The research is aimed to asses the validity of the communication system improving the quality of life and the degree of sanctification of clinical patients and their caregiver.

Inclusion Criteria:

• Escorial revised criteria (Brooks et al., 2000),The diagnosis of ALS requires:

(A) the presence of:

• (A:1) evidence of lower motor neuron (LMN) degeneration by clinical, electrophysiological or neuropathologic examination (A:2) evidence of upper motor neuron (UMN) degeneration by clinical examination, and

• (A:3) progressive spread of symptoms or signs within a region or to other regions, as determined by history or examination, together with: (B) the absence of (B:1) electrophysiological or pathological evidence of other disease processes that might explain the signs of LMN and/or UMN degeneration, and (B:2) neuroimaging evidence of other disease processes that might explain the observed clinical and electrophysiological signs.

  • If they were Taiwanese and used traditional Chinese(Mandarin).
  • If they were older than age 20 years.

Exclusion Criteria:

• If they had been diagnosed with frontotemporal dementia, severe depression, or schizophrenia.
• If they cannot see the communication board after correction.
• If they cannot complete the questionnaire with researchers or family members help.

Participants with ALS were recruited from ALS clinics(Taipei Veterans General Hospital, Taiwan, R.O.C),20 participants. Participants were eligible for this study if they were diagnosed with definite, probable, probable laboratory-supported, or possible ALS according to the criteria (Brooks et al., 2000).