EBP Compendium: Summary of Clinical Practice Guideline

Good Practice in the Management of Amyotrophic Lateral Sclerosis: Clinical Guidelines. An Evidence-Based Review with Good Practice Points. EALSC Working Group
Andersen, P. M., Borasio, G. D., et al. (2007).
Amyotrophic Lateral Sclerosis, 8(4), 195-213.

AGREE Rating: Recommended with Provisos

Description:

This guideline provides recommendations for the assessment and care of individuals with amyotrophic lateral sclerosis (ALS). This guideline may be relevant to a large range of professionals, including speech-language pathologists. Recommendations are based on a systematic review of the evidence in accordance with the European Federation of Neurological Societies (EFNS)criteria with good practice points (GPP) included when there was lack of evidence.

Recommendations:

• Assessment/Diagnosis
• Assessment Areas
  • Speech - "Regular assessment (i.e. every three to six months) of communication by a trained speech therapist is recommended" (p. 209).
• Treatment
• Speech
  • General Findings - Treatment should “optimize the effectiveness of communication for as long as possible” (p. 209) and focus on the individual’s communication as well as partner-to-partner communication (GPP).
  • Augmentative and Alternative Communication (AAC)
    • Use of augmentative and alternative communication (AAC) systems should be provided as dysarthria progresses.
    • Communication systems can range from simple alphabet or picture boards to high tech AAC systems with voice computerized speech synthesizers (GPP).
• Swallowing
• Compensatory Strategies and Diet Modification - Use of compensatory swallowing techniques is part of the initial management of dysphagia along with dietary modifications, dietary counseling and caloric supplements. Speech-language pathologists can provide swallowing techniques for individuals with dysphagia (GPP).  

Keywords: Amyotrophic Lateral Sclerosis

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Added to Compendium: November 2011