During the clinical progression of amyotrophic lateral sclerosis (ALS) various disorders of the motor effector mechanisms of the pharynx may develop, impairing its functions of airway maintenance, swallow, or speech. Among ALS patients the disorders vary in distribution and sequence, but potentially affect each of these functions. Cineradiography is of strategic value in distinguishing the particular mechanisms of motor disability, whether paralysis, contracture, or atrophy, and also in the identification of motor compensations (6, 9). It is useful in demonstrating severity of disabilities and their potentially critical elements, as failure of laryngeal occlusion in swallowing. This information is essential for therapy, for facilitation of care and comfort, and at times for survival. Cineradiography, now generally available in medical centers, should be employed consistently in the evaluation and care of the ALS patient. Procedures Observations on 6 ALS subjects were selected from data of continuing studi...