Breathe, Eat, Talk: Three Essential Ingredients to Quality‐of‐Life Outcomes in Movement Disorders
Year: 2026
Type: article
Abstract: BACKGROUND: Breathing, eating, and talking (BET) impairments are common yet frequently underrecognized features of movement disorders. Deficits in respiration, swallowing, voice, and speech may emerge early in the course of a disease, adversely affecting safety, participation, and quality of life. Routine neurological examinations may not adequately capture their impact. OBJECTIVE: To characterize the clinical importance of BET dysfunction across several movement disorders by comparing neurological and speech-language pathology (SLP) approaches to assessment and recommendations for improved early identification, referral and multidisciplinary management. METHODS: Case examples were used to illustrate and compare clinical findings obtained through standard neurological evaluation versus comprehensive SLP assessment. A targeted literature review and comparison of commonly used neurology and SLP clinical tools were also conducted to examine current approaches to BET evaluation and referral. RESULTS: Case examples illustrated how routine neurological examinations underestimated the severity and functional impact of BET impairments. This was contrasted with SLP identification of clinically meaningful deficits in respiratory function, cough, swallowing safety, communication effectiveness, and quality of life not captured by standard disease rating scales. Review of the literature demonstrated that commonly used neurological rating scales provide limited evaluation of BET dysfunction, whereas multidisciplinary assessment incorporating caregiver input, patient-reported outcomes, perceptual evaluation, and instrumental testing improves detection and treatment planning. CONCLUSION: BET dysfunction is prevalent across movement disorders and substantially influences quality of life. Early referral to SLPs and integration of multidisciplinary BET assessment can improve diagnostic precision, facilitate timely intervention, reduce preventable complications, and support person-centered care throughout disease progression.
DOI: 10.1002/mdc3.70758
Authors: John Dean, Lena C. O’Flynn, Michelle Ciucci, Cynthia Fox, Jessica E. Huber, Supraja Anand, Maira Rozenfeld Olchik, Jibrin S. Usman, Adam P. Vogel, Bettina Aguiar, Diana Khasanova, Dharshini Manoharan, Lorraine Ramig, Angela Roberts, Federico Rodriguez‐Porcel, Kristina Simonyan, Julie M. Barkmeier‐Kraemer
Institutions: Massachusetts Eye and Ear Infirmary, Harvard University, University of Wisconsin–Madison, LSVT Global (United States), University at Buffalo, State University of New York, University of South Florida, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Hong Kong Polytechnic University, Bayero University Kano, The University of Melbourne, Ridley College, Hospital de Clínicas, Kazan State Medical University, The University of Sydney, Western University, Medical University of South Carolina, Massachusetts General Hospital, University of Utah
Language: English
Subfield: Speech and Hearing
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
Funders: Purdue University, Tourette Association of America, University of South Florida, Inova Health System, Northwell Health, University of Cambridge, Canada Research Chairs, Asia University, National Institutes of Health, University of Illinois at Urbana-Champaign, University at Buffalo, Medical Research Council, National Health and Medical Research Council, National Institute on Deafness and Other Communication Disorders
OpenAlex ID: W7204249573