What ALS is and How it Affects Speech
Updated: Aug 25
In this article we will discuss:
What is Amyotrophic lateral sclerosis (ALS)?
ALS is a progressive neurological disorder that affects the nerve cells in the brain and spinal cord, leading to muscle weakness and eventually paralysis. It can affect all parts of the body, including the muscles used for speaking. As a result, people with ALS often have difficulty communicating because they are unable to control the muscles necessary for speech.
How does ALS affect the body?
The disease causes muscle weakness and paralysis and eventually leads to respiratory failure. There is no known cure for ALS, and it is typically fatal within two to five years of diagnosis. However, some people with ALS live much longer and a small percentage of people with the disease experience remission.
ALS typically begins with muscle weakness in the arms and legs. This may progress to paralysis of the muscles used for breathing, swallowing, and speaking. As the disease progresses, people with ALS may experience problems with cognition, communication, and swallowing. Eventually, most people with ALS will require full-time care.
ALS Speech Symptoms
Many people with ALS experience difficulty speaking because the disease affects their bulbar muscles. The bulbar muscles are responsible for controlling the muscles used for speech, and when they are affected by ALS, people often have trouble producing sounds, speaking in short phrases, and pronouncing words correctly. As the disease progresses, these symptoms may become more pronounced.
The person’s voice may become softer and harder to understand. People with ALS also may experience changes in their vocal range, such as a higher or lower pitch than normal. Speech therapy can help people with ALS learn techniques to make communication easier.
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Communication Disorders associated with ALS
ALS can also cause communication disorders such as dysarthria and dysphagia.
Dysarthria is a motor speech disorder that makes it hard to move the muscles used for speaking. People with ALS may have a slow, slurred, or labored voice. There are different types of dysarthria.
Spastic Dysarthria
Spastic dysarthria is the most common type of dysarthria associated with ALS. It is caused by muscle spasms and results in a slow, slurred, or labored voice. People with spastic dysarthria often have difficulty producing sounds and speaking in short phrases. They may also have difficulty pronouncing words correctly.
Flaccid Dysarthria
Flaccid dysarthria is caused by muscle weakness and results in a weak, breathy voice. This type of dysarthria is common in people with ALS, and it can make communication difficult. People with flaccid dysarthria may have difficulty producing sounds and speaking in short phrases. They may also have difficulty pronouncing words correctly.
Ataxic Dysarthria
Ataxic dysarthria is caused by problems with movement and balance. It results in an unsteady voice. This type of dysarthria is common in people with ALS, and it can make communication difficult. People with ataxic dysarthria may have difficulty producing sounds and speaking in short phrases. They may also have difficulty pronouncing words correctly.
Dysphagia and ALS
Dysphagia is a swallowing disorder that makes it difficult to swallow food, drink, and saliva. People with ALS often experience dysphagia because the muscles used for swallowing become weak and paralyzed. This can make it difficult to eat or drink, and can cause choking and aspiration, a condition where food or drink goes into the lungs instead of the esophagus.
The Role of Speech Therapy in ALS
Speech therapy can help people with ALS learn techniques to communicate more effectively and provide "speaking therapy". Speech therapists can also teach them how to use assistive technology, such as a computer-based speech aid or another communication device, if necessary. Additionally, speech therapists can help the person develop strategies for expressing themselves and communicating with those around them.
What can a speech therapist do?
First, a speech therapist can assess the person’s communication abilities and identify which areas need to be addressed.
For speech, assessment tools include tests that measure expressive language, phonation, articulation, and voice quality. For swallowing, assessment tools include tests that measure saliva control, swallowing capacity and oral-motor strength.
These tests will help the speech therapist identify the person’s deficits and create a treatment plan to improve his or her communication skills. After the assessment, the therapist will create a treatment plan tailored to meet their individual needs. It is important to know their diagnosis in order to create the most effective treatment plan.
The treatment plan
Once any communication disorders are identified, the speech therapist will develop a treatment plan that may include exercises to increase muscle strength and motor speech disorder that affects the muscles used for speaking and makes it difficult to produce sounds.
Speech Therapy Goals for ALS
The goal of speech therapy for people with ALS is to maintain or improve communication abilities. Speech therapists can help the person learn strategies for expressing themselves and communicating with others. They can also provide techniques for improving speech production, such as speaking slowly and using assistive technology to help produce words.
Strategies to maintain speech abilities for patients with ALS
1. Improving breathing and articulation
Since patients with ALS often struggle with articulation due to difficulty controlling their tongue and facial muscles, speech therapists can help them find ways to improve their breathing and articulation. Breathing is one of the most important aspects of speech, and exercises to improve the quality of the breath can help bolster articulation.
2. Increasing volume and clarity
Patients with ALS may find it difficult to produce loud and clear speech due to muscle weakness. Speech therapists can help by teaching them strategies for increasing volume and clarity, such as speaking in short phrases and using assistive technology.
3. Developing communication strategies
Speech therapists can also help ALS patients develop communication strategies to help them express their thoughts and feelings more effectively. This can include learning how to use alternative modes of communication, such as assisted technology and body language.
Speech therapy can help people with ALS maintain their communication abilities and develop effective strategies for expressing themselves. Through assessment, treatment plans, and exercises, speech therapists can help ALS patients to continue communicating with those around them.
It is important for people with ALS to receive early intervention and to be proactive in seeking speech therapy services. Early intervention can help minimize the effect of ALS on their speech and communication abilities, allowing them to maintain their independence for as long as possible.
4. Swallowing therapy
Additionally, speech therapists may recommend swallowing therapy to help improve a person’s ability to swallow safely. Swallowing therapy can help reduce the risk of aspiration and maintain nutrition levels in patients with ALS, allowing them to remain independent for as long as possible.
Speech therapists play an important role in helping people with ALS maintain their communication abilities and independence. Through tailored assessments, treatment plans, and exercises, speech therapists can help ALS patients maintain their quality of life.
It is important for people with ALS to seek early intervention and ongoing support from a speech therapist to help maximize their independence. With the right care and therapies, people with ALS can continue communicating with those around them throughout the course of the disease.
Overall, the goal of speech therapy for people with ALS is to maintain or improve communication abilities and help the person cope with their diagnosis. With the right support and strategies, people with ALS can continue to communicate effectively even as their disease progresses.
Emotional Effects of ALS
The words of someone living with ALS can often be inspiring, and speech therapists can help them find ways to express those thoughts in order to maintain their quality of life. Speech therapy is an important component of care for people with ALS, providing the support they need to stay connected to those around them. With the right guidance from a speech therapist, people with ALS can continue communicating with ease.
The emotional and physical toll of ALS can be overwhelming, but speech therapy can help people with the disease maintain a sense of connection to those around them. Through tailored assessment, treatment plans, and exercises, a speech therapist can help patients manage their symptoms and continue communicating effectively. For those living with ALS, speech therapy is an invaluable tool for maintaining both independence and quality of life.
By seeking early intervention and ongoing support from a speech therapist, people with ALS can maximize their communication abilities throughout the course of the disease. With tailored therapies and strategies, they can continue connecting to those around them even as their condition progresses. Speech therapists play an invaluable role in helping people with ALS stay connected during difficult times, helping them to maintain their independence and quality of life.
At Better Speech we know you deserve speech therapy that works. We have experts in your needs and assign the right therapist, not just the therapist that happens to be in your area. Having Amyotrophic Lateral Sclerosis can be difficult, but with the right support, you or your loved one can learn to lead a happy and successful life. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.
Frequently Asked Questions
What is ALS and why does it affect a person's ability to speak?
ALS, or Amyotrophic Lateral Sclerosis, is a progressive neurological disease that damages the motor neurons controlling voluntary muscles, including those used for speech, swallowing, and breathing. As these neurons deteriorate, the muscles weaken and speech becomes harder to produce. Understanding this process early helps individuals and families plan for communication support before significant changes occur.
What are the early speech changes someone with ALS might notice?
Early speech changes often include a slightly slurred quality, reduced volume, or a strained and effortful voice. Some people notice their speech sounds nasal or that they tire quickly during conversation. These subtle shifts can be easy to dismiss at first, so tracking any changes and reporting them to a neurologist or speech-language pathologist promptly is important.
Can speech therapy actually help someone with ALS, or is it too late once symptoms start?
Speech therapy can make a meaningful difference even after symptoms begin. A speech-language pathologist can teach compensatory strategies, recommend voice banking tools so a person can preserve their natural voice digitally, and introduce augmentative and alternative communication devices as needs evolve. Starting therapy early gives people more options and more time to practice effective techniques.
How do I find a speech therapist who has experience working with ALS patients?
Look for a licensed speech-language pathologist who has experience with neurological or progressive conditions. Better Speech offers licensed, insurance-ready care with no waitlists, connecting individuals and families to qualified therapists who can begin addressing ALS-related speech changes right away through convenient online sessions. Asking specifically about a therapist's familiarity with AAC devices and voice banking is also a great starting point.
What is voice banking and should someone with ALS consider it?
Voice banking is the process of recording a large number of phrases and sentences so that a text-to-speech system can later generate a synthesized voice that sounds like the person. Experts strongly recommend starting voice banking as early as possible, ideally before speech is significantly affected, because the recordings capture more natural-sounding speech. A speech-language pathologist can guide you through the best tools and platforms available.
About the Author
Aycen Zambuto
I’m a seasoned educator in speech therapy with over six years of experience helping people navigate challenges in communication. Throughout this time, I’ve found joy in guiding individuals through a variety of therapeutic journeys, from toddlers with apraxia to seniors with dysphonia.
I’m passionate about demystifying this complex world of speech therapy and helping readers around the globe achieve clear and effective communication. When I’m not writing about speech, you’ll often find me reading, traveling or spending time with friends and family.
