Remote Speech and Swallowing Assessment in ALS

Inclusion Criteria: Patients 1. At least 18 years of age 2. Possess a diagnosis of ALS (definite, probable, probable laboratory-supported, or possible by El Escorial criteria \[35\]) 3. Have symptom onset within the last 3 years 4. Demonstrate a score of 2 or 3 in either the speech (item #1) or swallowing (item #3) components of the ALSFRS-R at time of enrollment 5. Demonstrate decline in bulbar function prior to enrollment, measured by a reduction of at least 1 point on either the speech or swallowing components of the ALSFRS-R in the 6 months prior to enrollment. If 6 months of data is not available, an estimate of the change in ALSFRS-R will be calculated from the time of symptom onset. 6. Have a life expectancy ≥ 6 months as determined by the attending neurologist 7. Be fluent in written and spoken English 8. Possess a smartphone capable of running the study application 9. Follow up in the Penn State Hershey multidisciplinary ALS clinic over next 6 months 10. Be able to visit the study site for in-person procedures at weeks 0 and 24 Listeners 1. Between 18 and 40 years of age 2. Native speakers of American English 2.3. Currently residing within the United States. 3.4. Hearing within normal limits, as defined by self report. Exclusion Criteria: Patients 1. Possess a co-existing neurological or psychiatric illness that, in the opinion of the study team, exclude the subject from participation 2. Demonstrate clinically significant dementia, as determined by the ALS study neurologist 3. Possess abnormal speech or swallowing processes due to a condition independent of their ALS diagnosis Listeners 1. Have an identified speech, language, learning, or neurological disorders per self-report 2. Experience communicating with people with motor speech disorders