Hoarseness
* Difficulty pronouncing certain sounds
* Speech becoming slower or less clear
Mayo Clinic identifies slurred speech as a possible early symptom, especially when ALS begins in muscles controlling the mouth and throat. ([Mayo Clinic][1])
Sudden speech difficulty, however, can also indicate a stroke and should be treated as an emergency.
## 7. Difficulty Swallowing
ALS can weaken muscles involved in swallowing.
Early signs might include:
* Coughing during meals
* Choking more easily
* Difficulty swallowing certain textures
* Food feeling harder to move through the throat
* Taking much longer to finish meals
Trouble swallowing can have many causes and should be medically assessed, especially when it is new or worsening. ([Mayo Clinic][1])
## 8. Progressive Muscle Wasting
When motor neurons no longer stimulate muscles normally, the affected muscles may gradually shrink.
This is called **muscle atrophy**.
You might notice:
* One hand looking thinner than the other
* Reduced muscle bulk in an arm or
