Managing Speech Changes
Your ability to communicate at all times is vital and must be maintained even when speech alone is not sufficient. Augmentative Alternative Communication (AAC) tools and strategies are available to help. Three primary AAC tools are:
- Speech Generating Devices or Text-To-Speech Apps
- Low-Tech or Rapid Access Communication Methods
- Alternative Access Methods
A speech therapist specializing in AAC will help you review options, trial equipment, and tailor a customized and comprehensive solution for you. Please talk with your ALS clinic team, or ask your care manager for more information.
Prior to or at the First Sign of Speech Change
First, have a speech therapist measure your speech rate. This is an important baseline number that assists in determining timing for interventions.
Second, begin Message and Voice Banking so that your own voice can be used in a speech generating device (SGD) or text-to-speech (TTS) app if ever required.
- Message Banking is a process of recording phrases and expressions that are meaningful to you and those you love. Recording words of affection, your own quintessential expressions, and phrases that you often repeat, like greetings, are especially important. Banked messages preserve your cadence and unique delivery of each expression. Examples of phrases I often recommend include, “How are you doing?”, “It’s great to see you.”, “I use this device to speak but my thinking and hearing are fine. Please speak directly to me.”, “Give me a break.”, “Thanks for everything!”, “Hold on! I want to add something.” Speech therapists can assist you with lists of popular messages, but the best phrase ideas often come from the people who know you best.
- Voice Banking process creates a custom synthesized voice for you based on samples of your speech. There are different programs for Voice Banking that range in cost, time expenditure, and clarity of speech required.
Your speech therapist can make recommendations for Message and Voice Banking programs and apps. Scheduling an appointment or two with a speech therapist to provide assistance with Message and Voice banking can be a great way to get started.
When Changes in Speech Begin Causing Challenges in Communication
At the point when speech changes can be readily detected, it is vital that you meet with a speech therapist. The therapist will document your speech rate and listen to your speech characteristics. Together, you and your speech therapist will choose the best strategies to help you and those around you enjoy improved and less frustrating communication. Oral motor exercises are not recommended for speech changes resulting from ALS but there are many strategies that can help including the following:
- Consider customizing your own list of helpful communication strategies to share with frequent communication partners. It can be distributed directly, via emails or through social media. Don’t forget to explain your energy conservation needs, including preferred communication times for calls and limits for visits.
A speech therapist will have other strategies to help with challenges like phone communication, emergency alerting systems for times when you are home alone, and tools for signaling to others within the home if you have a need.
At the point when speech is beginning to require repetitions or your speech rate slows significantly a speech therapist will often recommend an evaluation for Augmentative Alternative Communication (AAC). A proactive approach to AAC involves obtaining and customizing the components of a complete AAC system prior to a time when you may need to rely on it for communication.
Consider customizing your own list of helpful communication strategies to share with frequent communication partners. It can be distributed directly, via emails or through social media. Don’t forget to explain your energy conservation needs, including preferred communication times for calls and limits for visits.
A speech therapist will have other strategies to help with challenges like phone communication, emergency alerting systems for times when you are home alone, and tools for signaling to others within the home if you have a need.
At the point when speech is beginning to require repetitions or your speech rate slows significantly a speech therapist will often recommend an evaluation for Augmentative Alternative Communication (AAC). A proactive approach to AAC involves obtaining and customizing the components of a complete AAC system prior to a time when you may need to rely on it for communication.
When Speech Doesn’t Meet All Communication Needs
Adapted from the ALS Functional Communication Scale, Roman 2014.