ALS Functional Rating Scale
A. Speech
- 4 - Normal speech processes
- 3 - Detectable speech disturbances
- 2 - Intelligible with repeating
- 1 - Speech combined with nonvocal communication
- 0 - Loss of useful speech
B. Salivation
- 4 - Normal
- 3 - Slight but definite excess of saliva in mouth; may have nighttime drooling
- 2 - Moderately excessive saliva; may have minimal drooling
- 1 - Marked excess of saliva with some drooling
- 0 - Marked drooling; requires constant tissue or handkerchief
C. Swallowing
- 4 - Normal eating habits
- 3 - Early eating problems - occasional choking
- 2 - Dietary consistency changes
- 1 - Needs supplemental tube feeding
- 0 - NPO (exclusively parenteral or enteral feeding)
D. Handwriting
- 4 - Normal
- 3 - Slow or sloppy; all words are legible
- 2 - Not all words are legible
- 1 - Able to grip pen but unable to write
- 0 - Unable to grip pen
E. Cutting Food and Handling Utensils
(patients without gastrostomy-feeding tube)
- 4 - Normal
- 3 - Somewhat slow and clumsy, but no help needed
- 2 - Can cut most foods, although clumsy and slow; some help needed
- 1 - Food must be cut by someone, but can still feed slowly
- 0 - Needs to be fed
Cutting Food and Handling Utensils
(alternate scale for patients with gastrostomy-feeding tube)
- 4 - Normal
- 3 - Clumsy but able to perform all manipulations independently
- 2 - Some help needed with closures and fasteners
- 1 - Provides minimal assistance to caregiver
- 0 - Unable to perform any aspect of task
F. Dressing and Hygiene
- 4 - Normal function
- 3 - Independent and complete self-care with effort of decreased efficiency
- 2 - Intermittent assistance or substitute methods
- 1 - Needs attendant for self-care
- 0 - Total dependence
G. Turning in Bed and Adjusting Bed Clothes
- 4 - Normal
- 3 - Somewhat slow and clumsy, but no help needed
- 2 - Can turn alone or adjust sheets, but with great difficulty
- 1 - Can initiate, but not turn or adjust sheets alone
- 0 - Helpless
H. Walking
- 4 - Normal
- 3 - Early ambulation difficulties
- 2 - Walks with assistance
- 1 - Nonambulatory functional movement
- 0 - No purposeful leg movement
I. Climbing Stairs
- 4 - Normal
- 3 - Slow
- 2 - Mild unsteadiness or fatigue
- 1 - Needs assistance
- 0 - Cannot do
J. Breathing
- 4 - Normal
- 3 - Shortness of breath with minimal exertion (e.g. walking, talking)
- 2 - Shortness of breath at rest
- 1 - Intermittent (e.g. nocturnal) ventilatory assistance
- 0 - Ventilator dependent
This scale was taken from the ALS Survival Guide, located at http://www.lougehrigsdisease.net.
You are here: ALS Functional Rating Scale
Back to Treatment
Home | About Site | Introduction | History | Symptoms | Forms | Causes | Diagnosis | Research | Facts | A True Case | Conclusion | Credits
