Language

Tips and Tricks

We all rely on speaking and hearing speech throughout the day, both directly from friends, family and other people and also electronically through the TV and radio. People with MS talk about getting “words muddled up”, or that “words come out wrong”, or “I talk but my mouth won’t make the words”. It can be very disturbing to discover that your usually effortless communication has become less reliable. Difficulties can feel very public. However, the good news is that most people with MS do not experience major language difficulties. Language problems tend to be at the level of irritation and embarrassment, rather than a major handicap. They are much less obvious to those around you, than they are to you.

Everyone makes slips of the tongue and gets stuck for a word now and again. Don’t be over critical of yourself if this happens to you. The chances are that the people around you will not think that you have a particular problem.
If a word is on the tip of your tongue, don’t tense up or panic. Stress will make it harder to get it out. Instead, either use another word or words to say what you need to, if possible. If it is a specific name or place where another word won’t do, just say “I’ll come back to that”.
If you are going to a family party or work meeting, where you expect to find people’s names hard to remember, plan in advance. You could write the work people’s names on the agenda or a piece of card and refer to it just before the meeting (or during, if necessary). Before a family party, run through who will be there with someone else and rehearse the difficult names in advance. Your partner or spouse may be able to greet people first, using their name, to give you a cue.
If a person has a name that is easy to turn into a picture, you may find visualising them in a scene related to their name helps you remember. For example, Mr Smith could be imagined as a blacksmith hammering a horseshoe. This will link their face to the word “smith”. This approach can take a bit of practise, but some books describe it in detail.
If you need to speak to a group, for example at work or making a speech at a wedding, you will probably find it helpful to plan what you are going to say in advance and prepare prompt cards with bullet points. Even if you have been able to speak without notes in the past, it is an insurance policy to practise and prepare notes in advance. This will help overcome pauses and “drying up”.

Gadgets and Gizmos

These details are supplied for information only, not by way of endorsement. Items are usually available from several retailers and items are often made by several manufacturers. The MS Trust cannot guarantee that these items are available, or suitable for any individual and accepts no responsibility or liability with regard to their usage.

If you are an internet person information to support your language will be easily available to you. Most public libraries offer internet access. Recent devices such as Blackberries and Netbooks allow you to access the internet more or less anywhere, but at a price.

Chambers Dictionary Pocket electronic thesaurus and dictionary

Electronic dictionary (250,000 words) and thesaurus (215, 000 words), (9.5 cm x 6.5cm)

Also available with bigger screen Chambers Dictionary Easy Read

Electronic Encyclopedia Britannica pocket electronic reference library

Handheld electronic device includes 25,000 entries from Britannica concise encyclopedia, Concise Oxford English Dictionary (240,000 words, phrases, and definitions), Concise Oxford Thesaurus (over 4 million synonym links), Oxford Dictionary of Quotations, plus 130,000 word spellchecker and 10,000 entry abbreviation dictionaries.

Other Important Influences

If you are having trouble understanding what is said to you at times, it may be worth considering a hearing test
If you are finding it hard to speak clearly and be understood, it may be that you have slightly less control of the muscles that work your throat and mouth, which you use when you speak. It may be that your speech sounds slurred. This is called “dysarthria”. If you think that this may be a problem for you, it may be worth contacting a speech and language therapist.
We use breath to speak. If you are finding it hard to speak loudly enough to be heard, or you find that you need to breathe several times in a sentence, the muscles that control the breath you need for speech may not be working as well as they should. If you think that this may be a problem for you, it may be worth contacting a speech and language therapist.

Professional Help

There are many underlying reasons that can result in language difficulties. Your health professional will probably want to investigate exactly where the weaknesses are in your language, to develop effective management strategies with you.

It is likely that a speech and language therapist will be able to help you if:

there are motor or sensory impairments affecting your breathing, which makes clear or loud speaking difficult
you have weakness or poor co-ordination in the muscles of the mouth and throat, which may make your speech slurred or make it hard for people to understand your speech
a communication device is necessary

It is likely that a psychologist will be able to help you if you find it hard to:

turn your thoughts into speech
follow conversations

MS Trust Publications

Cognition Factsheet

This factsheet describes the range of cognitive problems that can occur with MS difficulties with short-term memory, concentration, verbal fluency - and discusses ways to approach managing the various problems.

Cognition problems chatroom Transcript

Transcript of an open forum chatroom where issues raised about cognitive problems are answered by health professionals. The views expressed by participants are not necessarily those of the MS Trust.

More general information about MS

MS explained

MS Explained is a book for anyone who wants to understand the mechanisms of MS and what is causes symptoms to occur.

It describes the immune system and the central nervous system and then explains how MS is thought to cause them to malfunction and the symptoms that result.

MS: what does it mean for me?

If you have recently been diagnosed with MS, you will almost certainly have a number of questions about how it will affect your life.

In our experience, one of the best ways of learning to adjust to your new circumstances is to have access to clear and accurate information. This booklet provides a practical introduction to MS to help you to maintain a positive attitude to managing your MS.

At work with MS

The book considers some of the ways in which MS might affect work, the protection afforded under the Disability Discrimination Act and what adjustments can be made for a successful working life with MS.

Tips for living With MS

A compilation of nearly 150 useful ideas sent in by people with MS. The book contains practical suggestions on saving time and energy, getting around, making the most of benefits and getting equipped and more. There is also an extensive section of contact details for useful organisations.

Living with fatigue

Fatigue is one of the commonest symptoms of MS and can have a major impact on daily life. Living With Fatigue was written in conjunction with an MS specialist occupational therapist and illustrated with comments by people with MS who know what it is like to live with the symptom.

Open Door

Quarterly newsletter that contains articles news and research relevant to people living with MS and their families.

Practical management of cognitive impairments associated with MS

Patrick Carroll, Clinical Specialist Occupational Therapist, Gosport War Memorial Hospital, Gosport Way Ahead 2004;8(2):4-5.

Involving Family and Friends

If you talk to your family and friends about your difficulties with words it is likely that they will not have noticed that you are experiencing anything unusual. They may well seek to reassure you that they have the same problems. In some ways this should reassure you, because it shows that your slips have not been noticed. However, if you feel that the slips and hitches in your language are occurring more than they should, you could let you family and friends know. You could tell them exactly the kind of problems you are having. You could give examples of when something was hard to say. If you find remembering peoples’ names hard, a family member of friend could help you on a social occasion. It may be that finding the right word has become a fairly frequent challenge for you. If so, you may wish to amend your work duties to reduce the number of presentations, for example. If your workmates understand what is happening, they are more able to help.

Research

Cognitive difficulties

The primary language disorders which are common in other conditions are very rare in MS.

Rehabilitation

There are no cognitive rehabilitation studies in MS that specifically address language difficulties.