Les is a 54-year-old man who was referred to speechlanguage pathology due to gradual onset of swallowing and speech difficulty. In terms of swallowing, Les has begun to cough when drinking thin liquids as well as sometimes on his own saliva. In terms of speech, he reports that his tongue feels “thick and slow” and that his voice has become hoarse. Overall, Les demonstrates both upper motor neuron (UMN) and lower motor neuron (LMN) symptoms. His neurologist just diagnosed him with amyotrophic lateral sclerosis (ALS).
1. Given what you know about ALS, what stages of the swallow will be affected by this condition as it progresses?
2. What is the long-term prognosis for Les in terms of eating safely by mouth?
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