Supporting Communication for Adults with Functional Neurological Disorder (FND): The Role of Speech Pathology

Functional Neurological Disorder (FND) is a complex and often misunderstood condition where individuals experience neurological symptoms, such as motor or sensory dysfunction, that cannot be explained by structural or organic damage to the nervous system. These symptoms are real and can significantly impact a person’s quality of life, including their ability to communicate effectively. Speech pathologists play a vital role in supporting people with FND by addressing the communication challenges associated with the disorder.

In this blog post, we’ll explore how speech pathology services can benefit adults with FND and provide five practical communication tips for individuals living with this condition.

What is Functional Neurological Disorder?

FND is characterised by a range of symptoms that affect the body’s movement and sensory functions. Common symptoms include tremors, gait disturbances, weakness, seizures (non-epileptic), and speech or swallowing difficulties. Speech-related symptoms may include:

Dysarthria: Slurred or slow speech due to weak or uncoordinated muscles.

Aphonia: Loss of voice or an inability to produce sound.

Stuttering or disfluencies: Irregular speech patterns that disrupt communication.

Cognitive-communication difficulties: Challenges with processing, organising, or expressing thoughts.

These symptoms can fluctuate, and they are not caused by structural damage but rather by a disconnect in the way the brain processes and executes functions. This makes managing FND uniquely challenging.

How Can Speech Pathologists Support People with FND?

Speech pathologists are trained to assess, diagnose, and treat communication and swallowing difficulties. For individuals with FND, speech pathology services focus on:

1. Understanding Individual Needs: Speech pathologists work closely with clients to understand how FND affects their communication and swallowing. They consider the person’s specific symptoms, triggers, and lifestyle.

2. Improving Functional Communication: Therapy may involve teaching strategies to overcome barriers to effective communication, such as breathing techniques, pacing strategies, and tools to reduce vocal strain.

3. Building Confidence: FND can cause significant anxiety, particularly when symptoms fluctuate. Speech pathologists provide a supportive environment to help clients rebuild confidence in their communication abilities.

4. Collaborating with a Multidisciplinary Team: Managing FND often requires input from neurologists, psychologists, occupational therapists, and physiotherapists. Speech pathologists are key members of this team, ensuring that communication and swallowing concerns are addressed comprehensively.

5. Addressing Swallowing Issues: Dysphagia (swallowing difficulties) can accompany FND, posing risks for nutrition, hydration, and safety. Speech pathologists assess swallowing and develop tailored management plans.

Communication Challenges in FND

Communication difficulties can affect social interactions, work, and overall quality of life. Common challenges faced by individuals with FND include:

- Sudden loss of voice or speech.

- Difficulty finding words or forming sentences.

- Fatigue impacting speech clarity and volume.

- Increased stress or anxiety worsening symptoms.

- Misunderstanding or stigma due to the fluctuating nature of FND.

Speech pathology interventions are designed to address these challenges, equipping individuals with tools to manage symptoms and communicate effectively in daily life.

5 Tips for Communication for People with FND

If you or someone you know is living with FND, these tips can support effective communication:

1. Pace Yourself

FND symptoms, including those affecting speech, can be exacerbated by fatigue or stress. To maintain clear communication:

- Break tasks or conversations into smaller, manageable chunks.

- Take regular pauses during speaking to avoid vocal strain.

- Use relaxation techniques, such as diaphragmatic breathing, to stay calm.

2. Utilise Visual and Written Aids

When speech is affected, having alternative communication tools can be invaluable. Consider:

- Carrying a small notepad or smartphone for writing down key messages.

- Using apps designed for text-to-speech communication.

- Creating flashcards with commonly used phrases or requests.

3. Be Open About Your Condition

Educate friends, family, and colleagues about FND and how it affects your communication.

Let them know:

- Symptoms can vary day-to-day.

- They may need to adjust their communication style (e.g., speaking slower, allowing extra time for responses).

- Their patience and understanding make a big difference.

4. Practice Grounding Techniques

When stress or anxiety heightens symptoms, grounding exercises can help bring focus and control back to communication. Try:

- The 5-4-3-2-1 technique (identify five things you see, four you can touch, three you hear, two you smell, and one you taste).

- Mindfulness exercises to calm the mind and body.

- Pausing and taking deep breaths before speaking.

5. Work with a Speech Pathologist

A tailored therapy plan from a speech pathologist can address your unique needs. They can:

- Teach specific strategies for managing symptoms.

- Provide exercises to improve speech clarity and coordination.

- Offer tools to boost confidence in communication, even during challenging times.

The Role of Advocacy and Awareness

FND is a complex condition that often comes with misunderstanding or stigma, especially when symptoms appear inconsistent or without a clear medical explanation. Speech pathologists not only provide therapy but also advocate for individuals with FND, helping to raise awareness and foster empathy among healthcare providers, families, and the broader community.

By increasing awareness of FND and its impact on communication, we can create a more supportive environment for those living with this condition. This includes encouraging workplaces, schools, and social groups to accommodate fluctuating symptoms and recognising the need for flexibility and understanding.

Functional Neurological Disorder can significantly impact communication, but speech pathology offers hope and practical support. By addressing communication challenges, building coping strategies, and collaborating with other healthcare professionals, speech pathologists empower individuals with FND to regain control of their communication and improve their quality of life.

If you or someone you know is living with FND and experiencing communication difficulties, consider reaching out to a speech pathologist. Together, you can develop a plan to navigate the challenges and make communication more effective and less stressful.

For more information about speech pathology services and how they can support individuals with FND, feel free to get in touch with our team. We’re here to help!