AAC 2026: Managing speech and swallowing challenges with FA
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Speech and swallowing issues are common with Friedreich’s ataxia (FA) and can be challenging to manage. At the 2026 Annual Ataxia Conference in Orlando, Florida, one presentation focused on helping people better understand these challenges, and offered practical tools to support communication and safety in daily life.
Presented by Caitlin Cloud, a speech-language pathologist (SLP) and a PhD student at the University of Nebraska in Lincoln, the talk discussed strategies, resources, and assistive technologies designed to help support clearer communication and safer eating and drinking for those living with FA and other forms of ataxia.
Ways to manage speech issues
Speech issues with ataxia can be managed through two complementary approaches: rehabilitation and compensation.
Rehabilitation aims to maintain and improve the function of the speech system, while compensatory strategies can be used as needed to help a person be better understood and communicate more effectively.
Rehabilitation
Rehabilitative approaches often include speech therapy programs done under the supervision of an SLP. Their goal is to improve speech clarity, vocal loudness, and voice quality through targeted exercises.
“Because just like exercise is good for your body, it’s good for the muscles of speech production,” Cloud said.
Compensation
Compensation strategies involve both speaking techniques and augmentative and alternative communication tools (AAC) that support communication.
Speaking strategies may include:
- overarticulation, or clearly enunciating every sound in every word you produce
- slowing down the rate of speech
- breath control strategies, such as taking a preparatory breath before you speak
- speaking in shorter phrases and pausing more frequently
AAC options may involve:
- accessibility features on the devices you already own, such as text-to-speech apps
- other phone and tablet apps
- alphabet boards, where you point to specific letters
- speech-generating devices
A speech therapist can help you figure out which strategies or devices are most appropriate for you, Cloud said.
“At the end of the day, the most important thing is communication,” Cloud said. “And so, my job as a speech therapist is to work with my clients to find what strategies work for them.”
Strategies to address swallowing issues
Similar to speech challenges, swallowing problems can also be managed through rehabilitative and compensatory approaches.
Rehabilitation for swallowing issues involves swallowing exercises guided by an SLP, aimed at improving control and coordination, optimizing function, and maintaining it over time.
Compensatory strategies focus on making eating and drinking safer and more manageable. These may involve:
- modifying textures of food and liquids, such as thickening liquids to help prevent choking
- applying sensory modifications to food and drinks, such as adding flavoring to plain water to ease swallowing
- maintaining certain head and neck postures that may be recommended by an SLP
- eating and drinking slowly
- alternating solids and liquids
- taking small bites and sips
- holding a bite or sip in your mouth for a moment before swallowing
- sitting upright while eating
- reducing distractions during meals
- eating mindfully
- trying assistive feeding tools, such as cups and straws that allow the user to only take small sips
Cloud also noted that, in some cases, swallowing issues may be related to allergies or acid reflux. Working with a physician to address these problems may help improve swallowing as well.
She added that people should stop using any swallowing strategies that worsen their symptoms. Even if you’ve heard anecdotally that a specific strategy worked for someone else, it doesn’t mean it will work for you.
Final tips
Cloud shared a few final tips for both speech and swallowing issues:
- Let your doctor know right away if you notice changes.
- Ask for a referral to an SLP.
- Keep track of your symptoms in a journal.
Although speech and swallowing challenges can feel overwhelming, meaningful strategies can help. With the right tools and support, people with FA can find ways to communicate effectively and maintain safety while eating and drinking.
Note: The Friedreich’s Ataxia News team is providing live coverage of the 2026 Annual Ataxia Conference April 9-11 in Orlando, Florida. Go here to see the latest stories from the conference.
