A recent survey of augmentative and alternative communication use and service delivery experiences of people with amyotrophic lateral sclerosis in the United States.

Results highlight the importance of early referral for AAC intervention, ongoing re-evaluation and treatment, involvement of communication partners and support for multimodal communication and adaptation to changing needs. Implications for rehabilitationMost people with amyotrophic lateral sclerosis (PALS) in this sample reported experiencing dysarthria, with 71.3% indicating at least some detectable speech disturbance (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating ≤ 3) and 56.5% reporting reduced intelligibility (ALSFRS-R speech rating ≤ 2).Respondents used a wide variety of communication methods. Among respondents who were unable to meet their communication needs with speech alone, 84.6% used unaided methods (including speech), 52.3% used low-tech augmentative and alternative communication (AAC) and 90.8% used a speech-generating device.Service delivery improvements are needed to ensure timely, ongoing and comprehensive AAC education and intervention for PALS and their families.Communication over video calls (including virtual healthcare visits) is common among PALS and may be an important target for AAC intervention as the COVID-19 pandemic continues to limit in-person gatherings and appointments.