One of the most important issues for quality of life – as I see it – is friends and family. Depending on your condition, spoken communication may become difficult, because spoken communication requires the coordinated effort of a great many muscles, some of which are difficult to exercise. I strongly recommend seeing a speech therapist early, they may be able to extend the amount of time you can still speak.
Speech therapists also help with other complicated actions involving the mouth and throat. Mine is helping me to swallow – I have trouble with swallowing, and tend to choke every so often. Every other meal. Maybe more frequently.

If spoken communication becomes difficult, the obvious next step is to write. Unfortunately, writing also requires complex muscle work and fine motor control. Write if you can, but watch your capability.

Now – I have become somewhat familiar with assistive communication technology, and I don’t like it much. For the most part, it limits what you can ‘say’. Many of them will not enable you to have discussions like deciding on the colour scheme for the bedroom. And working out whether to breastfeed or bottlefeed a baby stretches the technology.

So I recommend learning Auslan (or the sign language for your part of the world). Even with muscle weakness, enough of Auslan is done with greater muscle movements and potentially clumsy muscle movements that I think it’s worth a try for free communication. It’s a full, complete language, with a living vocabulary. Discuss it with your physiotherapist, if they think you can do it, give it a try. Ask those closest to you to learn it with you.

If this doesn’t work, seek out the best communication assistance you can manage. Being a part of your circle of family and friends is a major aspect of maintaining quality of life.