Jeff has ALS. He used a number of different spelling strategies and techniques to supplement his speech over the course of his disability.

Verbally Spelling a Word
When Jeff's speech became slurred to the point that his wife occasionally had a hard time understanding him. When his wife didn’t understand a word, she would let him know, and he would verbally spell out the word.

Spelling a word using an alphabet board
Jeff speech continued to get more slurred. Jeff’s wife had a difficult time understanding him when he spelled out a word. He started using a small alphabet board. When his wife didn’t understand a word, he spelled it out on his alphabet board. He continued to use speech as his primary form of communication, though…

Pointing to the first letter of each word
As Jeff’s speech continued to become harder to understand, he switched to a new strategy. He held a small alphabet board on his lap. He pointed to the first letter of each word as he said it. His partner then said the word out loud. This did a number of things:

• It provided the listener with information about the first letter of each word.
• It helped him to slow down, and put a space between each word. This made it easier for his communication partner to understand.
• Because the partner was providing verbal feedback on every word, it was unlikely that Jeff would speak for a long time with his partner not understanding what he said.

Note: Jeff had a speech generating device during this time, and practiced using it, but he wanted to use his natural speech for as long as possible. Even though his speech was slow, it was still faster than using the communication device. When Jeff got to the point that it was harder and harder for people to understand him, he finally switched over to using the communication device.