A survey was conducted to study the situation of adults who are in speech therapy at community-based health-care and social-welfare facilities, in order to explore future directions of community-based speech therapy. A total of 364 subjects with cerebral vascular injury receiving community-based speech therapy in Tokyo participated in the survey. The following observations were made based on the results. (1) 98 percent of the subjects were covered by long-term nursing-care insurance and approximately 70 percent were aphasic. (2) The median post-onset time when they first received community-based speech therapy was 13.2 months, and of the 47 percent who started receiving community-based speech therapy within one year post-onset, more than 30 percent had never had speech therapy before. (3) Most subjects started speech therapy at hospitals and subsequently were referred to community-based services.
    Problems associated with community-based speech therapy covered under long-term nursing-care insurance were discussed based on the results.

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     We report a case of neologistic jargonaphasia accompanied by stereotypic occurrences of neologisms. The neologisms in the patient's speech varied according to phonological and/or semantic associations. This characteristic pattern of neologism variations suggests a phonological as well as a semantic breakdown that may contribute to the genesis of neologistic jargon. We try to account for the stereotypic occurrence of neologisms using the interactive spreading activation model of language processing postulated by Dell (1986) , and we discuss some aspects of phonological and semantic disorganization in neologistic jargonaphasia from the viewpoint of cognitive neurolinguistics.

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    A case of crossed aphasia with jargonagraphia was reported. We discussed the underlying mechanisms of the subject's jargonagraphia from the standpoint not only of free running hypothesis (Yokoyama et al., 1981) , but also of phonological disorders and voluntary action disorders of the upper limbs. The case was a 56-year-old right-handed male suffering from fluent aphasia after cerebral infarction on January 7, 1999. MRI showed lesions of the temporo-parieto-occipital lobes in the right hemisphere. Language comprehension was well preserved, and one prominent symptom other than jargonagraphia was literal paraphasias. Our data showed that : 1) his abilities in tracing letters were intact, suggesting that his motor engrams of writing behavior were well preserved ; 2) he showed great difficulties in processing more than one phonemic letter or phoneme ; and 3) he could not voluntarily stop the actions of his right upper limb according to instructions. These observations suggest that voluntary action disorders of the upper limbs accompanying motor engrams of writing behavior lateralized in the intact hemisphere, when control has been lost from the center of the phonological processing lateralized in the affected hemisphere, result in jargon selectively seen in writing behaviors.

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    The present study examined the relation between deficits in speech and frequency transition discrimination in aphasia. Nine aphasic patients with left hemisphere damage and 11 normal subjects participated in the experiments. A speech discrimination task and a non-speech frequency transition discrimination task were employed. The speech discrimination task used 2 stimulus pairs. The first pair consisted of /ba/ and /da/, both of which had rapid second formant (F2) transitions. The second pair consisted of /wa/ and /ra/, both of which had gradual F2 transitions. The non-speech frequency transition discrimination task also used 2 stimulus pairs. The first pair consisted of 2 pure tones with a rapid frequency transition, and the second consisted of 2 pure tones with a gradual frequency transition. The first non-speech pair corresponded to the /ba/-/da/ pair, and the second corresponded to the /wa/-/ra/ pair.
    The following results were obtained : (1) Overall discrimination performance with the /ba/-/da/ pairs characterized by rapid F2 transition was not significantly lower than that with the /wa/-/ra/ pairs characterized by gradual F2 transition in the aphasics. (2) However, the error pattern in the /ba/-/da/ discrimination and that in the /wa/-/ra/ discrimination were different. (3) A significant correlation between performances with the /ba/-/da/ discrimination and those with the rapid frequency transition discrimination was observed in the aphasics. (4) Patients who showed poor performances with both the /ba/-/da/ discrimination and the rapid frequency transition discrimination had a lesion in the transverse temporal gyrus of the left hemisphere.
    These findings suggest that perceptual disturbance caused by a lesion in the transverse temporal gyrus is not a principal factor behind speech discrimination deficits in aphasic patients, but it does have a negative effect on the discrimination performance of syllables with rapid frequency transition.

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    We report a 31-year-old right-handed woman who presented a pure form of word-meaning deafness. Her comprehension impairment fulfilled the criteria of this syndrome described by Flanklin (1989) ; She was not able to comprehend spoken words that could be immediately understood in written form. Repetition and auditory lexical decision were preserved.
    After the operation of left cerebral hemorrhage, she developed mixed type aphasia. In 10 weeks, her speech output gradually improved and the symptoms of word-meaning deafness developed. During conversation, she sometimes echolalically repeated even simple words several times in an attempt to grasp its meaning. When the same words were shown in written form or presented in other words, she could immediately comprehend them. The repetition was 97% correct for single syllables and 80% correct for four-syllable non-words. Lexical decision was 98% correct even in an early stage. Her auditory comprehension was not affected by word frequency but was influenced by word imageability.
    These findings suggest that she is a condition in which “acoustic sounds are accurately perceived, correctly analyzed, and recognized as verbal sounds, and the sequences of verbal sounds are recognized as word forms, but semantic information cannot be accessed : Word-meaning deafness”.

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