Speech pathology intervention for the HD patient

Speech pathologists can provide assessment and intervention in the areas of feeding, swallowing, motor speech disorders, e.g. loudness and articulation, and [for those in the early to middle stages of the disease], cognition. Feeding and swallowing evaluations can be done clinically, that is, by a thorough history taking, observation and evaluation of eating and drinking, then providing the individual with food and diet recommendations based upon these findings. A swallowing evaluation may be undertaken instrumentally, i.e., a videofluoroscopic swallow evaluation may be necessary for more finite determination of dysphagia including dysmotility and aspiration.

Counseling regarding proper and optimal nutrition is best done by a clinical nutritionist, but may also be addressed by the speech pathologist in an overview fashion in order to provide basic nutrition education. Discussion regarding alternate means of nutrition, i.e., feeding tubes, may also be undertaken at a point in time before such a measure is deemed necessary by the interdisciplinary team. Addressing this beforehand enables the patient and their family to make an informed, educated decision in a non-emergent manner. Motor speech disorders may be the focus of treatment if loudness, prosody, and articulation are disordered. 

Finally, cognition may be the focus of treatment for those in the early to middle stages of the illness. Addressing such issues as memory function, problem solving, judgement, abstract reasoning, or dealing hands-on with work-related issues may be beneficial in helping the individual with HD to continue to tackle activities of daily living and maintain their independence.

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