How Huntington’s Disease Affects Communication & How Can We Help?

2025-07-31 / by Avivit Ben-Aharon • 4 min read

What is Huntington's Disease

Huntington’s disease (HD) is a progressive brain disorder. It is caused by a faulty gene on chromosome 4 that results in changes to the central area of the brain, affecting a person’s physical, mental, and emotional abilities.

Unfortunately, Huntington’s disease does not have a cure at this time. Typically, people start to develop symptoms of HD between the ages of 30 to 50; however, juvenile and late-onset forms also exist.

Huntington’s disease is known as a family disease because every child of a parent with this disease has a 50% chance of inheriting the faulty gene that causes it. Today, there are approximately 41,000 symptomatic Americans and more than 200,000 at-risk of inheriting the disease.

How does Huntington's affect speech?

The deterioration caused by Huntington’s disease affects both the cognitive and motor systems required for communication. As the disease progresses, people with this disease may experience the following speech problems:

Aphasia - a disorder that results from damage to areas of the brain that are responsible for language. Aphasia impairs the expression and understanding of language, reading, and writing.
Apraxia of Speech - Difficulty planning and coordinating the movements required for speech, despite intact muscle strength.
Cognitive-communication disorder - Problems with memory, attention, organization, and problem-solving that affect the use and understanding of language.
Dysarthria - a motor speech disorder that occurs when muscles used for speech are weak. This results in speech that sounds slurred, hoarse, choppy, or robotic.
Dysphagia - Difficulty swallowing, which can compromise communication, eating, and overall safety.

All of these issues can lead to speech being hard to understand. This not only impairs the individual’s day-to-day communication but also can lead to social isolation, emotional distress, as well as increased dependence on caregivers.

Symptoms of Early Huntington’s Disease

In the early stages of Huntington’s disease, physical and cognitive changes are often subtle, but they may already impact communication. Recognizing these early signs is essential for early intervention.

Physical and behavioral symptoms of early Huntington’s disease:

Mild chorea (involuntary movements)
Subtle problems with coordination
Slight changes in handwriting
Mild depression, irritability, or anxiety
Difficulty concentrating or completing tasks

Speech symptoms of early Huntington’s disease:

Mild articulation difficulties: Speech may sound less precise or less fluid.
Changes in vocal quality: The voice may become softer or lose its usual variation in pitch.
Word-finding issues: The individual may struggle with word retrieval.
Pauses and hesitations: Sentence flow may be interrupted by pauses and hesitations.
Reduced speech rate: Individuals may speak more slowly and deliberately than usual.

While these symptoms may appear minor at first, they can have a negative effect on self-esteem and social participation. Unfortunately, individuals may not always recognize these changes themselves, making caregiver observations incredibly important.

Stages of Huntington’s Disease and Their Impact on Communication

Understanding how communication abilities change during the various stages of Huntington’s disease is critical in helping families, caregivers, and professionals tailor support to suit their needs.

Early Stage

In the early stages of HD, there may be signs of mild dysarthria, reduced speech fluency, as well as mild cognitive impairments. Individuals may also start to show early signs of swallowing struggles, such as coughing while eating.

Middle Stage

In the middle stages of HD, speech becomes harder to understand. It may be slower and take a lot more effort than usual for the individual to talk. Their cognitive decline may also affect their ability to communicate effectively. Swallowing will become more difficult, and the risk of choking and aspiration increases. Modifications to their diet are often needed.

Late Stage

During the late stages of HD, verbal communication may be severely limited or completely lost. Individuals may rely on alternative ways to communicate (communication tools, gestures, etc). Swallowing becomes more difficult, and sometimes, feeding tubes are required.

The Role of Speech Therapy in Huntington’s Disease

Speech therapy is an important resource during the various stages of Huntington’s disease.

The goals of speech therapy may include

Preserving communication skills for as long as possible
Educating on tools to deal with speech and cognitive difficulties
Ensuring safe swallowing
Supporting and educating caregivers in managing communication and swallowing challenges
Improving the quality of life for the individual with HD as well as their caregivers

Since HD affects everyone differently, the course of treatment will vary from patient to patient. Possible speech therapy techniques and strategies can include:

Voice exercises to help with voice clarity and volume.
Exercises to improve/maintain the muscles used for speaking and swallowing
Cognitive exercises for memory, attention, and sequence abilities
Word finding exercises
Education on Augmentative and Attentive Communication (AAC)

Devices such as communication boards, apps, or speech-generating devices. AAC tools can be introduced early before speech loss, to ease the transition.

Training family and caregivers on how to support their loved one.

Dealing with the devastating news that you or your loved one has Huntington’s disease often leads to feeling overwhelmed and heartbroken. The challenges of this disease are not just physical; they impact every aspect of a person’s identity, relationships, and overall quality of life. At Great Speech, we understand these challenges. With proactive support from one of our qualified speech-language pathologists (SLPs), the right strategies, and a supportive home environment, individuals with HD can continue to express themselves and maintain meaningful connections throughout the course of the disease.

If you or someone you love is affected by Huntington’s disease, don’t wait for speech symptoms to become severe. Early intervention with speech therapy, combined with caregiver education and home strategies, can make a huge difference. Communication is a lifeline - let us help you! We are experts in online speech therapy! Reach out today to schedule your free introductory call.