Motor Neurone Disease: Assessment and Management
National Clinical Guideline Centre. (2016).
London (United Kingdom): National Institute for Health and Care Excellence, (National Guideline 42), 1-319.
This guideline provides recommendations for the assessment and treatment of individuals with motor neuron disease from diagnosis to end-of-life-care. The intended audience is healthcare professionals, including speech-language pathologists. This guideline subsumes the recommendations in the 2010 NICE guideline–<i>Motor neuron disease: The use of non-invasive ventilation in the management of motor neuron disease.</i>
National Institute for Health and Care Excellence (United Kingdom)
<p>This guideline was reviewed with the following:</p>
<ul>
<li>National Institute for Health and Care Excellence. (2016). <em>Motor Neurone Disease </em>(Quality Standard 126). Retrieved from <a class="ApplyClass" href="https://www.nice.org.uk/guidance/qs126">www.nice.org.uk</a></li>
</ul>
<p>Additionally, the data in this guideline are included in other documents which can be found in the Associated Article section below.</p>
<p>Individuals with motor neuron disease should have access to augmentative-alternative communication (AAC) services. The speech-language pathologist should:</p>
<ul>
<li>ensure that communication and AAC assessment be completed without delay and/or AAC is readily accessible at end of life;</li>
<li>include assessment of multiple methods of communication access (e.g., telephone, email, and social media);</li>
<li>collaborate as needed with other members of the multidisciplinary team to integrate AAC with other assistive technology (e.g., computers, tablets, environmental controls);</li>
<li>ensure ongoing support and training as needed for AAC and compensatory communication strategies; and</li>
<li>complete reassessment to monitor changes in communication.</li>
</ul>
<div>If an individual with motor neuron disease has issues with thick saliva or drooling, he/she may benefit from various interventions including education regarding posture, hydration, swallowing, or oral care.</div>
<div>Individuals with motor neuron disease and suspected swallowing difficulty should be referred for clinical swallow evaluation to assess and determine factors that may contribute to swallowing problem such as positioning/seating, ability to manage food/drink consistencies and risk of/fear of choking or aspiration.</div>
<div>Speech-language pathologists should be part of the multidisciplinary team treating the issues of motor neuron disease (e.g., swallowing, saliva problems, speech, communication, respiratory function, cognition).</div>
<div>Individuals with motor neuron disease experiencing difficulty with cognition or behavior should be referred for further cognitive evaluation.</div>
