IntroductionDysphagia is defined as difficulty swallowing saliva, liquids, foods and medications of all consistencies (Murry and Carrau, 2012). Dysphagia is one of the most significant problems affecting people with amyotrophic lateral sclerosis (ALS). ALS, a degenerative neurological disease, slowly degenerates an individual's swallowing function, most commonly in the oral and pharyngeal phases of swallowing (Stand, Miller, Yorkston, & Hilltel, 1996; Ertekin, Aydogdu, Yuceyar, Kiylioglu, Tarlaci and Uludag, 1999). According to Clave, P., De Kraa, M., Arreola, V., Girvent, M., Farre, R., Palomera, E. and Serra-Prat, M. (2006), 60% of ALS patients have complaints of oropharyngeal dysphagia which may lead to reduced oral feeding, as well as malnutrition, dehydration and aspiration. The progression of swallowing dysfunction is typically seen several months after the onset of the disease (Ertekin et. al, 1999) and eventually begins to impact a person's ability to swallow effectively and safely, leading to a ultimate inability to ingest food orally. Due to bulbar involvement in ALS, there is a higher risk of pulmonary aspiration and malnutrition (Murry and Carrau, 2013), as well as other side effects including aspiration pneumonia, dehydration and weight loss. These secondary characteristics can have a significant impact on the quality of life of these individuals and prevent adequate intake of food, water or oral medications. Swallowing Stages Affected in ALS Drooling, an early indication of oral phase disturbance, occurs in ALS patients. Chapman (2013) also describes other characteristics of the oral phase of people with ALS with early tongue and lip movement, increased eating duration, difference in middle of paper......). San Diego, CA: Plural Publishing. Sorenson, E.J., Crum, B., & Stevens, J. (2007). Incidence of aspiration pneumonia in ALS in Olmstead County, MN. Amyotrophic Lateral Sclerosis, 8(2), 87-89. doi: 10.1080/17482960601147461Spataro, R., Bono, V., Marchese, S., & La Bella, V. (2012). Mechanical tracheostomy ventilation in patients with amyotrophic lateral sclerosis: clinical characteristics and survival analysis. Journal of Neurological Sciences, 323(1-2), 66-70. Retrieved from http://www.sciencedirect.com.proxyhu.wrlc.org/science/article/pii/S0022510X12004406?np=ySpataro, R., Ficano, L., Piccoli, F. and La Bella, V. (2011 ). Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis: effect on survival. Journal of Neurological Sciences, 304(1-2), 44-48. Retrieved from http://www.sciencedirect.com.proxyhu.wrlc.org/science/article/pii/S0022510X11000712?np=y