Agraphia due to the left parietal lobe dysfunction is a condition characterized by various symptoms, including distortion of character morphology, errors in stroke order, and impaired character recall. These errors can differ depending on the writing system, which differs across languages; for example, complex Chinese characters in Japanese and Chinese require visuospatial processing for accurate writing. Despite these observations, the establishment of clear and consistent classification criteria for these errors remains a challenge. In this study, the error response classification for Chinese character in degenerative diseases, proposed by Tee et al. (2022), was applied to a Japanese case of agraphia caused by a focal left parietal lobe lesion. Our aim was to evaluate the usefulness of the assessment and to investigate the underlying mechanisms of agraphia caused by damage to the left parietal lobe. The patient was a right-handed male aged in his 70s who presented with agraphia due to a brain tumour on the left parietal lobe. The patient exhibited characteristics of apraxic agraphia, such as distorted character shapes, disorder of sequencing writing strokes, and repeated self-corrections, as well as a characteristic of pure agraphia, namely the inability to recall character. The analysis revealed that in the early stages, "stroke errors", characterized by distorted character shapes, were highly prevalent, clearly indicating the features of apraxic agraphia. However, as the patient's condition improved, the frequency of "stroke errors" decreased, while "radical errors", which involve substituting or omitting parts of a character, and "blank responses", typically associated with pure agraphia, became more prominent. These results suggest that the apraxic agraphia, which was noticeable in the early stages, improved significantly over time. This classification method proved beneficial in comprehending the intricacies of the errors observed in this case. However, it was deemed essential to augment the prevailing cognitive model to elucidate the underlying mechanisms of apraxic agraphia caused by focal damage, particularly to the left parietal lobe.

Over 20 years ago, when my husband was 43, he suffered a subarachnoid hemorrhage. Although his life was saved, he was left with severe cognitive impairment after brain injury (hereafter referred to as 'CIBI' ). After undergoing rehabilitation and vocational training, he was able to return to work under a disability employment program two years and four months after the onset, marking his return to society. However, due to prominent symptoms such as severe memory impairment, emotional instability, and confabulation, he cannot live freely as he sometimes causes trouble for those around him. Furthermore, because he lacks awareness of his condition, he does not perceive these limitations as problematic. While I am grateful that he can live within a small, comfortable world where he is understood, I hope that society as a whole will come to understand and support people with this kind of disability. I truly believe that if that happens, my husband could live more vibrantly and freely, and that even his symptoms might improve. That, I believe, would bring true happiness not only to my husband but to all people with CIBI. And more than anything, I hope that greater support will be given to families and caregivers—those who are worn out by providing care and support to individuals with disabilities, and by the lack of resources for those living with the condition and by society’s limited understanding of this invisible disability.

Anosognosia for hemiplegia, the denial of one's own motor palsy mainly during the acute phase, sometimes persists chronically in some cases. Although anosognosia for hemiplegia is a poor prognostic factor for motor function during rehabilitation, there are few reports aimed at improving it. In the present study, we implemented three intervention conditions in two patients with anosognosia for hemiplegia after the acute phase of stroke, both of whom also exhibited severe unilateral spatial neglect: movement of the paralyzed limb only (Method A), movement of the nonparalyzed limb and visual confirmation of movement using a mirror (Method B), and movement of the paralyzed limb and visual confirmation of movement using a mirror (Method C). Clear improvement of anosognosia for hemiplegia was most likely observed under Method C. In patients with anosognosia for hemiplegia complicated by severe unilateral spatial neglect, using a mirror to visually confirm the paralyzed limb and encouraging movement of the paralyzed limb may improve their awareness of the paralysis.

Introduction: While the effectiveness of group-based interventions for individuals with acquired brain injury is well established, private organisations in Japan often face challenges in providing such interventions due to institutional and financial constraints. This study introduces a community-based day programme collaboratively provided by local government and private occupational therapists, and retrospectively evaluates its effectiveness.

Methods: The day programme comprised a comprehensive set of activities focusing on goal setting and enhancing participants’ understanding of brain injury. Of the 17 individuals with acquired brain injury who participated in one of three programme cycles conducted over an 18-month period beginning in 2023, 10 first-time participants were included in the analysis. Pre- and post-intervention outcome scores were compared, and participants’ status at programme completion was also examined.

Results: Among the participants (median age: 52 years), positive changes were observed after the intervention in self-awareness, self-esteem, caregiver burden, and social participation. At the end of the programme, three participants had returned to employment, and five were actively pursuing employment with support from local services.

Discussion: These findings suggest that comprehensive community-based support, delivered through public–private collaboration, may serve as an effective group intervention to facilitate social reintegration for individuals with acquired brain injury.

I experienced a stroke in my 40s, resulting in moderate aphasia and right-sided hemiparesis. For me, as a translator whose livelihood revolves around “words,” the loss of language represented a collapse of identity, directly leading to isolation and depression. Although conventional speech therapy was effective to some extent, I found it mechanical, difficult to find meaning in, and limited in motivating recovery. A turning point came with recitation based on my background in theater. Recitation is not mere vocalization; it is an act of conveying meaning to someone, infused with emotion. Beyond improving language function, it promoted self-expression, emotional release, and connection with others. At the recitation class I established after discharge, people with aphasia learn from each other and demonstrate increased motivation for social participation. This paper reports the process of self-recovery through recitation and its practical applications, discussing the effectiveness and social significance of recitation in aphasia rehabilitation. Recitation serves not only as “language rehabilitation” but also as “rehabilitation for reclaiming the self,” offering a new avenue to support the regeneration and social reintegration of people with aphasia.

・Conventional speech and language rehabilitation has focused on the accurate use of language as a tool, emphasizing the “body functions and structures” component of the ICF.

・In contrast, rehabilitation approaches that promote “activities” and “participation” have not been sufficiently explored.

・This study examined the incorporation of performative reading into speech and language rehabilitation, comparing it with conventional oral reading.