This investigation is a longitudinal study of how hearing-impaired infants, ages three to five, use communication repair strategies in conversational situations. The subjects consisted of six hearing-impaired infants in a preschool for deaf children. For each subject, data was collected from their group interaction with their preschool teacher and their hearing-impaired peers. The results indicated that three-year-old infants used no repair strategy, but that four-year-old infants began to use some repair strategies. Five-year-old infants frequently used a great variety of repair strategies. There was a significant correlation between the frequency of their use of repair strategies and their level of social maturity (particularly communication ability). A developmental model of repair strategy use was also proposed.

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This paper presents a case of dysphagia in a patient with cervical vertebrae fracture, thoracic spinal cord injury, and diffuse brain injury. The causes of the swallowing disorder are mostly attributed to the brain injury, partially to the limited movement of the larynx due to an eight-month immobilization of the cervical spine, and to a psychological factor (the fear of swallowing due to a history of respiratory arrest following aspiration). While respiratory management should be given priority during the acute phase of high cervical cord injuries, this case suggests that swallowing disorders should be taken into account in cases accompanied by brain trauma.

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This study reviews the activities of the Seminar for Stutterers in Tokyo. The Tokyo Genyuu-kai (self-help group for stutterers) started these seminars in 1972 with the sponsorship of the Tokyo Metropolitan Government. The program has dealt with the following topics: (1) coping with stuttering problems in daily life, and (2) strategies for speaking with more ease. The seminar is based on the principle that all members both give and receive training but has also discussed the ways in which speech therapists and clinical psychologists can cooperate with its self-help activities.

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This paper reports on two years of guidance, which began at the age of three years and one month, for a child with eating and motor disabilities whose main problem was dysphagia. At the beginning, the child required total assistance. Through guidance, the child acquired the ability to chew and feed by herself with hands. The role of the speech therapist in this guidance for eating and swallowing was discussed in terms of: (1) the development of the child, (2) guidance of the mother, (3) the selection of food, (4) the development of a support network, and (5) the importance of relationships of trust.

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This paper reports in detail on practical training for a patient with severe dysphagia. Though the patient was seriously handicapped, I found that our training was able to bring about continued improvement. Among the factors responsible for this, I discuss how the medical staff patiently continued the medical treatment and training and, by enabling the patient to eat through her own efforts, were able to draw out her desire to live. While reconsidering the importance of “eating” for people to live humanely, I state my personal opinion about the role of the speech therapist and concrete methods to help a patient with dysphagia. I also presented two suggestions concerning the “team approach” for rehabilitating a patient with dysphagia and the “professional ethics” of the speech therapist.

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This paper investigates the efficacy of therapeutic intervention for 46 patients, suffering from dysphagia due to neurological disorders, and the relationship between swallowing and articulatory functions. The results are as follows. (1) 28 patients achieved sufficient recovery of the swallowing function. (2) Age, time elapsed between onset and admission, the duration of intervention, and the severity of dysphagia were unrelated to recovery. Only problems of cognitive function affected the outcome of intervention. (3) There was no significant correlation between the swallowing function, based on Fujishima's swallowing function grade, and intelligibility of speech. Oral preparatory functions in swallowing significantly correlated with articulation. These findings suggest that the swallowing function and articulatory function consist of common factors and their own particular factors and thus that therapeutic intervention might require distinct strategies for each.

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With an occupational therapist, the author provided joint therapy for a boy with severe cerebral palsy who also had difficulty eating comfortably because of a tonic bite reflex with an overall increase in body extension. The purpose of this study was to examine the effects of joint therapy by comparing it with therapy carried out only by a speech therapist. The results were as follows. (1) During the course of twelve sessions, the tonic bite was gradually reduced. (2) Even within a single session, where therapy by a speech therapist was followed by joint therapy, the tonic bite reflex abated and the tonic bite with an overall body extension decreased. (3) The joint therapy also positively effected the next session of single therapy. (4) It seems that the better alignment of the patient's head attained in joint therapy served to reduce the tonic bite reflex.

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