This paper presents a critical account of research into the non-motor symptoms associated with amyotrophic lateral sclerosis (ALS). Although research examining the cognitive and behavioural features of ALS has been extensively report -ed, social communication and emotion recognition changes have not been comprehensively explored. Furthermore, the current research and diagnostic criteria for diagnosing such changes, which have served as a useful conceptual model, do not provide a means of assessing the subtle cognitive changes reported in non-demented ALS patients. In addition, the impact and challenges of providing care for a person with a diagnosis of ALS who is also experiencing changes in cog-nition and behaviour have been explored only tangentially in the literature, and require immediate attention. We argue that the establishment of criteria to detect mild cognitive impair-ment may serve as a useful model to provide effective clinical interventions for both patients and caregivers at the earliest possible moment.