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What Are the Symptoms of Functional Neurological Disorder?
FND-related speech and swallowing symptoms can show up in several different ways. You may be experiencing one or more of the following:
Stuttering or Dysfluency: This may appear suddenly in adulthood without prior speech difficulties or differences. Dysfluencies are often variable, with patterns that differ from those seen in developmental or neurogenic stuttering. Speech may be hesitant and stuttering can include extended pauses, whole word repetitions, single sound repetitions, stretchy sounds, and interjections, amongst other characteristics.
Cognitive Communication: This can involve difficulties with word finding or expressing yourself, memory, attention, and organization. These difficulties may be described as “brain fog”. It may feel like the word is “on the tip of your tongue” or like your thoughts are jumbled. The right word can feel just out of reach, conversations may wash over you, and appointments may be forgotten. This may fall under the umbrella of Functional Cognitive Disorder.
Slurred Speech or Articulation: This can sound similar to speech changes related to fatigue or weakness, but can happen variably and without any of the usual causes. It may feel like your mouth isn’t cooperating, speech may be described as slurred or “lazy”, or your tongue might feel heavy. The muscles may feel weaker or like it’s “talking through sand”.
Voice Changes: It may feel like a sore throat, despite not having been sick. Voice changes can include whispery or hoarse voice (dysphonia), loss of voice (aphonia), pitch changes, or what is called puberphonia, often seen in youths. The loss of voice control is involuntary, but may include excessive muscular tension, which can be addressed.
Swallowing Difficulties: Globus sensation refers to feeling like there is a lump in the throat, despite the throat being clear. This can make swallowing difficult, despite the throat being physically clear. A comprehensive assessment is recommended to rule out structural differences.
Chronic or Persistent Cough: This refers to ongoing coughing or laryngeal hypersensitivity without an underlying respiratory condition. This may arise from altered sensory processing.
Do You Need a Diagnosis to Start FND Speech Therapy?
Speech Language Pathologists do not diagnose FND in Ontario, although trained clinicians can identify and treat the presentation. For a formal diagnosis, you may contact your family doctor for a referral to a neurologist or ENT. If you’re unsure what you’re experiencing is FND, that’s okay. Get in touch with a professional to begin answering your questions.
At Cognicare Speech Therapy, you do not need an FND diagnosis to begin working with us. Speech and language therapy can start based on your symptoms and their impact on your day-to-day communication or swallowing, not on a specific label. For many people, therapy and the diagnostic process happen alongside each other, not one after the other.
What Happens in Speech Therapy for fnd?
Assessment and treatment are collaborative and use responsive, evidence-informed practices tailored to your specific symptoms, their presentation, and their daily impact on your life. Sessions typically focus on:
Retraining the brain-body connection between the nervous system and your speech, voice, or swallowing function.
Building consistency, with personalized strategies that help symptoms respond more predictably over time.
Understanding the "why" behind your symptoms, so you’re informed and feel in control of your own care.
Coordinating with your broader care team as speech therapy is often one part of a wider FND care plan, alongside neurology, physiotherapy, occupational therapy, or psychology, and we're glad to communicate with your other providers.
Frequently Asked Questions About FND Speech Therapy
Is Functional Neurological Disorder a real diagnosis?
Yes. FND is a recognized neurological condition in which the nervous system has difficulty sending and receiving signals correctly. It is a diagnosis of inclusion, meaning neurologists look for markers that indicate FND, not markers that exclude other diagnoses.
Can speech therapy help with FND symptoms?
Yes. Speech-language pathologists trained in the assessment and treatment of functional neurological disorder can help retrain the brain-to-speech and brain-to-swallow connection, improve symptom consistency, and build practical strategies for day-to-day communication.
What does FND speech therapy treat?
Treatment is specific to the individual. Speech therapy treats what has been impacted in their body. Commonly, individuals may experience functional dysphonia (voice loss or whispering), functional stuttering, word-finding difficulty, functional swallowing difficulty (dysphagia) or oral sensations such as burning mouth syndrome or globus sensation, or foreign accent syndrome.
Do I need a referral or diagnosis to book?
No formal diagnosis is required to begin. Many clients start therapy while still completing the diagnostic process with a neurologist or ENT.
Is virtual therapy effective for FND?
Yes. Functional speech, voice, and swallowing symptoms can be assessed and treated effectively through virtual sessions, allowing you to access care anywhere in Ontario.
You Don't Have to Have It All Figured Out
If you're navigating a new diagnosis, or still figuring out what's going on, you don't have to have it all figured out before you reach out. We're here to help you understand what's happening and work through it with you, whether that’s through education, recommendations, or initiating treatment. Have questions about your diagnosis or referral? Book your free consultation and let’s begin the conversation.
Virtual FND speech therapy available in Toronto and across Ontario.