[SarahVeela]

I am a psychiatrist's PA and we visit patients at a secondary facility of his once a week. One elderly female patient speaks in an unusual pattern and we are trying to determine if there is a medical reason in particular for this and if so, what it is called/causes, etc. For example, when asked a question she will pause for up to 10-20 seconds normally with a somewhat blank look and when she does speak it comes out very abruptly and quickly, with emphasis on the first word or two. Almost as though she were holding her breath before letting a phrase escape. If this happened rarely I would not even consider it unusual...but this happens every single time she speaks! Any ideas?

[monkeybrains21]

She's deciding how much to reveal and once she decides she gets it out before they tell her to keep her mouth shut

[saw_q]

algoria - unclear speech. unable to speech properly (something like that). tq

Neuropsych eval.

Sounds like an Oliver sacks patient. Not any sort of expert but what you want to say has to be communicated from one side of the brain to the other. Maybe this is somehow not working properly. I have this problem but not anywhere near this extreme. I got better with Neurofeedback. There was a TED talk by a neurologist who had a stroke and describes the experience from her perspective. It's kind of like that.

Sent from my iPad using Tapatalk

[possum220]

I would have thought that your psychiatrist would have come across this before. It may not be organic but psychological. This person may have had problems with speech going years back. Maybe they don't feel safe talking and it takes her a while to get her thoughts in order and even harder to get the words out. Sometimes its just hard to talk. Ask the staff if she has trouble talking to them. If she doesn't, maybe she feels safe with them.

Maybe your patient would feel more comfortable writing things down? Maybe you could ask your patient when she noticed this style of talking started.

Ever thought about consulting a speech pathologist?

[SarahVeela]

Interesting theories, thank you guys! I think perhaps he'll try to discuss it with her directly on the next visit and see if she personally can provide some insight.

[amandalouise]

Originally Posted by SarahVeela

I am a psychiatrist's PA and we visit patients at a secondary facility of his once a week. One elderly female patient speaks in an unusual pattern and we are trying to determine if there is a medical reason in particular for this and if so, what it is called/causes, etc. For example, when asked a question she will pause for up to 10-20 seconds normally with a somewhat blank look and when she does speak it comes out very abruptly and quickly, with emphasis on the first word or two. Almost as though she were holding her breath before letting a phrase escape. If this happened rarely I would not even consider it unusual...but this happens every single time she speaks! Any ideas?

her medical doctor and her psychiatrist would probably be the best person to ask. here we dont diagnose each other or others that each other knows...

all we do here on Psych central is share our own problems, what our own treatment providers have called our own problems and what treatments our treatment providers have us on. we can also ....in general....tell you what things are called by what you would find if you googled the symptoms....

for example when I have had speech problems my own treatment providers called it...

a medication dosage problem,
a hang over from going out drinking,
side effect from being in the room when someone was smoking marijuana
stress
anxiety
panic disorder
DID (an alter who could not verbalize correctly)
sleep deprivation
sore throat/strep throat
polyps on the vocal cords
Multiple Sclerosis

I also know someone who has this problem and in them its called a stutter, with another person I know its called Alzheimers, with another person I know its called menopause....

as you can see this kind of thing can be anything and everything...which is one of the reasons why we are not allowed to diagnose or tell each other what their or others problems are...it is you that must tell us what you or those who have problems are called.

my suggestion talk since you are part of this persons treatment team talk with this persons treatment providers. they can tell you what this persons medical and mental health issues are called and what treatments plans she is on.

Originally Posted by SarahVeela

Interesting theories, thank you guys! I think perhaps he'll try to discuss it with her directly on the next visit and see if she personally can provide some insight.

...it's pretty ridiculous that this is not the first approach.

[-jimi-]

I knew someone who spoke exactly like this. It was his way of dealing with stuttering. If he tried just speaking, he would stutter so badly he basically could not speak.

Of course there is about a million other reasons for the same thing, too. I agree on asking her...

[Undercoverwarrior]

I wouldn't know, that sounds interesting though...

[Auntie2014]

Originally Posted by jimi...

I knew someone who spoke exactly like this. It was his way of dealing with stuttering. If he tried just speaking, he would stutter so badly he basically could not speak.

Of course there is about a million other reasons for the same thing, too. I agree on asking her...

This was my thought along with the fact that I dealt with some speech issues when i was 24/7 caregiver for my dad through his Alzheimer's and thought perhaps this person might be loosing what was a coping skill for stuttering since you mention that she is an older person.

Good Luck!

[justbeingme80]

The best person to ask would be her treating psychiatrist. If he/she can't figure out what's going on, perhaps a visit for a wellness checkup or a neurology/neuropsych eval. My parent does this same thing, but that's because they had a stroke. I'm curious though as to why you're asking here--as we're all just here for support and not a diagnosis, which only a qualified professional can do.

[marmaduke]

Hard to give it a name without knowing the patient, schizotypal PDs can have odd speech pattens.

[kindachaotic]

my mom has mod to severe dementia & she does this.

I don't know about this particular patient, but the weirdest speech pattern I ever heard was a woman who would start out talking normallyyyyyyyyy, but then before a pauuuuuuuse, she'd drag out that last syllabllllllllllle. At the end of a sentennnnnnnce, she might even add an an extra vowel or twooooo-ee-oh.

I'm not trying to make fun of her, just reproduce the speech so you get the idea. Does anyone know if there's a name for it?

ETA: I got curious and researched it. The woman I knew apparently had a dysfluency disorder characterized by prolongations and interjections. It's a rare form of stuttering.

[SarahVeela]

Thanks again people, well, I only asked because he (the psychiatrist) asked me to look into it on my own before he talks with her about it because she is very sensitive. No harm in asking around...or at least I thought! Lol. Lovebird, that's very interesting...people tend to generalize too much when it comes to "disorders", myself included in this case, I wouldn't have even considered that.