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) following a new program for  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 is studied. Multimodal Intensive Rehabilitation of Aphasia and Apraxia of speech (MIRAA) is a model for intensive rehabilitation of speech and language impairment following stroke developed by members of the research group. Implementation of this method in Swedish health care and effects of intervention are investigated in the MIRAA -study.

Project group members

Project group members
Name Title Function
Ellika Schalling Associate professor, SLP Project group leader
Maria Södersten Adjunct professor, SLP Researcher
Per Östberg Associate professor, SLP Co-supervisor
Kerstin Johansson PhD, SLP Researcher
Joakim Körner Gustafsson PhD, SLP Researcher
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 Lärosäte
Lena Hartelius Professor, SLP Researcher Department of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University
Ingrid Henriksson PhD, SLP Co-supervisor Department of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University
Trandur Ulfarsson PhD, Medical doctor Co-supervisor Department of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University
Sten Ternström Professor, MScEE Co-supervisor Speech Music Hearing, The Royal Institute of Technology
Elisabeth Lindström Associate professor, SLP Co-supervisor Division of SLP, Åbo akademi
Agneta Herlitz Professor Co-supervisor Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet
Påvel Lindberg Associate professor, physio-therapist Co-supervisor Department of Clinical Sciences, Danderyds Sjukhus, Karolinska Institutet
Catharina Nygren Deboussard PhD, MD Co-supervisor Department of Clinical Sciences, Danderyds Sjukhus, Karolinska Institutet
Erika Franzén Associate professor, physio-therapist Researcher Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet
Fredrik Karlsson Associate professor Researcher Division of Speech and Language Pathology, Department of Clinical Science, Umeå University

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)
  • Stuttering in young men and women  (Ineke Samson, Elisabeth Lindström, Ellika Schalling)
  • 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)
  • Intensive rehabilitation of aphasia and apraxia of speech (Marika Schütz, Ingrid Henriksson, Trandur Ulfarsson, Åke Nygren, Ellika Schalling)
  • Implementation of MIRAA (Multimodal Intensive Rehabilitation of Aphasia and Apraxia of speech) in Swedish health care (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, Hanna Steurer in collaboration with Erika Franzén et al.)

Selected publications

Samson I, Lindström E, Herlitz A, Schalling E. (2020). Larger reported impact of stuttering in teenage females, compared to males – a comparison of teenagers’ result on Overall Assessment of the Speaker’s Experience of Stuttering (OASES)  

Journal of Fluency Disorders, 2020 Dec 8;67:105822. doi: 10.1016/j.jfludis.2020.105822. Online ahead of print.PMID: 33348210

Johansson, H., Freidle, M., Ekman, U., Schalling, E., Leavy, B., Svenningsson, P., Hagströmer, M., & Franzén, E. (2020). Feasibility Aspects of Exploring Exercise-Induced Neuroplasticity in Parkinson's Disease: A Pilot Randomized Controlled Trial. Parkinson's Disease, 2020, 2410863. https://doi-org.proxy.kib.ki.se/10.1155/2020/241086

Karlsson, F., Schalling, E., Laakso, L., Johansson,K., Hartelius, L. (2020). Assessment of speech impairment in patients with Parkinson’s disease from acoustic quantifications of oral diadochokinetic sequences. Journal of Acoustical Society of America  Feb;147(2):839. doi: 10.1121/10.0000581.PMID: 32113309

Lohmander A, Klintö,K, Schalling E, Szabo Portela, A, Johansson K, McAllister, A. (2019). Students take charge of learning - using e-learning in perceptual assessment of speech. Scandinavian Journal of Educational Research. 1–13. https://doi.org/10.1080/00313831.2020.1716064

*Johansson K, *Schalling E, Hartelius L (2020). 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 Jan -21, 1–13. Advance online publication. https://doi-org.proxy.kib.ki.se/10.1159/000505063

*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, 131–141 doi.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

Content reviewer:
Åsa Catapano