title: Supporting communication for patients with neurodegenerative disease.
abstract: BACKGROUND
  Communication supports, referred to as augmentative and alternative communication (AAC), are an integral part of medical speech-language pathology practice, yet many providers remain unfamiliar with assessment and intervention principles. For patients with complex communication impairments secondary to neurodegenerative disease, AAC services differ depending on whether their condition primarily affects speech and motor skills (ALS), language (primary progressive aphasia) or cognition (Alzheimer's disease). This review discusses symptom management for these three conditions, identifying behavioral strategies, low- and high-tech solutions for implementation during the natural course of disease. These AAC principles apply to all neurodegenerative diseases in which common symptoms appear.
  
  
  OBJECTIVE
  To present AAC interventions for patients with neurodegenerative diseases affecting speech, motor, language and cognitive domains. Three themes emerge: (1) timing of intervention: early referral, regular re-evaluations and continual treatment are essential; (2) communication partners must be included from the onset to establish AAC acceptance and use; and (3) strategies will change over time and use multiple modalities to capitalize on patients' strengths.
  
  
  CONCLUSIONS
  AAC should be standard practice for adults with neurodegenerative disease. Patients can maintain effective, functional communication with AAC supports. Individualized communication systems can be implemented ensuring patients remain active participants in daily activities.
authors.forename: Melanie
authors.initials: M
authors.lastname: Fried-Oken
authors.forename: Aimee
authors.initials: A
authors.lastname: Mooney
authors.forename: Betts
authors.initials: B
authors.lastname: Peters
mesh_terms: D003143:Communication Devices for People with Disabilities; D006801:Humans; D019636:Neurodegenerative Diseases / Q000523:psychology / Q000534:rehabilitation*; D013070:Speech Therapy / Q000295:instrumentation / Q000379:methods*
keywords: ALS; Augmentative and alternative communication; communication disorders; dementia; progressive aphasia