Daily care
Communication tools and resources for ALS caregivers
As ALS progresses, speaking gets harder, and that is frustrating for the person with ALS and for you. There are two families of tools that help: low-tech boards and charts you can print today, and high-tech devices and apps that speak for the person. This page lists both, plus the organizations that explain how to choose between them and the free guides worth reading first.
How to use this page
Start with the low-tech section, because a printable board costs nothing and works on day one. Read the high-tech section next so you know what exists before you need it, and take that list to the speech-language pathologist on the care team. For the devices themselves, see our communication and alerts equipment guide.
Low-tech communication aids
Alphabet boards and communication charts
Physical boards that display letters, words, and phrases. The person with ALS points to them, or uses a head pointer to indicate the message. Simple, readily available, and enough for basic communication.
The Les Turner ALS Foundation publishes a free printable communication board you can start with: see the ALS communication guide and printable board.
Eye gaze boards
Similar to communication charts, but designed to be used with eye movements instead of a finger or a pointer. These boards help when hand mobility is limited.
High-tech communication aids
Speech-generating devices (SGDs)
Electronic devices that let someone communicate with synthesized speech, choosing words and phrases from a screen or a keyboard. For many people with ALS they become the main way they are heard.
The ALS Association offers a guide to speech generating devices, published on the Your ALS Guide communication page.
Augmentative and Alternative Communication (AAC) apps
Mobile apps that offer picture-based communication, text-to-speech, and other features for people with communication challenges. They run on a tablet or a phone you may already own, which makes them a cheaper first step than a dedicated device.
Two places to look at what is available: the AAC Essentials bundle on the App Store and this AAC app roundup, which the original list gave as the Google Play option.
Eye gaze technology
Advanced systems that let someone control a computer, including communication software, using eye movements alone. They cost more than the other options here, and they matter most for people who have lost every other means of communicating.
Ask about a device before you need one
Assessment, funding, delivery, and training all take time, and eye gaze systems are the most expensive option on this page. Ask the speech-language pathologist on the care team what the process looks like well before speaking becomes difficult, so nothing is waiting on paperwork. Our financial resources page covers who helps pay for communication equipment.
Organizations and guides
Talking with someone whose speech is changing
Be patient and allow extra time
People with ALS may need longer to process what you said and longer to answer. Silence in the gap is not a problem to fix. Wait it out.
Watch the non-verbal cues
Facial expression and body language carry a lot once speech is limited. Pay attention to sighs, frowns, and smiles to read what someone needs and how they feel.
Break complex topics into smaller parts
Use short, simple sentences and skip the jargon. One idea at a time is easier to answer than a paragraph with three questions buried in it.
Keep eye contact and speak clearly
Speak slowly, enunciate, and do not mumble. Facing the person while you talk makes you easier to follow.
Validate their feelings
Say out loud that you can see the frustration and that you are there. Being understood matters as much as getting the message across.
Communication runs both ways. With these tools and a bit of patience, the person you care for stays connected, valued, and heard.
Related pages
Educational content only, never a substitute for your care team. Ask the speech-language pathologist on the ALS clinic team before choosing or buying a communication device.