This paper reports on a study of fifteen Japanese preschool children with specific language impairment (JSLI) regarding the syntactical and phonological processing abilities which many studies have pointed out as the core of deficits in English-speaking children with SLI. The JSLI children had lower scores on a syntactic test than the CA (chronological age)-matched controls, with lower scores more prominent in production and in younger children (five-year-olds compared to six-year-olds). The five-year-old JSLI children also performed poorly on almost all types of sentence reproduction whereas the six-year-olds performed poorly on only on passive and causative constructions. Phonological short-term memory, which was assessed by an obsolete word repetition task, was also significantly poorer in the five-year-old JSLI children relative to the CA-matched controls, but not in the six-year-old JSLI children. Thus we found a developmental resolution in syntax and phonological processing which has not been reported in other languages. We also found a qualitative similarity of the language profile of the JSLI children compared to the ELA (expressive language age)-matched controls on all tasks. The crosslinguistic similarities and differences observed in the language characteristics of JSLI children are discussed.

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The purpose of this paper is to examine the development of phonological awareness and the relationship between phonological awareness and reading ability in Japanese children. The subjects were 123 preschool children and 98 school children (grades one through three) who were considered to have normal mental, language, auditory, and visual abilities. They were given four phonological awareness and reading tasks. The results were analyzed in terms of correct response rate, score, and reaction time. Based on a 70% achievement criteria for each task, the following points were concluded: 1) phonological awareness tasks were accomplished at different age levels, 2) deletion tasks for three-mora-words and reversal tasks for four-mora-words were achieved by the end of the pre-school period, and 3) deletion tasks for six-mora-words, reversal tasks for four-mora-words, and vowel identification tasks were achieved soon after formal instruction in reading and writing of hiragana. Statistically, a strong correlation was found between deletion ability and reading comprehension ability, as well as between reversal ability and reading comprehension ability. How phonological awareness skills of deletion and reversal tasks facilitate reading are also discussed.

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The use of distorted tones is a common phenomenon in children with hearing impairments learning to speak. This paper reports on a study of tone identification among children with hearing impairment learning to speak. Though the sample was not large enough for conclusive statistical analysis, our results indicate that the mean level for tone recognition is lower for children with hearing impairment than for normal children. At the same time, there are some children with hearing impairment who match the standard level for normal children. Along with demonstrating the negative impact of hearing impairment on tone recognition, this study also suggests that children with hearing impairment have the potential to improve their tone recognition if given proper speech training.

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Aphasia peer circles (APC) are one means of community-based rehabilitation for aphasics who have difficulties in daily life at home after discharge from the hospital. Unlike other public services, APCs are open to all aphasics without membership requirements. Both regular and irregular meetings can held on days convenient for members. According to a survey done by the Japanese Association for ADCs in 2000, about 70% of APCs have relationships with speech therapists to some degree. Speech therapists contribute to APCs by helping severe aphasics to communicate with others in the APC, helping APCs be active in programs suitable for its members, and coordinating supporters with different specialities. At the same time, participation in APCs allow speech therapists to study many problems they do not encounter in hospital training programs.

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This paper reports on the activities of a speech rehabilitation group, based on the Health and Medical Service Law for the Elderly, in a small town in Kochi Prefecture and discusses the activities and future prospects of such groups. Speech rehabilitation groups play an important role for people with language disorders. The groups are sponsored and directed by local governments. They are therefore easily accessible to clients living in rural areas, even to those with severe physical handicaps. Moreover, the groups are able to cooperate effectively with other local community service and volunteer groups. However, in accordance with the Long-Term Care Insurance System which was introduced in the spring of 2000, activities based on the Health and Medical Service Law for the Elderly must be reorganized and the focus of speech rehabilitation groups may have to be changed. Speech therapists must endeavor to maintain the framework of the groups and at the same time develop alternative programs in response to the needs of people with language disorders in the community.

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There has been a growing interest in providing support groups in the community for aphasics. Ten years ago, however, there was no well organized support system for aphasics in Saitama Prefecture. In order to develop such a system, it was necessary to campaign for the importance of aphasic rehabilitation. We organized two different types of support groups for aphasics, speech rehabilitation groups based on the Health and Medical Service Law for the Elderly and aphasia peer circles. Thus far we have held six meetings with the slogan of “Let's Work Together with Public Health Nurses and Create Speech Rehabilitation Groups Throughout All 92 Cities, Towns, and Villages.” As a result, progress has been made in the development of community based rehabilitation for aphasics.

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This paper reports on the activities of a speech group at a day-service center providing community-based rehabilitation. This group is conducted at the center as a class for home care providers. The class is made up of people with linguistic disorders, their family members, and interested local residents. A special characteristic of this group is that many staff members and volunteers attend and help out in the activities. The group has positive benefits for all of its participants. Since the Long-Term Care Insurance System came into effect, speech rehabilitation classes based on the Health and Medical Service Law for the Elderly tend to have been reduced. It is therefore necessary to establish new programs for adults with communication difficulties under various insurance and welfare systems while concentrating on the Long-Term Care Insurance System.

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Opened in Setagaya Ward, Tokyo in September of 1998, the Sakurashinmachi Rehabilitation Clinic has no beds for in-patients but has the standard facilities required for second-level physical and occupational therapy. There are morning hours for outpatients and an afternoon program of home-visit therapy for patients throughout Setagaya Ward. The significance of the home-visit speech and language therapy program is illustrated through a discussion of four cases: 1) an 86-year-old female with severe aphasia, 2) a 72-year-old male with severe aphasia, 3) a 36-year-old female with higher brain dysfunction, and 4) a 60-year-old male with severe dysarthria. All of the patients had been recently discharged form the hospital. Both the communication problems the patients face at home and the necessity of home-visit therapy are discussed. By way of conclusion, it is strongly suggested that a system of home-visit therapy by speech and language therapists needs to be put into practice as soon as possible.

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This paper reports on a day care service, mainly for people with aphasia, established at a doctor's clinic with a staff of one full-time speech and language therapist and three part-time staff members. The service is offered four days a week, and each day ten members participate in the four- to six-hour program. At present a total of thirty members participate in the program. Members pay only ten per cent of the cost of the program with the remainder being covered by Long-Term Care Insurance. The daily program consists of medical checks, speech and language group therapy, lunch, and some social activities. Seasonal events and trips are also planned on occasion. Many volunteers are also involved in the program as “conversation partners.” The program has been in existence for one year and the following benefits have been observed: 1) members who could not adjust to the usual type of day care services have come to enjoy this program, 2) members showing signs of deteriorating intellectual abilities are provided with stimulation and chances for meaningful communication, and 3) members are becoming more independent and showing more care for others.

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Since aphasia cannot be cured completely, aphasics must learn to live with a linguistic disorder. Even if aphasics receive treatment, they must come to live positively while accepting the linguistic disorder. There are various organizations spreading throughout Japan for supporting aphasics. It is necessary, however, to provide more stimulus and opportunities for communicating, establishing new relationships, and creating a positive outlook on life. Tsukushi Kobo is a workshop which has been established to fulfill these needs and goals. Through attending this workshop and enjoying hobbies, aphasics are able to receive new stimulation and improve their skills in communicating with others. Tsukushi Kobo plays an important role for aphasics in that it allows them to experience overcoming their linguistic limitations and problems by expanding their sphere of communication and acquaintances.

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