Communication for those with ALS

Amyotrophic lateral sclerosis (ALS) is a disease that leads to wasting of the muscles, and in many cases, paralysis. This applies not only to the large muscles that help us navigate our daily tasks, but also the muscles that let us speak.

Approximately 75% of those diagnosed with ALS will ultimately need some form of help to communicate effectively. Patients may experience slurred speech, which can become more severe with time, or even completely lose the ability to speak (dysarthria). As motor speech disorders develop, technology can facilitate communication and ensure that patients remain active in the medical process, making decisions about their health and treatment.

When speech is impaired, patients can turn to Augmentative and Alternative Communication (AAC), that is, methods that either supplement or replace verbal speech. AAC can be as simple as using hand gestures, facial expressions, and writing, but can also include using high-tech devices to communicate.

Here are a few technologies that are enabling ALS patients to communicate more effectively with AAC devices.

Amplification and Text-to-Speech

Voice amplification systems can benefit those experiencing a weakened voice or having problems projecting their voice as a result of respiratory issues. For such patients, the frustration of using the phone can be reduced with the help of computer software that translates text into speech.


Before they experience a disability to speak, some ALS patients use voice-banking services to store their voice onto a computer for use in a speech-generating device. In one method, digitized speech, users record common phrases such as, "How are you today?" and "Let's go out to eat." In an alternative method, patients record a range of sentences and the individual sounds are used to synthesize speech. To communicate, patients can point to images and letters with their fingers, or in the case of less mobile patients, with a laser pointer strapped to the head.

Eye Tracking

Eye tracking is helping many people with ALS continue to communicate beyond the loss of mobility. A special camera using an infrared or near-infrared light source follows eye movement, allowing patients to use their eyes like a computer mouse. The technology is easy and comfortable to use, and can make for quick and natural communication.

Using AAC devices integrated with these technologies, people with ALS can communicate effectively despite even complete loss of mobility and speech.

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