This study examined the effects of the use of picture cards and manual signs as facilitators in language training, designed to develop two-word combination skills in a mentally retarded child. The two methods did not yield significant differences either in number of sessions required to reach mastery criteria for target sentences, or in pause durations between the first and second words in two-word utterances. However, the productions of subject nouns tended to be facilitated in the picture card method, whereas verb productions were more readily elicited in the sign method. These results suggested that the two methods did not differ in the extent to which two-word combinations are prompted, but that the functional mechanism underlying these methods is quite different. An analysis of word pause durations also indicated that intervals may decrease even before the attainment of mastery criteria. It was concluded that two-word productions in a mentally retarded child require both the acquisition of language structure rules and word retrieval skills.

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We compared the threshold of auditory brainstem response (ABR) with that of pure tone audiometry on 129 children (67 boys and 62 girls). ABR was administered to the subjects between the age of 1 month and 12 years old, and the pure tone audiometry between 2 years and 12 years old. In ABR, clicks of 0.2 milliseconds in duration were used. The results showed that there was a high correlation (r=.92) between the threshold of ABR and the pure tone audiometry in the speech frequencies. The types of hearing losses did not affect the results. Also, no differences in the correlation was found among the different age groups. In the patients with sensorineural hearing loss in the low tones, differences were observed between ABR and the pure tone audiometry: one such case was described in this paper. Therefore, it is suggested that clinicians should follow up the children who were tested with ABR until conditioned orientation response audiometry (COR) or pure tone audiometry can be performed. We also studied the patient group with no response in ABR (at 106 dBnHL). While most of them were determined as having a severe hearing loss in the pure tone audiometry, 58% of them were under 100-110 dBHL, for whom utilizing hearing ability may be expected. Clinicians, therefore, must be careful in giving information and fitting hearing aids especially for those children with hearing loss at the level of no response in ABR.

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This study reports a therapy process introducing augmentative and alternative communication (AAC) strategies to a severe aphasic patient who lost the motivation to communicate. He could not fully utilize any single AAC strategy. By combining several AAC strategies step by step, he gradually became able to communicate successfully. At the same time his speech improved. The improvement was also seen in his ADL and QOL.

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