The role of SLPs in ALS care

Amyotrophic Lateral Sclerosis (ALS) is a progressive, neurodegenerative disease that essentially causes motor neurons to die, leading to a complete inability to move. ALS is aggressive, and progresses relatively quickly. The average life expectancy after diagnosis is 3 years according to the ALS Association.

Given the quick progression of the disease, SLP support needs to happen and it needs to happen immediately. Most people aren’t aware of the role that SLPs play in the care for individuals with ALS, but like with those with other degenerative diseases (like dementia), SLPs can be a huge part of the care team. How so? Let’s talk about it in (very) brief.

Diagnosis

Obviously, SLPs do not diagnose ALS. However, we are pros at identifying voice and speech disorders. There are a few different types of ALS, one of which presents first with what are called “bulbar symptoms,” or symptoms pertaining to nerves that start in the brainstem. For SLPs, this includes symptoms with speech and swallowing. While SLPs might not know outright that an individual’s symptoms are caused by ALS, they will likely refer out to a neurologist if they are unable to help pinpoint the cause of the symptoms. This can lead to a speedier diagnosis, which then leads to treatment.

Cognition

As with all neurodegenerative diseases, cognitive decline goes hand-in-hand with ALS. SLPs can help prepare the individual for failing memory and behavioral changes that eventually arise. This can include memory strategies (picture books, visual schedules, memory journals, etc.) and modifying environments to make them easier to navigate and less distracting. Most importantly, the SLP will work with the caretakers of the individual to help them adapt their behaviors and responses to the individual with ALS.

 An example of an eye gaze system. Picture found  here .
An example of an eye gaze system. Picture found here .

Speech

Because ALS affects motor neurons, it ultimately impedes the individual’s ability to communicate verbally. Initially, SLPs will work on compensatory strategies for symptoms like hypernasality or strategies for communication breakdowns due to unintelligibility. SLPs will also work on alternative and augmentative communication (AAC) systems with these patients. AAC education begins as early as possible so that the individual can learn a system that they can use throughout the progression of ALS. Systems can include low or no tech communication such as developing a consistent yes/no response system or letter boards. AAC systems could also be high tech devices that have speech generating abilities or eye gaze systems. We’ll talk some more about these later this week and next week.

Swallowing

Just like speaking, swallowing will eventually become difficult for individuals with ALS because of the person’s inability to control their motor movements. SLPs can provide maneuvers to use during swallowing to prevent aspiration, or food going into the lungs. Changes in diet may also be made in order to prevent aspiration (remember puree foods?). However, because of the quick progression of the disease, it’s important to consider comfort and quality of life measures. This can be a bit controversial, and is the choice of the individual and their care takers.

As you can see, speech-language pathologist can play a big role in helping those with ALS. Questions? Have a loved one with ALS? Call your friendly neighborhood SLP!

4 Comments

  1. Dr. David GreeneJanuary 20, 2021

    Thank you for this informative post and i am sure it will be helpful for many individuals suffering from ALS.

    Reply
    1. marianApril 17, 2021

      My dad was diagnosed with ALS, and I was so confused because I love my dad and I wouldn’t want to lose him so soon so I decided to look for a possible solution to get rid of this ALS despite knowing it has no Medical cure as advised by the medical doctor , everyday my dad’s heath depreciate and keeps losing weight and strength, a friend advised me to try dr santy wise ALS therapy that she used dr santy therapy to cure her dad’s heart disease and I was reluctant about it until after a second thought I decided to give it a try because no harm in trying and immediately I contacted him on hangout he assured me that my dad will be cured within few weeks of medication and he sent me the therapy and I applied it on my dad as advised by Dr santy and within 3 weeks of medication my dad was cured and now my dad has no symptoms of ALS anymore. contact dr.santyjatto@gmail.com or whatsapp +2348145243120

      Reply
  2. Kira WinkelmannJuly 15, 2021

    I was diagnosed with ALS/MND last year in May 2019. our doctor put me on riluzole, letting me know there was no cure but the medication might provide me a few more months of delayed symptoms. ALS progresses at different rates and affects different body parts first. me being 60 at this time, fell into a category of what they call “fast progression” (older female). My arms weakened first, then my hands, my mouth, and throat, and finally my lungs. Throughout my two-and-a-half-year  ordeal, I  was able to walk with assistance until I was told to use Dr Amend herbal formula which helped me get rid of this ALS/MND totally after using it for just 12 weeks treatment plan. The total cure of Dr Amend herbal remediation brought me back to life again and terminate all the symptoms. I have a great herbal doctor, unique and honest….contact Dr Amend right now if you have same problem, WhatsApp him now via +2348073861816

    Reply
  3. Jose AnthonyAugust 2, 2021

    My father was diagnosed with ALS in the summer of 2013;  His initial symptoms were quite noticeable. He first experienced weakness in his right arm and his speech and swallowing abilities were profoundly affected. We all did our best to seek help for this disease, no medications they prescribed worked ,we were all scared we might lose him due to his condition, as he had been his brother’s caregiver a few years earlier for the same disease before he passed. doctor recommend natural treatment from multivitamincare .org for his ALS we have no choice to give a try on natural organic treatment ,this herbal cure has effectively reverse my father condition ,losing his balance which led to stumbling and falling stop  after the completing the herbal supplement which include his weakness in his right arm and his speech, home remedies from multivitamincare .org is the best although their service is a little bit expensive but it worth it, they save lives.

    Reply

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