Abstract
The majority of individuals with amyotrophic lateral sclerosis (ALS) benefit from augmentative and alternative communication (AAC) at some point during the disease process. Different AAC approaches are used, depending on functional status, communication purposes, familiarity of the communication partner, and the environment. Early, middle, and late stages of AAC intervention have been identified and reflect changes in an individual's functional status and subsequent changes in communication needs. Trends in the use of low- and high-technology AAC systems appear to correspond to these stages. In this article, case studies are used to demonstrate how individuals tend to rely on both unaided and low-technology AAC methods during the early stages of ALS, on high-technology systems during the middle stages of the disease, and again on unaided and low-technology AAC methods during the late stages of ALS.