How Speech Therapy Helps People Living with ALS
Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative condition that affects nerve cells in the brain and spinal cord. Over time, individuals with ALS lose muscle strength and control, including the muscles used for speaking, swallowing, and breathing.
While there is currently no cure for ALS, speech therapy plays a vital role in supporting communication and swallowing—two functions that are often profoundly impacted as the disease progresses. As speech-language pathologists (SLPs), our goal is to help individuals maintain their independence and quality of life for as long as possible.
What Can a Speech Therapist Do for Someone with ALS?
1. Maximize Natural Speech for as Long as Possible
In the early stages of ALS, individuals may notice changes in their voice, such as hoarseness, slurred speech, or fatigue while talking. A speech therapist can assess these changes and teach strategies to conserve energy, speak more clearly, and reduce communication breakdowns.
We also monitor for signs of bulbar involvement (the part of ALS that affects speech and swallowing) and provide exercises and techniques that can support articulation and breath control while they are still effective. I currently see an individual with ALS who is in her 20’s. Although at the stage in the disease process her voice has been severely impacted, one of her goals is to continue conversing verbally until she cannot, and we have incorporated that desire into speech treatment.
2. Introduce Augmentative and Alternative Communication (AAC) Early
Because ALS is progressive, speech intelligibility often declines over time. One of the most valuable things we do is introduce AAC systems before speech becomes too difficult. This might include:
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Low-tech tools: communication boards, picture cards, yes/no eye gaze boards
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High-tech devices: speech-generating devices, tablets with text-to-speech apps
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Eye-tracking or switch-based systems for individuals who can no longer use their hands
Planning ahead ensures that individuals maintain a reliable means of communication even as their physical abilities change.
3. Support Safe Swallowing
Dysphagia (swallowing difficulty) is common in ALS. A speech therapist trained in swallowing disorders can perform clinical assessments and recommend strategies to minimize the risk of aspiration (food or liquid entering the airway). These may include:
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Postural adjustments during meals
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Modifying food textures or liquid thickness
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Techniques to make swallowing safer and more efficient
We work closely with dietitians and physicians to ensure nutrition and hydration needs are safely met.
4. Empower Patients and Families
Perhaps just as important as the technical skills we bring is our ability to support and educate. Living with ALS is incredibly challenging—for both the person diagnosed and their loved ones. Speech therapists provide:
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Education about the progression of speech/swallowing changes
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Training for caregivers on how to support communication
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Guidance on navigating difficult conversations and advance care planning
Our goal is to ensure individuals feel heard—literally and emotionally—throughout their journey.
The Bottom Line
Speech therapy is more than just helping someone “talk better.” For individuals with ALS, it’s about preserving connection, dignity, and independence. If you or someone you love is living with ALS, don’t wait to reach out to a speech-language pathologist. Early intervention can make a powerful difference.
If you or a loved one is in need of speech or swallow therapy, reach out to Live Well Speech Therapy for a free consultation. We serve Utah County.
