Which of the following is a symptom of ALS that may affect speech?

Decreased swallowing ability is indeed a symptom of ALS (Amyotrophic Lateral Sclerosis) that can significantly affect speech. ALS is a progressive neurodegenerative disease that impacts motor function, including the muscles responsible for speech and swallowing. As the disease progresses, individuals often experience dysphagia, or difficulty swallowing, which can lead to aspiration and may also affect the coordination of the muscles used in speech production.

While ALS can cause various speech issues, such as low vocal pitch or nasal quality, the connection between decreased swallowing ability and overall speech function highlights the broader implications of muscle weakness and coordination in individuals with ALS. This makes it a correct choice in understanding the symptoms related to speech in this condition.