Speech and language disorders in adults

Speech and voice may be affected in individuals with chronic neurological disease or injury. This is for example common in individuals affected by Parkinson’s disease, Multiple Sclerosis, stroke, hereditary cerebellar ataxias or cervical spinal cord injury.


Project group leader

Ellika Schalling

The project group studies symptoms and consequences of speech and voice disorders in neurological disease/injury in different projects. Gender differences in different ages in young women and men who stutter are also studied. The group also works with development and evaluation of different intervention methods for individuals with chronic neurologic diseases or impairments. We work on methodological development and evaluation of treatment following biofeedback provided with a portable voice accumulator in people with Parkinson’s disease. In a randomized controlled trial treatment effects (including neuroplastic changes) of an intensive group treatment for speech and communication disorders (HiCommunication) is investigated. In another project effects of intensive rehabilitation of aphasia and acquired apraxia of speech following stroke, as well as implementation of the methods in Swedish healthcare, are studied.

Project group members

    Name Title Function
    Ellika Schalling Associate professor, SLP Project group leader
    Maria Södersten Adjunct professor, SLP Co-supervisor
    Per Östberg Associate professor, SLP Co-supervisor
    Kerstin Johansson PhD, SLP Researcher
    Joakim Körner Gustafsson SLP Doctoral student
    Helena Hybbinette SLP Doctoral student
    Ineke Samson SLP specialist Doctoral student
    Marika Schütz SLP Doctoral student
    Hanna Steurer SLP Doctoral student

    In collaboration with

    In collaboration with
    Name Title Function

    at the Department of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University

    Lena Hartelius Professor, SLP Researcher
    Ingrid Henriksson PhD, SLP Co-supervisor
    Trandur Ulfarsson PhD, Medical doctor Co-supervisor

    at Speech Music Hearing, The Royal Institute of Technology

    Sten Ternström Professor, MScEE Co-supervisor

    at the Division of SLP, Åbo akademi

    Elisabeth Lindström Associate professor, SLP Co-supervisor

    at the Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet

    Agneta Herlitz Professor Co-supervisor

    at the Department of Clinical Sciences, Danderyds Sjukhus, Karolinska Institutet

    Påvel Lindberg Associate professor, physio-therapist Co-supervisor
    Catharina Nygren Deboussard PhD, MD Co-supervisor

    at the Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet

    Erika Franzén Associate professor, physio-therapist Researcher

    at the Division of Speech and Language Pathology, Department of Clinical Science, Umeå University

    Fredrik Karlsson Associate professor Researcher

    Research projects

    • Voice disorders and treatment effects in Parkinson's disease studied with a portable voice accumulator (Joakim Körner Gustafsson,  Maria Södersten, Sten Ternström, Ellika Schalling)
    • Speech breathing control and voice function following low cervical spinal cord injury: implications for treatment and effects of respiratory and speech interventions (Kerstin Johansson)
    • Effects of exspiratory muscle strength training (EMST) on voice, speech and swallowing in Parkinson’s disease and multiple sclerosis (Kerstin Johansson in collaboration with professor Lena Hartelius)
    • Acquired apraxia of speech - prevalence, differential diagnosis, progression and relation to hand motor function and brain function following stroke (Helena Hybbinette, Per Östberg, Påvel Lindberg, Catharina Nygren.Deboussard, Ellika Schalling)
    • Stuttering in young men and women  (Ineke Samson, Elisabeth Lindström, Ellika Schalling)
    • Intensive rehabilitation of aphasia and apraxia of speech (Marika Schütz, Ingrid Henriksson, Trandur Ulfarsson, Åke Nygren, Ellika Schalling)
    • Treatment effects following intensive group treatment of speech and communication (HiCommunication) for people with Parkinson’s disease (Ellika Schalling, Erika Franzén et al.)

    Selected publications

    *Johansson K, *Schalling E, Hartelius L (2019). Self-reported changes in cognition,
    communication and swallowing in multiple sclerosis: data from the Swedish MS
    Registry and from a national survey. Folia Phoniatrica et Logopaedica accepterad 191125 *shared first authorship

    Körner Gustafsson J, Södersten M, Ternström S, Schalling E. Voice use in daily life studied with a portable voice accumulator in individuals with Parkinson’s disease and matched healthy controls. Journal of Speech Language Hearing Research, Nov 18;62(12):4324-4334. doi: 10.1044/2019_JSLHR-19-00037. Epub 2019 Dec 10

    Franzen E, Johansson H, Freidle M, Ekman U, Benka Wallén M, Schalling E, Lebedev A, Lövdén M, Holmin S, Svenningsson P, Hagströmer M (2019). The EXPANd trial: Effects of exercise and exploring neuroplastic changes in people with Parkinson’s disease: a study protocol for a double-blinded randomized controlled trial NURL-D-19-00729, BMC-Neurology accepterad 191030

    Näsström A-K, Schalling E (2019) Development of a method for assessment of dysarthria in a foreign language: a pilot study. Logopedics Phoniatrics Volocology (accepted for publication 190725), doi: 10.1080/14015439.2019.1650392.

    Körner Gustafsson J, Ternström S, Södersten M, Schalling E. (2018) Effect of Lee Silverman Voice Treatment on habitual voice use in Parkinson’s disease studied with a portable voice accumulator in a monozygotic twin patient-control pair. Logopedics Phoniatrics Vocology, 15, 1-10. doi: 10.1080/14015439.2018.1435718.

    Johansson K, Seiger Å, Forsén M, Nilsson-Holmgren J, Hartelius L, Schalling E (2018) The identification of individuals with spinal cord injury who are at risk for voice problems. International Journal of Language and Communication Disorders, 53(4):761-775. doi: 10.1111/1460-6984.12380.

    Schalling E, Johansson K, Hartelius L (2017) Speech and communication changes reported by persons with Parkinson’s disease. Folia Phoniatrica et Logopaedica, 69, 131–141doi.org/10.1159/000479927

    Lohmander A, McAllister A, Hansson K, Hartelius L, Blom Johansson M, Karlsson F, Samuelsson C, Schalling E, Södersten M, Östberg P, van Doorn J. (2017). "Kommunikations- och sväljstörningar genom hela livet - ett logopediskt ståndpunktsdokument. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-139757

    Vogel AP, Keage MJ, Johansson K, Schalling E. (2015) Treatment for dysphagia (swallowing difficulties) in hereditary ataxia.  Cochrane Database of Systematic Reviews, Nov 13;11:CD010169.

    Wannberg P, Schalling E, Hartelius L. (2015) Perceptual assessment of dysarthria: Comparison of a general and a detailed assessment protocol. Logopedics Phoniatrics Vocology, 7, 1-9

    Gustafsson J, Ternström S, Södersten M, Schalling E. (2015) Motor-Learning-Based adjustment of ambulatory feedback on vocal loudness for patients with Parkinson’s disease. Journal of Voice, 10. pii: S0892-1997(15)00120-4. doi: 10.1016/j.jvoice.2015.06.003. [Epub ahead of print]

    Van Stan J, Gustafsson J, Schalling E, Hillman R. (2014) Direct comparison of three commercially available devices for voice ambulatory monitoring and biofeedback. Perspectives on Voice and Voice Disorders, 24, 80-86

    Schalling E, Hartelius L. (2013) Speech in spinocerebella ataxia. Brain & Language, 127(3),

    Schalling E, Gustafsson J, Ternström S, Bulukin Wilén F, Södersten M. (2013) Effects of tactile biofeedback by a portable voice accumulator on voice sound level in speakers with Parkinson’s disease, Journal of Voice, 27(6), 729-37

    Johansson K, Hartelius L, Kjellmer L, Fredriksson S, Schalling E. (2013) "I can walk briskly and talk at the same time’ – effects of Expiratory Muscle Strength Training (EMST) on respiration and speech in multiple sclerosis” Journal of Medical Speech-Language Pathology, 20(4), 70-76

    Johansson K, Nygren-Bonnier M, Schalling E. (2012) Effects of glossopharyngeal breathing in multiple sclerosis, a case-report. Multiple Sclerosis, 18(6), 905-8

    Johansson K, Nygren-Bonnier M, Klefbeck B, Schalling E. (2011) Effects of Glossopharyngeal Breathing on Voice and Speech in Individuals with Cervical Spinal Cord Injury. International Journal of Therapy and Rehabilitation vol 18, no 9, 1-11

    Hartelius, L., Schalling, E., Krull, D. & Lindblom, B. (2010). Formant transitions in ataxic speech: the shape and speed of formant trajectories in individuals with multiple sclerosis and control speakers. Journal of Medical Speech-Language Pathology 18(4), 54-60