Practice Parameter Update: The Care of the Patient with Amyotrophic Lateral Sclerosis: Multidisciplinary Care, Symptom Management, and Cognitive/Behavioral Impairment (an Evidence-Based Review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Neurology
Miller, R. G., Jackson, C. E., et al. (2009).
Neurology, 73(15), 1227-1233.
This guideline and corresponding systematic review is an update of a 1999 Practice Parameter on the care and management of individuals with amyotrophic lateral sclerosis (ALS). While this guideline is primarily intended for neurologists; the authors include recommendations for the assessment and/or treatment of cognition, communication, and swallowing.
American Academy of Neurology
<div>No consensus was found regarding the best cognitive screening tools. The authors indicated that screening of executive function may be considered to detect cognitive impairment prior and need for formal evaluation (Level C Evidence; p. 1231).</div>
<div>There was insufficient evidence to support or refute the use of speech interventions or augmentative and alternative communication to optimize communication in individuals with ALS.</div>
<div>There is now considerable evidence for cognitive and behavioral manifestations in ALS. While there is little consensus regarding assessment methods, the authors conclude that screening for cognitive and behavioral impairment be considered in this patient population (Level B Evidence).</div>
<div>No controlled trials investigating dysarthria treatments for individuals with ALS were found; therefore, there was insufficient evidence to support or refute specific treatments to improve communication (Level U Evidence).</div>
