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Updated: Jun 1, 2026

A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
Published on: February 21, 2011
Communication Support for People with ALS
David Beukelman1, Susan Fager, Amy Nordness
1Institute for Rehabilitation Science and Engineering Madonna Rehabilitation Hospital and University of Nebraska, 202 Barkley Memorial Center, P.O. Box 830732, Lincoln, NE 68583-0732, USA.
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.
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