Linguistic and social aspects of communication in Parkinson’s Disease.

Descriptions of speech characteristics and speech impairments in speakers with Parkinson’s disease are well advanced. Recent literature has also begun to describe the experience of Parkinson’s disease from the patient’s perspective and to analyse it from social as well as psychological viewpoints. A key finding is that in many cases the struggle to adapt to physical limitations including speech impairment leads to social withdrawal. The presence of primary PD is associated with deterioration in activity and social functioning which is marked by lowered likelihood of fulfilling certain social roles (e.g. paid employment) and increased likelihood of spending time in solitary activity (e.g. watching TV). This has been described as evidence of premature social ageing since the social profile of those with PD is that of more elderly groups in the general population. However, existing studies have relied on relatively simple measures of activity and social networks and have not explored relationships between other communication measures, such as motor speech functioning and intelligibility, and measures of social participation. This is an ongoing study which aims to investigate social aspects of communication in speakers with Parkinson’s disease of differing intelligibility and to understand relationships between measures of speech impairment and social participation. Possible outcomes of the study include informing and enhancing current assessment procedures for people with hypokinetic dysarthria in particular and motor speech disorders in general. The study uses a between subjects design to compare groups of mildly, moderately and severely speech-impaired speakers using measures of social network, social participation and social anxiety. Speech measures include the Frenchay Dysarthria Assessment (Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (Yorkston and Beukelman, 1981) and the Phonetic Intelligibility Test (Kent, Weismer et al, 1989). Social network size and density are measured using the convoy model (Antonucci and Akiyama, 1987), social activity using the Social Activities Checklist (SOCAT) (Cruice, 2001) and social anxiety using the Inventory of Interpersonal Situations (Van Dam Baagen and Kraaimaat, 1999). Participants are screened for physical functioning, depression, apathy and cognitive impairment. Preliminary results suggest no differences in measures of social participation and social anxiety between groups of speakers of differing severity of motor speech impairment. There are implications for the timing of speech and language therapy intervention for people with Parkinson’s disease as it would appear that social withdrawal may be quantified before speech impairments emerge