Compass is still being developed and is effectively in beta. Some content and features may be incomplete, change, or not work as expected.

Content is anchored to trusted sources where available, but Compass has not yet been clinically reviewed. It provides general information rather than medical advice.

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Therapies and allied health

Speech pathologist

Helps with both being understood and swallowing safely, which is why they are often the first person to notice a change in either.

A speech pathologist works on communication and on swallowing. Those sound like two jobs and are one profession, because the same muscles do both. They can help you be understood when speech gets harder, set up other ways to communicate before you need them, and work out what is safe and comfortable to eat and drink.

How you reach this person, and who pays, depends on where you live. Set your country in Location and Compass will show what applies there.

What they can help with

  • Being understood for longer, including pacing, positioning and voice conservation
  • Voice banking and message banking, which are time sensitive and best started early
  • Communication aids, from a simple alphabet board to eye-gaze technology
  • Swallowing assessment, and practical changes to food and drink texture
  • Working out whether coughing at meals is a warning sign or a nuisance
  • Helping the people around you learn how to make conversation easier
  • Advising on timing when a feeding tube is being considered

When you might meet them

  • As early as possible if speech has changed at all, because voice banking needs voice
  • Before swallowing feels like a problem, so there is a baseline to compare against
  • When meals take much longer, or you cough or choke on food or drink
  • When you have started avoiding certain foods, or eating less because it is tiring
  • When people are asking you to repeat yourself more often
  • Alongside any conversation about a feeding tube

Things you could ask about

  • Is it too early to bank my voice, and what would you do first if it were you?
  • What exactly should I watch for that would mean I should call you sooner?
  • Which of these changes are about safety, and which are about comfort?
  • What can we set up now that we will not need for a while?
  • How do I get a communication device assessed and funded here?

Not to be confused with

Not a speech coach or an elocution teacher. In ALS/MND the work is about keeping you understood and keeping eating safe, not about changing how you sound.

About this entry

Not everyone meets all of these people, and nobody here is compulsory. Who does a particular job differs between countries and between services, so treat this as a way to understand who is who rather than a description of the team you should have.

Based on NICE MND guideline.