Augmentative and alternative communication devices for MG

Myasthenia gravis (MG) can affect your ability to speak, and you may need to find ways to support your communication needs. For example, augmentative and alternative communication (AAC) devices for MG can serve to supplement or replace speech.

AAC tools can include low-tech options, such as writing on paper or a whiteboard. They can also include more advanced technology, such as speech-generation equipment.

Learning about them can help you continue expressing yourself while preserving social connections and independence.

How myasthenia gravis can affect communication

When MG causes weakness in the muscles of the vocal tract, throat, mouth, and lungs, it can lead to speech-related symptoms.

Examples include:

• MG speech fatigue
• slurred or weak voice
• trouble controlling pitch
• hypernasal voice
• monotone voice

Symptoms may fluctuate or worsen throughout the day or with prolonged talking. You may feel fine in the morning, but by the evening, your voice may weaken or become strained. MG flares can also bring about a temporary worsening of speech issues and other MG symptoms.

Communication challenges may affect your emotional well-being and relationships. You may feel frustrated and stressed when you experience issues expressing yourself. Speech problems may also cause you to avoid or withdraw from important conversations with relatives and colleagues, potentially affecting your relationships at home and at work.

Considering the impact that MG communication difficulties can have on your life, addressing them through assistive communication tools for MG is essential.

When people with MG may use AAC devices

Because MG symptoms often fluctuate in their frequency and intensity, the need for AAC devices for MG can be specific to certain times or situations.

For example, you may require such support with late-day fatigue or during flares. Communication aids for neuromuscular disorders can play an especially important role during medical appointments and emergencies, as you have to convey key medical information to doctors.

They can also be useful at work and in other social settings, whether during presentations or meetings, by providing support and reducing the likelihood of being misunderstood.

Finally, AAC can be used to conserve energy and manage MG fatigue. Straining your vocal cords and muscles to speak can lead to overexertion, but supportive devices can help prevent it.

Types of AAC tools that may help with MG

There are different kinds of AAC tools that can support your communication needs with MG. Your neurologist or speech-language pathologist can help you choose the type of AAC that’s most suitable for your symptoms.

No-tech or low-tech options include:

• writing on paper or a whiteboard
• pointing to written words and photos on communication boards
• pointing to letters on alphabet boards to spell words
• using yes/no signaling
• relying on prewritten cards for frequently used phrases

High-tech solutions include:

• devices or apps that generate speech from text
• app-based or tablet communication tools
• speech-amplification tools
• apps with predictive text and pre-set phrases

Getting started with AAC support

Before you select and start using AAC devices, consult with your neurologist or speech-language pathologist. They will be able to advise you on how to best manage your communication needs.

Ask them if you can try a few options before committing to purchasing and using any of them long-term. For instance, some AAC apps offer free trials, and some clinics may let patients borrow devices. You may want to choose something you will actually use that will truly help address the speech issues you’re dealing with.

Inquire whether your insurance plan covers the devices. If they are not covered, ask your doctor whether they know of any sources of financial assistance.

Keep in mind that your MG symptoms, including those that affect speech, may change over time. This means that your care provider may need to reassess your needs and recommend adjustments to your AAC tools.

Overall, speech changes in MG can pose certain challenges, and navigating them may require a careful, comprehensive approach. But with the help of AAC devices and your care team’s guidance, you can feel more supported in maintaining social connections, managing fatigue, and communicating with confidence.