Communication with family, friends, physicians and other caregivers is essential for everyone, and can be a challenge for many individuals with ALS as speech and/or respiratory conditions decline. Having options to continue effective communication is very important and should be considered throughout the disease process. This can range from low tech pen and paper, a device to help make a person’s speech louder as it becomes weaker, to high–end dedicated devices operated by eyegaze.
Such devices are often referred to as AAC (alternative and augmentative communication) devices or SGDs (speech generating devices). Requesting a dedicated communication device does require working with a Speech Language Pathologist (SLP),. Lower tech or non-dedicated devices are often used prior to dedicate devices or as a backup system. Support from and SLP or assistive technology specialist can help guide the selection and assist with implementation and training on AAC devices. Commonly used AAC strategies, devise and Apps are provided below.
As individuals often own smartphones or tablet devices, many apps are available to add communication abilities to existing devices such as iPads. The range of apps varies based on platform, with more currently available for Apple devices. App prices range from free to a few hundred dollars.
The features and method to access the app can vary. Many apps require a user to touch the screen to make selections. Special adapted styluses can allow extend the time a user can directly access a device as the task becomes more difficult. More advanced apps allow a user to scan through choices if motor skills decrease, with the user pressing any appropriate switch to make a selection. Switches cannot plug in to the tablet or phone devices. Connectivity is required through a Bluetooth switch. More information about switches is included in a separate section. As motor skills decline, placement of a device is also important as range of motion may be limited. A mount may be necessary to place the device in the proper location.
App development is ongoing, with new options or upgrades becoming available regularly. The link below is one resource to help with app selection and review.