In order to study characteristics of grammatical deficits, two non-right-handed aphasic patients with impaired sentence production, following left hemisphere lesions, are presented. The patients are a 49-year-old man (case A) and a 37-year-old woman (case B). A second group without grammatical deficits consisted of two right-handed nonfluent aphasics following left hemisphere lesions are also presented for contrast. We quantitatively analysed the syntactical and morphological aspects of their verbal expressions using stimulus drawings. The results were as follows: Case A produced very simple structured sentences and presented morphological problems, such as a tendency to use nouns, a reduction of units in predicates and errors (omissions and substitutions) of particles. He was considered to have both syntactical and morphological deficits. On the other hand, case B showed difficulties in structurizing sentences. Her ability to process grammatical morphemes was not much different, when compared with the right-handed aphasics, besides the substitutions of particles. Therefore, we speculated that her grammatical deficits were predominantly syntactical. We discuss these results based on a typology of agrammatism by Tissot, Mounin, Lhermitte et al. (1973).

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First, we briefly present an introduction to the structuro-global audio-visual methodology (Verbo-Tonal System). Then several studies of linguistic, clinical and cultural problems based on these principles for the rehabilitation of Japanese aphasic patients are covered. Finally we report and investigate the efficiency and possibilities of applying this methodology to 4 patients who were suffering from global or Broca aphasia. This study strongly suggest the importance and the necessity of studying and approaching human beings not simply or the sum of isolated senses and functions, but also are endowed with a much more complex whole spirit.

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The definition, classification, anatomy, physiology, assessment and treatment of dysarthrias are described from a neurologist's perspective. Dysarthria is usually classified by the level of impairment to the motor systems which consist of the central nervous system, the peripheral nervous sysytem and the muscular system. The central nervous system is involved in voluntary movements and has three subsystems: the pyramidal, the extrapyramidal and the cerebellar systems. In addition to these sysytems, sensory feedback systems play a significant role in speech production. The speech symptomatology caused by a lesion involving each system is described with contrasting motor and sensory symptomatology. Dysarthria is usually assessed from two points of view, one from the patient's speech characteristics, the other from his or her motor and sensory functions of speech organs. Finally some treatment approaches for dysarthrias including pharmacotherapy are suggested.

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The assessment of dysarthria is usually composed of the acoustic analysis and the examination of movements of speech organs. In cases of dysarthria resulting from neurological deseases, especially from central neurological ones, the abnormal movements are caused by an abnormality in the motor control mechanism, which is a neurophysiological aspect of dysarthria. Althrough the whole of the motor control mechanism is not elucidated, muscle tonus, coordination and sensation are essential elements for motor control. Therefor the assessments of these elements gives very important information for analyzing the causes of the abnormal movements. From this point of view, central postural control mechanism which support fine motor functions is discussed. Abnormal muscle tonus and incoordination observed in functional movements are also discussed and a number of cases are presented. With regard to the method of assessment, it is necessary to add palpation and reevaluation of the response to treatments to conventional method.

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In this paper, I investigated the structure of therapeutic approaches which seek to improve speech motor control. Treatments discussed can be defined as “a process to optimize relearning of speech motor control through operation of variables on those speech production seems to depend.” I classified variables and manners of operation in some advocated treatments and analyzed speech therapy based on “Bobath Approach” by using this framework. The characteristics of this approach are as follows: (1) utilization of automatic oral movements, including eating, in order to practice elements of speech movement; (2) consideration of the normal postural control mechanisms, which are the basis of skilled movements; (3) improvement of postural tone and movement patterns of the whole body and oral area. The differences between Bobath approach and others are also discussed.

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There are various problems in the oral communication of patients with neuromuscular diseases such as progressive muscular dystrophy and amyotrophic lateral sclerosis. In this paper, communication is not limited to those between persons, but is expanded to those between persons and the life environment and persons and society: communication is defined in a wide sense. Some typical equipment to achieve such communication is introduced. In addition, one scene of the daily life of two patients with neuromuscular diseases is introduced to discuss the meaning of communication for them.

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