Augmentative communication gives a voice to people with ALS

For the past six years, John Costello, MA, director of the Boston Children’s Augmentative Communication Program, has been working at night and on weekends with adult patients with Amyotrophic Lateral Sclerosis (ALS), which is commonly known as Lou Gehrig’s disease.

Now thanks to the partnership of a private donor, Boston Children’s Hospital is transforming Costello’s efforts into a formal program: the Augmentative Communications Service for People with ALS at Boston Children’s Hospital.

Costello and his team examine each patient’s needs and skills and match those to the best tools and technology. Recommendations typically include low-tech solutions, which may be combined with a speech-generating device, computer software, an alternative keyboard or mouse. Message banking is one of the tools that Costello finds particularly powerful for patients with ALS.

With message banking, Costello records and stores patients’ meaningful messages and then links them to a technology that allows the patients to communicate in their own voice once they have lost the ability to speak.


“We can’t change someone’s medical diagnosis,” says Costello. “But we can support people to maintain dignity, control and social connectedness, while expressing their true selves and remaining active members of the world around them.”

Learn more about the Boston Children’s Augmentative Communication Program.