diseases that contribute to breathing problems can have difficulty swallowing and communicating. If a person is unable to properly coordinate breathing patterns for appropriate air transfer, particle have a chance of going towards the airway when they swallow. This happens because during the trigger of a swallow, a person has to hold their breath to close off the airway. Inadequate breath support may prevent this necessary airway closure which may result in choking or aspiration.
Breathing problems will also affect one’s ability to vocalize with appropriate volume, rate, and clarity. As one’s muscles for breathing weaken, so does their ability to phonate appropriately for conversation.

Stroke happens when there is a blockage of blood vessels or bleeding in the brain. Some things that can trigger strokes are high blood pressure, diabetes, and aneurysms. A wide range of speech and swallowing disorders can result from stroke depending on the location of bleeding or blockage. These disorders include aphasia, dysphagia, dysarthria, and voice disorders. (

Cancer of the head and Neck
Cancer of the neck can negatively affect a person’s voice. If neck or throat cancer is detected, parts of the larynx may be removed to prevent the spread of cancerous cells. In the event that surgery, radiation or chemotherapy does not effectively treat the cancer, a total laryngectomy (removal of the larynx) may be the only solution. Voicing cannot occur without a larynx. To initiate speech production, a new voice has to be constructed. Options include learning esophageal speech, using an artificial larynx, or having a tracheoesophaeal puncture (TEP) to shape sound from the esophagus.


Patients who undergo radiation treatment may also have problems with triggering a swallow, dry mouth, breathing difficulties, and decreased taste, which can cause dysphagia.

Voice Problems

Everyone has times when his or her voice has failed in one way or another. It may have been from excessive talking, colds, allergies, or cheering. When the problem lingers, there may be a true disorder that needs to be examined by an Ear Nose, and Throat (ENT) Doctor. There are a number of different types of voice disorders:
◾Vocal cord nodules are cause by repeated abuse to the vocal cords. Nodules can be described as callous-like growths on the vocal cords. Polyps are sometimes cause by vocal abuse as well, but they are more similar to blisters. Some signs and symptoms of vocal chord growths are hoarseness, breathiness, harshness, neck pain, a “lump in the throat” sensation, decreased pitch range, and a “scratchy” voice.
◾Vocal cord paralysis occurs when one (unilateral) or both (bilateral) cords have little or no movement. Since the cords are not coming together appropriately, there are a number of signs and symptoms of a person with paralysis of the vocal cords may experience. They can include:
◾Breathy voice
◾Inability to speak loudly
◾Choking or coughing while eating,
◾Inability to sustain voice
◾Paradoxical vocal fold movement (PVFM) occurs when the vocal cords close when they should be open. This disorder produces a wheezing sound when vocalization should occur. It can often be mistaken for asthma since it presents with difficulty breathing. Diagnosis of PVFM is difficult because it happens without warning. People with PVFM have normal voice almost all of the time except when an episode occurs.
◾Spasmodic Dysphonia is when the vocal cords are forced and strained which causes a jerky, hoarse, tight, or groaning voice. The vocal cords have spasms, or periods of no sound, hindering the forward movement of speech.