Language impairments in children vary greatly between developmental and acquired brain damage. While I agree with the view that the clinical symptoms of children with acquired brain damage are more similar to those of adult aphasia than previously thought, I would like to add that children with seriously abnormal EEGs show a higher cortical dysfunction, with the exception of language impairment.
    As for children whose language comprehension is impaired, there needs to be discussion as to how to locate them as clinical patients, especially in relation to Aspergar syndrome. It should be judged in light of the detection of much more patients and the longitudinal studies.
    The notion that the pathogenesis of dyslexia is attributable not only to a deficit of phonological awareness, but also to a visual processing failure is a welcome one. It is also important that therapeutic approaches be considered in accordance with the variation of symptoms in individual patients.
    The development in Japan of a nationwide plan for the education of children with learning disabilities is a welcome move. However, children with developmental disorders will benefit from the implementation of an Individual Educational Plan (IEP). It is anticipated that an IEP will proceed in tandem with the support of a speech therapist.

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    About communication disorders of acquired childhood higher brain dysfunction, the clinical picture of acquired childhood aphasia (ACA) , childhood auditory agnosia due to bilateral auditory cortices (AA) and Landau-Kleffner syndrome (LKS) were reported.
   The traditional description of the clinical picture of ACA claims that ACA is invariably nonfluent, that recovery of language disorder is rapid and complete, and that ACA commonly occurs after right hemisphere damage. However, since the late 1970s the publication of several case studies has led to reject this longstanding standard doctrine. This review, which concerns the revised insights into ACA, aims at making an inventory of the recently described aphasic symptomatologies and neuroradiological data. Recent case studies show a great variety of aphasic symptomatologies including auditory comprehension disorders, paraphasias, neologisms, logorrhea, jargon, impaired repetition abilities, and a host of linguistic deficits in reading and writing. Not only the aphasic typology but also the recently established clinicoradiological correlations appear to resemble those found in adults. Also, recovery from ACA shows to be less complete than previously thought.
   AA is a rare disorder characterised by loss of speech discrimination and auditory comprehension in spite of normal hearing. Most children were afflicted with herpes simplex encephalitis. Sign language is helpful for children with auditory agnosia, because they can not develop normal auditory perception.
   LKS was first described in 1957. The disorder is characterised by gradual or rapid loss of language in a previously normal child. All children have abnormal EEG compatible with the diagnosis of epilepsy. However, only 70% have clinical seizures. The present article presents a review of the current knowledge concerning this disorder.
   It is necessary to provide an appropriate language education and also long-term follow up for each child with acquired higher brain dysfunction.

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    Neuropsychologycal evaluations were performed in 15 children who were suspected to have a disorder in the process of comprehending linguistic meaning. Regional cerebral blood flow (r-CBF) was also studied. These children had low scores on the linguistic tests compared with normal children of the same age. Although they could understand non-linguistic meaning, they had difficulty in understanding linguistic meaning. The disorder involved both auditory and visual processes. Even if these children could repeat verbal information and read aloud relatively well, they could not understand the meaning of what was spoken or read. It was thought that there was a discrepancy between phonological and semantic ability. A common decrease lesion of r-CBF to each case was the left temporal lobe that was known to cause the semantic disorder in acquired adult aphasia.

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    We analyzed Japanese developmental dyslexia using neuropsychological and cognitive-neuropsychological methods. First, we prepared the standardized data for normal children on reading and writing tests. Second, we selected 22 developmentally dyslexic children, 20 male and two female, using reading and writing tests. Their average IQ using WISC-III or WISC-R was 102 (VIQ 102, PIQ101) . Regional cerebal blood flow (rCBF) in the left temporo-parietal lobe accoding to the Patrak method showed greater than 10% rCBF reduction compared with the same area of the right hemisphere. The subjects manifested lower scores in tests of both phonological and visual information processing. As a result, we assume that developmental dyslexia is a higher brain dysfunction, accompanied by disorders in both phonological and visual information processing.

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    It was not until recently that schools in Japan were aware that there were children with learning disabilities and began to offer a real educational support for them. However, many practical studies on education for LD have brought about great change in the educational system of schools in Japan.
   First, there has been a shift in the educational concept from ‘Special Education' to ‘Special Needs Education.’ ‘Regular Education’ and ‘Special Education’ have been different fields of education in Japan, so children who learns in ordinary classes but have needs for special educational support have not been able to sufficiently receive ‘Special Education.’ Today's education for LD which is based on the concept of ‘Special Needs Education,’ pays enough attention to such children as well as LD.
   Next, we can observe another change in a growing understanding toward the importance of the regular classroom teachers' roles. Influenced by a report ‘Guidance to children with learning disabilities’ (1999), many practical studies on Special Needs Education are appearing in Japan. They propose that regular classroom teachers should be key persons when schools try to support children with special educational needs.
   Education for LD has just started. To develop this education further, we should train specialists in LD education, promote the cooperated attempts of education and medical cares, and the participation of speech and language therapists who specialize in languages.

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    Factor analysis was carried out on 26 improved scores of 195 aphasic patients. Improvement was defined according to differences in subtest scores obtained using the Standard Language Test of Aphasia (S. L. T. A.) before and after speech therapy. In all, we extracted 7 factors. We named the first the “central improvement factor,” which is thought to reflect “non-converting” language production and complex language information processing improved by speech therapy. We discussed the important role of the central improvement factor in aphasia rehabilitation.

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    We observed a patient with Foreign Accent Syndrome (FAS). The patient was a 54-year-old right-handed female who had suffered a left putamen-corona radiata stroke. She exhibited mild dysarthria and prosodic impairments, and the combination of these symptoms was thought to create the impression of a foreign accent. To clarify whether FAS arises during the process of recovery from dysarthria, aphasia or apraxia of speech, or rather constitutes an independent symptom, we had the patient carry out nonverbal repetitive tasks. No parapraxia was observed in the patient, as is the case also with dysarthric patients. In complex nonverbal repetitive tasks, the number of movements declined in comparison with dysarthria. Also, the change in number of movements was drastic in some items. These findings suggested that one factor of FAS may be nonverbal movement impairment. In this patient, it was thought that FAS was present because of a similar paralysis of movement which leans heavily toward the organization pattern of nonverbal movement.

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