Edinburgh Cognitive and Behavioural ALS Screen (ECAS)

A cognitive and behavioural screen designed specifically for people with ALS.

Clinician-administered; approximately 20 to 25 minutes.
ALS-specific domains: language, executive function, fluency (total 100).
ALS-nonspecific domains: memory, visuospatial (total 36). Overall total: 136.
Behaviour scale completed separately by a carer.

What it measures

The ECAS was designed for ALS specifically, so tasks avoid motor responses that ALS makes difficult. The ALS-specific section covers fluency (word generation), executive function, and language (comprehension and spelling). The ALS-nonspecific section covers memory and visuospatial ability. A separate carer questionnaire probes behavioural change. The tool detects frontotemporal involvement (the ALS-FTD spectrum).

What the result tells you

Total scores out of 136 (higher is better), with separate totals for ALS-specific (100) and ALS-nonspecific (36) domains. Cut-offs differentiate cognitive impairment in ALS from healthy performance. Behavioural change on the carer scale is reported separately. The ECAS is used in clinical research and monitoring.

Used for

Evidence, psychometrics and provenance

Psychometrics

Sensitivity for cognitive impairment≈ 80%

Specificity vs healthy controls≈ 80%

Screening accuracy against healthy controls. Higher is better.

References

1.Abrahams S, Newton J, Niven E, Foley J, Bak TH. Screening for cognition and behaviour changes in ALS. Amyotroph Lateral Scler Frontotemporal Degener. 2014;15(1-2):9-14.

This assessment uses a validated instrument and is reference information, not a diagnosis.