ALS: Speech And Swallowing

The bulbar muscles are one of the primary targets of ALS, which involves the mouth and throat. As such, the gradual weakening of the throat and mouth muscles may be experienced, which may result in difficulty swallowing or speech problems. Patients who are suffering from these symptoms (and their caretakers) may consult this guide on how to best deal with the challenges as mentioned above.

A Person With ALS Will Have Speech Difficulties


ALS can wreak havoc to a person’s speech capabilities and may need extra effort on both sides to have a better conversation. The severity of symptoms experienced by patients with ALS can change on an individual basis, but all commonly experience some level of speaking difficulties,” explains Laura Flavell, Ph.D. “This is caused by the muscles of the tongue, lips, vocal cords, and chest being affected by the disease. The difficulty in speaking is referred to as “dysarthria.” In the meantime, some things can be done to ease through this difficulty.

  • Focus entirely on speaking. Try not to drink or eat while doing it.
  • Speak slower. Take the time to pronounce all syllables in a word.
  • Repeat if necessary. If it doesn’t work, spell it.
  • Be concise; refrain from adding unnecessary words.
  • Try and emphasize ending sounds per word; many speakers tend to trail off. “If you have repeated a word two times and it is still not understood, consider spelling it aloud or using your finger to spell on your palm or on a table,” suggests Amy Roman, MS, CCC-SLP, Speech-Language Pathologist at Forbes Norris ALS Research & Treatment Center. “Often just providing the first letter of the word in question is enough to help others.”
  • Speech isn’t all of the communication, so do make use of gestures and facial expressions.
  • Take a breath per few words. It helps.
  • Use synonyms or substitutes if a word is particularly hard to say.

Write down the keyword for the conversation, preferably a single keyword. In doing so, the listener has a better gist of the general idea of what you’ll say.

Some can pretend to understand everything you said. If you suspect so, you can make them repeat what you said, to ensure that they did understand.

Over time, speaking will become more of a challenge, due to how ALS is progressive. As such, some record their voices, accumulating a library of recorded words, so that when the time comes they can’t finally speak, there can be a way of communicating with their voice, instead of relying on computer voice.

Personalized assessment and intervention with a specific communication strategy are key to improving communication in patients with amyotrophic lateral sclerosis (ALS),” wrote Ashraf Malhas, Ph.D. In a study on communication of ALS patients, the participants highlighted “the importance of: staging assessment and intervention over time, providing individual training activities according to the needs of the patient and their communication partner, and ensuring that patients have access to a variety of AAC systems.”

To The Listener


Give the speaker your full attention. Unnecessary noises should be silenced, and focus should be solely on the speaker, to spot for nonverbal cues.

Check if your hearing is in shape. If not, a hearing aid or amplifier is recommended.

If you didn’t understand fully what they said, it is perfectly fine to ask the person to repeat what was said. It would of help if you do remember some of what was said. But do not remember everything.

Practice, practice, practice. Speaking more with the affected person regularly can make you better understand the patient’s patterns. With much practice, you can even understand the patient better than an average stranger.



To an average person, swallowing may be a simple process. Several body parts are involved in this, such as the tongue, mouth, jaw, and the throat. Having ALS complicates it, and either food or liquid may go down the wrong pipe, which can result in choking, among other things.

People with ALS may try these simple tips when eating:

  • Consume smaller quantities of food and drink.
  • Per mouthful, swallow twice or thrice to thoroughly clear food in the throat.
  • The head position helps. Ask a speech pathologist for the best head position.

When dealing with dry food, immersing it in a sauce such as gravy may help with the flow of the pieces of food. Taking a sip may also help matters.

Foods that are both solid and liquid are not recommended, such as soups with food pieces inside. Substitute instead of things such as oatmeal or thick cream soups.

However, due to the nature of ALS, eating, and drinking may soon prove to be impossible. To this end, feeding tubes can be availed so that the patient doesn’t miss out on their nutrition.

Leave a Reply

Your email address will not be published. Required fields are marked *