In this paper we present the role of speech and language therapist in the interdisciplinary team focused on the management of patients with amyotrophic lateral sclerosis (ALS; Latin sclerosis lateralis amyotrophica, SLA). Depending on the clinical variant of ALS, speech disturbances may be the first disease manifestation or appear later in the disease course. In the differential diagnosis, it is useful to assess the type of dysarthria as well as describe the severity and profile of other deficits, such as dysphagia and aphasia. Assessment performed by a speech and language therapist is an ancillary examination in the differential diagnosis of clinical syndromes from frontotemporal lobar degeneration spectrum. Moreover, it enables devising optimal communication strategies and individualized therapeutic programme, not only applicable at a given disease stage but also aiming to support communication and prevent dysphagia.

The aim of this article is to analyse the activities that stimulate the linguistic development of the child up to the age of 2, influencing the growth of his/her speech level, and to show the benefits of prophylaxis as a set of preventive tasks aimed at reducing the risk of speech defects, forming correct habits in parents, doctors, midwives and informing about available effective forms of supporting language development from birth. The theoretical part describes the speech development of the newborn and infant up to the age of 2. The methodological section presents a qualitative research on a case study of a child whose speech was stimulated from birth. This child is at a high level of development at the age of 2 years. To assess the level of language and communication development, the Inwentarz Rozwoju Mowy i Komunikacji: Słowa i Zdania (Polish adaptation of MacArthur-Bates Communicative Development Inventory: Words & Sentences) has been used. The anatomical structure of the articulatory organs has been assessed using the visual-tactile method. Primary functions, the linguistic development of the child up to the age of 2 and measures to stimulate the child’s speech development have also been discussed.

In the articulation of a 4-year-old child, the phenomena related to speech ontogenesis overlap. A 4-year-old child articulates more phonemes than a 3-year-old, and at the same time some phonemes have not been mastered by him/her yet, and although these elements may appear occasionally, especially in certain, e.g. more difficult to produce phonological contexts, they are not yet acquired to the extent that would allow to talk about the completion of the acquisition process. This dynamics accompanying the development of the speech of a 4-year-old child and the overlapping of linguistic phenomena characteristic of the development of speech is the reason why in this age group there can be observed a higher rate of occurrence of different ways of implementing the same phonological contexts than in the younger and older population. This tendency is especially noticeable in the case of consonant groups that are difficult to articulate.

The article presents a description of selected theories of motivation and theoretical models related to it, as well as psychological and social factors influencing the motivation to act (its initiation and sustainment), with particular emphasis on motivation and factors influencing the effectiveness of speech therapy. External factors (form and type of interventions within the therapy), internal factors (psychological and intellectual resources) and mediating factors (gender, age and place of residence) are described. An analysis of the results of various research in this area has been conducted. Particular attention has been paid to strategies for stimulating intrinsic motivation. The concept of motivational dialogue (MD) is also described, including brief interventions and a MET session protocol that can be used to increase patients’ motivation for therapy.