How is Speech Affected by ALS?

For anyone who has been diagnosed with Amyotrophic Lateral Sclerosis (ALS), there are many challenges that need to be faced as the disease progresses. This is a neurodegenerative disease that damages and eventually destroys nerves in the body causing a wide range of symptoms.

Initially, one of the most common symptoms associated with ALS is muscle weakness, a gradual reduction in mobility and impaired muscle function.

Another particular symptom that can appear early on in the ALS progression timeline is slurred speech.

Slurred speech can be an early indication that an individual has ALS before they are actually diagnosed with the disease, although there are many other medical reasons that can cause slurred speech. It often leads to frustration for the individual as their ability to communicate begins to diminish. This symptom is also usually closely associated with trouble swallowing and eating which add to the challenges someone faces.

Here we take a closer look at how speech is affected by ALS, what a person can do to deal with these specific issues and the technology that is currently available to help the individual effectively communicate once their ability to speak has diminished.

How Speech Can Be Affected by ALS

The most immediate issue with ALS and speech loss is the development of a condition called dysarthria. This happens when the muscles used for vocalization weaken and reduce the ability to articulate words properly.

Speaking is a complex process and there are a number of different muscle groups and processes that go into making even the simplest of sounds.

Dysarthria prevents the individual from making a clear sound, it can affect the breath needed to talk clearly and also inhibits the natural rhythm of speech.

• The experience of speech being affected following an ALS diagnosis will vary from individual to individual. Some might find their speech initially becoming slurred or slow and unclear.
• They may have trouble finding the right pitch or tone when talking, so their voice will go up and down unusually.
• Their voice may start to become faint and there may be issues pronouncing certain words, particularly consonants.

Dealing With Speech Issues

There are several challenges to face for someone who has been diagnosed with ALS. The first is coping with the physical impact of weakening speech muscles and finding ways to communicate, particularly as the disease progresses and the situation becomes increasingly difficult.

The second is the psychological impact of losing the ability to speak and communicate effectively with friends and family, even in the most mundane situations. This can be a highly frustrating symptom and one that requires careful management and understanding.

The first step is to work with a speech therapist who will be able to help develop strategies for improving and maintaining communication for as long as possible. A therapist will also be able to help with selecting the right assistive device that may be needed later on, as the disease progresses.

It’s important to have an assessment by a speech therapist as soon as communication issues arise. There are a variety of different techniques that can be used to make sure that the individual is understood better.

Putting communication plans and processes in place will also help reduce the level of frustration experienced by the individual whose speech has been affected. This includes working with partners and family members to create strategies such as facing the individual with ALS while they are talking and making allowances for fatigue in attempting to speak.

Eating a meal together as a family, for example, can be not only challenging when it comes to communicating but eating as well.

Communication Devices

Stephen Hawking is probably the most famous example of an individual diagnosed with ALS who used a communication device. The technology in this area has evolved dramatically over the last couple of decades and there are a lot of high and low tech options to choose from.

If someone has mobility in their hands and can type, for example, there are numerous smartphone apps and other devices that can be used to communicate, converting written words into audible speech. There are also speech generating devices that can be operated purely from eye or head movements.

It’s important to plan for the future once speech issues start to appear. Speech banking or voice banking allows an individual to save words and phrases that are spoken in their own voice for later use with a speech-generating device (SGD) or text-to-speech application.

One of the Most Challenging Symptoms

Losing the ability to speak and communicate effectively can be one of the most challenging symptoms associated with ALS. Working with a speech therapist can help to develop strategies in the early stages of the disease so that individuals are understood better. In the later stages, assistive technology can be used to communicate effectively with friends, family and loved ones.