Varieties of chromosomal diseases are induced by an abnormal number of chromosomes due to non-disjunction at miosis or by its mosaicisms. Others are caused by structural changes such as a break or a deletion of a certain chromosome and by a translocation in a paired one. New concepts, such as small deletion syndromes, contiguous gene syndromes, gene imprinting syndromes, and DNA triplet repeating diseases are also described. Each disease shows its characteristics in patient's language behaviors. Some people with Down's syndrome, for instance, can express easily their mind but some others can not talk at all. Patients with fragile X syndromes show stuttering in their speech. The purpose of the Pediatric Infant Class in Nishitaga hospital (PIC'n) is described. This class is for children with Down's syndrome and their families. It is helpful for them to meet each other and to get information about the disease and their management.

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This paper reports a therapy process for an agrammatic patient with apparent telegraphic speech caused by a large infarction in the right cerebral hemisphere. Therapy aimed at improving his telegraphic speech was initiated 11 months after the onset for a period of 4 years and 5 months. In the first period, training of insertion of postpositional particles was given. Then, in order to reduce omissions and replacement errors, training of predicate parts was commenced, which was analyzed in detail in this study. This training included verb inflection, inserting auxiliary verbs, and inserting verb phrases in explaining 4-frame comic strips. As a results, the patient acquired the ability to use conjugations and his ability to recall and select auxiliary verbs. He also demonstrated some improvement in inserting verb phrases.

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This study investigates the noun-verb dissociation problem in word finding abilities in aphasia from a longitudinal point of view. At least 4 consecutive performances on oral naming of objects and actions on the Standard Language Test of Aphasia (SLTA) were analyzed in 26 aphasic patients. The results were as follows: (1) Four groups were recognized: One group showed a consistently better performance in producing verbs than nouns (the verb-dominant group, N=5); another group showed the reverse pattern, that is, a consistently better performance in producing nouns than verbs (the noun-dominant group, N=6); the remaining two groups comprised the equivalently recovered group (N=9) and the fluctuating group (N=6); (2) All cases in the verb-dominant group showed early verb-dominant recovery patterns, fluent speech, and all had predominantly left temporal lesions; (3) All cases in the noun-dominant group showed early noun-dominant recovery patterns, but they had either fluent or nonfluent speech and diverse lesion sites. Furthermore they made various types of error in action naming. It is concluded that the disproportionately noun-impaired group seems to be relatively homogeneous whereas the disproportionately verb-impaired group seems to be heterogeneous. It is suggested that there are a variety of reasons why verbs should be harder than nouns to retrieve.

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This study describes the communicative behaviors of a nonspeaking girl with cerebral palsy who utilized a communication board of letters. Observation of her communicative interactions in one day revealed the following facts. (1) She often used the communication board of letters, but she sent few messages by the board. (2) The communication board of letters played an important role in terms of information transfer and initiations of topics in communicative interactions. (3) There were some situations where the girl was not able to use the board because it was not located within her reach. (4) She utilized the board little in group sessions. (5) There were only a few occasions when she initiated a topic and dominated a conversation.

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Therapy goals for children with developmental disorders in language are reported referring to cases in a children's rehabilitation hospital. For these children entering school can be an opportunity to terminate therapy and may coincide with a turning point in their language development and in their life cycle. In reality, there are various other factors which may or may not bring an end to therapy, such as developmental stage of their language, their parents' or speech therapists' viewpoints on the child's overall development, and the nature of the institution which the child is in. Although each child's developmental stage of language varies at the end of therapy, speech therapists should guide the children and their parents to the point where they can accept their circumstances and learn by themselves to make their social lives stable.

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The purpose of this article is to discuss the timing of terminating treatment for stuttering in 4 different age groups. The groups consist of children of preschool age, school-age children, young adults, and adults. The results were as follows: 1) The preschool children improved in fluency in comparison with the other 3 groups; 2) Treatment for most cases terminated within 3 years; 3) In many cases, the timing of termination corresponded with a change of the patients' life stage.

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In deciding on terminating speech management for cleft lip and/or palate (CLP), understanding the medical system and issues in this field is critical. Firstly in this article, an outline of the medical system generally taken for CLP is explained. Secondly, a viewpoint of finishing speech management is reported based on the results of examining 88 cases who underwent surgery for cleft palate in the Department of Oral Surgery, Nagoya University School of Medicine. Items examined included articulation, velopharingeal closure function, and perforation. In deciding on finishing speech management, clinicians have to consider not only the aspects of patients' speech functions but also medical and dental aspects as well as social factors such as patients' psychological states and school environments.

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Three factors were discussed in relation to terminating clinical services for speech-language-hearing problems in children with cerebral palsy. These factors were “the variety of disabilities, ” “the enhancement of service approaches”, and “the rehabilitation service system”. Speech therapists often have to decide whether clinical services are to be continued or discontinued when children with CP enter school. A decision is made based on the further need for professional support rather than on the severity of disabilities. This is due to “the variety of disabilities” in CP. Based on this criterion, we decided to terminate services for 86 children and to continue for 45 out of 131 children with CP. “Enhancement of service approaches” causes a prolongation of service duration. For example, support for severe dysphagia and an augmentative and alternative communication approach for severe dysarthria tend to require a long duration. The maximum service duration was 12 years. In order for the services to continue for such a period, “the rehabilitation service system” must be improved.

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Long-term follow-up data of aphasic patients were studied in regard to the recovery of language functions, the acceptance of disability and return to social life. Criterions for terminating speech therapy are discussed. Adolescent and young adult aphasic patients show remarkable recoveries following intensive speech therapy. After their recovery the content of therapy changes into a training for academic or vocational skills. Among middle and old aged persons, therapeutic effects are limited for severely impaired, and only moderate and mild aphasics may recover well. When therapy aimed at facilitating language function, functional reorganization and communicative function at a chronic stage have brought a certain result, speech therapy is considered to have reached an end. Concerning emotional problems in aphasics, speech therapists are to advise patients to confront tasks which will promote their social adjustments and to accept their disabilities. By giving patients and their families appropriate information on medical personnel and institutions for their future use, speech therapy comes to an end.

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Suffering from language disturbances with/without physical disabilities due to cerebral damages patients experience a loss of their world of language and/or of their own space. It can mean the loss of their self image. Even for a patient with severe aphasia, clinicians can facilitate various responses by asking and talking empathetically about the internal reality of the patient's own world. Patients may lack a sense of reality, reject reality, feel inconsistent with the present, experience loss of their own space, and/or feel anxiety. They may face the image of death and bury their own world beyond it, returning to the present at a later stage. This is the first step towards recovery when they accept themselves and turn towards a real life again. The role of language clinicians in rehabiliation is to help the patients understand their internal experience and through empathy to help them express themselves. The timing of terminating language therapy is when patients can feel their own active sense of loss and thereby adapt themselves to their external reality loss.

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