For day to day interactions, we use speech, writing, and gesturing as a way of expressing our needs and conveying our thoughts and feelings. Each of these functions requires adequate muscle strength and fine-tuned coordination of several different muscle groups.
Speech production involves primarily the muscles of the tongue, lips, palate, and vocal cords.
There is no set pattern by which muscle groups are affected. In this case, speech production becomes difficult even though the arms and legs may function normally. As a first symptom, the patient may only have involvement of the vocal cords. With dysphonia, the patient may sound hoarse and breathy and have difficulty increasing vocal intensity or with projecting the voice, making simple tasks such as ordering food in a restaurant difficult. The role of the SLP varies depending on the presenting symptoms seen in individual patients and the stage of the disease process.