Abstract
Almost all people with amyotrophic lateral sclerosis (ALS) experience a motor speech disorder, such as dysarthria, as the disease progresses. At some point, 80 to 95% of people with ALS are unable to meet their daily communication needs using natural speech. Unfortunately, once intelligibility begins to decrease, speech performance often deteriorates so rapidly that there is little time to implement an appropriate augmentative and alternative communication (AAC) intervention; therefore, appropriate timing of referral for AAC assessment and intervention continues to be a most important clinical decision-making issue. AAC acceptance and use have increased considerably during the past decade. Many people use AAC until within a few weeks of their deaths.
Highlights
Almost all people with amyotrophic lateral sclerosis (ALS) experience a motor speech disorder as the disease progresses
At some point in the disease progression, 80 to 95% of people with ALS are unable to meet their daily communication needs using natural speech
Clinical decision-making related to communication is quite complex as screening, referral, assessment, acquisition of technology, and training must occur in a timely manner, so when residual speech is no longer effective, alternative communication (AAC) strategies are in place to support communication related to personal care, medical care, social interaction, community involvement, and perhaps employment
Summary
Almost all people with amyotrophic lateral sclerosis (ALS) experience a motor speech disorder as the disease progresses. At some point in the disease progression, 80 to 95% of people with ALS are unable to meet their daily communication needs using natural speech. Communication support involves a range of augmentative and alternative communication (AAC) strategies involving low- and hightechnology (speech generating device) options [2]. Clinical decision-making related to communication is quite complex as screening, referral, assessment, acquisition of technology, and training must occur in a timely manner, so when residual speech is no longer effective, AAC strategies are in place to support communication related to personal care, medical care, social interaction, community involvement, and perhaps employment. There is considerable research on the speech characteristics of people with ALS, it is the primary purpose of this paper to review the published research related to communication supports for people with ALS whose natural speech no longer meets their communication needs
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