Download the Functional Communication Scale for SLPs Here
ALS Functional Communication Scale (AFCS) and Measurement Tool
SCALE
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Communication Competencies
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Short Term Goals (examples) |
Interventions (examples) |
| 1. Alerting/Emergency | (Clinic Visit Goal)
(Home Visit Goal)
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Call chime Switch adapted call chime Emergency alerting system (adapted if needed)
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| 2. Communication Strategies |
2. Patient (and caregiver) demonstrate patient and partner strategies (via speech or SGD) that improve communication success, efficiency, speed and reduce fatigue.
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Energy conversation speech strategies Partner communication strategies Voice amplifier Rate enhancement strategies for AAC
Modification of communication pages to compensate for reduced physical abilities |
| 3. Non-Voiced Communication | 3. Patient demonstrates the ability to communicate novel messages via spelling or combining words using a low tech AAC method. |
Writing Pointing on communication board Typing Typing with adaptive modifications Message input with alternative access
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4. Speech Generation
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4. Patient demonstrates the ability to communicate a novel message via spelling or combining words with voice. |
Via patients own speech or Via speech generating device Via app on mobile device |
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5. Communication with those at a Distance
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5. Patient describes a (adapted) method/s to communicate with partners at a distance.
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Adapted phone Skype or other, State Telephone Access Program, Text Messaging Instant Messaging
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6. Independence with Set-Up and Customization of AAC Systems
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6. Patient (and caregiver) demonstrate the operation, set up and customization of low or high tech augmentative communication equipment adequately to use the equipment independently in 5/5 trials.
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Adjust mounting to appropriate heights and angles Calibrate screens Attach access devices and adjust settings Adjust volume Switch languages Program simple message buttons etc. |
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7. Prepared for future changes
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7. Patient (and caregiver) describe a pro-active strategy designed to prepare for typical changes in speech and SGD access seen in patients with ALS.
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Voice banking Message banking Storing message & customizing communication pages, Beginning process for acquiring speech generating device Learning about alternative access method etc.
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Score The Score is the number of competencies a patient demonstrates out of the 7 ALS functional communication abilities.
G-Code severity modifiers are required for Medicare reporting |
7/7( CH) 6/7 (CI) 5/7 (CJ) 4/7 (CK) 3/7 (CL) 2/7 (CM) 0-1/7 (CN) |
CLINICAL MEASUREMENT TOOL
| G-Code | G9174 | G9175 | G9176 |
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Communication Abilities:
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Current Status/ Baseline |
Projected Goal Status | Discharge Status/ Able at End of Today’s Session |
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1. Patient (and caregiver) can describe the method by which patient can alert others, not in patient’s immediate environment, to a need or emergency. (clinic goal) 1. Patient is able to activate an alerting system 100% of the time to notify people in other rooms when he has a need or emergency. (home visit goal) |
+/- | +/- | +/- |
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2. Patient (and caregiver) demonstrate patient and partner strategies (via speech or SGD) that improve communication success, efficiency, speed and reduce fatigue.
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3. Patient demonstrates the ability to communicate novel messages via spelling or combining words using a low tech AAC
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4. Patient demonstrates the ability to communicate a novel message via spelling or combining words with voice.
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5. Patient describes a (adapted) method/s to communicate with partners at a distance.
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6. Patient (and caregiver) demonstrate the operation, set up and customization of low or high tech augmentative communication equipment adequately to use the equipment independently in 5/5 trials.
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7. Patient (and caregiver) describe a pro-active strategy designed to prepare for typical changes in speech and SGD access seen in patients with ALS.
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| Score (total “+” in each column) # / 7 | /7 | /7 | 7/ |
| Severity Modifier (CH, CI, CJ, CK, CL, CM, CN) | X | X | X |
Score Noms Level Severity Modifier
7/7 7 CH 6/7 6 CI 5/7 5 CJ 4/7 4 CK 3/7 3 CL 2/7 2 CM 0-1/7 1 CN
About the Scale and Tool
The ALS Functional Communication Scale and Measurement Tool were developed to provide a means for documenting the communication abilities as well as the change resulting from AAC interventions for patients with ALS at any point in progression.
The measurement tool can be used to document a patient’s abilities at baseline, their projected abilities, and their abilities following intervention for the following codes:
92506-Speech/Language/Communication Evaluation
92507- Speech/Language/Communication Treatment
92607- SGD Evaluation (first hour)
92608- SGD Evaluation (each additional half hour)
92609-SGD TX for use of SGD including Programming+ Modification
Scale and Measurement Tool developed by Amy Roman, MS, CCC-SLP
HANDOUT FOR PATIENTS WITH ALS (Downloadable PDF)
Here is a version of this scale designed for patients and caregivers. This can be used in support groups or provided to patients during or before therapy/clinic to alert them to the many aspects of communication we can help them maintain. The checklist provides a column in which patients can jot down “My Challenges” with each of the competencies.