A Note From the Director

Welcome to the ALS Augmentative Communication Program (ACP).  This program is born out of a 30+ year history of augmentative communication service delivery at Boston Children’s Hospital (BCH).  While a pediatric center, the ACP has been honored to support many people with ALS since the program was founded by Howard Shane, PhD and formally established in 1985. Early clinical innovations, offering significant benefit to children with complex communication needs and adults with ALS include the development of communication software and creation of the DECTalk speech synthesizer and later the Multivoice synthesizer in partnership with Digital Corporation. In addition, in the early 90’s, the ACP had a first of its kind mobile outreach van dedicated to community based service delivery for children and adults.   

The ALS Augmentative Communication Program was formally established in December of 2015 with the generous support and vision of Jay and Randy Fishman. With this gift, we have been able to establish a comprehensive augmentative communication service with both full time speech-language pathologists and full time occupational therapists who specialize in augmentative communication, assistive technology and physical access considerations.  

Our clinical philosophy is to be proactive and introduce and review many communication strategies and tools as early as possible. This allows a person with ALS to be well informed and to be intimately involved with the creation and selection of communication tools and strategies. Proactive participation also allows some people to complete ‘message banking’, a clinical innovation first invented at Boston Children’s Hospital in the pediatric ICU and later incorporated into our service delivery model for people with ALS.    

We are deeply grateful to all the people with ALS and their families who have collaborated with us, educated us, informed our content and given us permission to share their stories, photos and videos. But most of all we thank them for inspiring us and allowing us to be part of their journey with ALS.         

This website is intended to be a resource of information to our patients, their families and certified speech-language pathologists and occupational therapists who are providing comprehensive and evidence based AAC assessment and intervention to people with ALS.   We will continue to evolve this site based on clinical lessons learned, evidence based practice, research outcomes, guidance we receive from people with ALS and their families/care team and innovations and advances in technology.   Please check back often for updates and new resources!

Thank you,


John Costello, Boston Children's Hospital ALS Augmentative Communication Program

John M. Costello, M.A. CCC-SLP
Director, ALS Augmentative Communication Program
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