Abstract
An effective way of oral communication was searched for a female patient whose intelligence was normal but limbs were paralyzed due to brainstem and cerebellum lesions. She needed to use a respirator, so phonation was impossible. She could control her tongue and lips to a certain extent but not enough to form all consonants and vowels. The following three methods were tried: 1) Using an electrical larynx. 2) Using a speaking tube. 3) Developing the nonphonating communication skill with signs using facial and oral movements. These signs represented some consonants and vowels. For example, when she wants to represent /ka/, she had to blink twice, then to make the oral form of /a/. She could not use the first and second methods effectively. With the third method she learned the signs representing the consonants and vowels and was successful in communicating with others. This nonphonating oral communication skill improved her quality of life greatly.
