In this study, four types of behavior related to dementia were examined and classified into two categories; 1) an information processing component including responses and gestures and 2) a component, including pause time and eye contact, based on convention-dependent aspects of automatic processing and not related to the symbolic functions of language. Forty-five institutionalized, demented individuals were categorized on the basis of their performance on MMSE, into profound, severe, and moderate groups. On the basis of eight different interviews with the individuals, this study analyzed the appropriateness of the individuals' behaviors and the degree to which the four types of behavior were preserved. The main findings were as follows. Within the profound group, responses were the most significantly vulnerable to deterioration. Pause time was relatively preserved and also performed independently of response. Bowing was observed in greetings that were categorized as gestures. Other gestures, however, were rarely present. Eye contact was preserved. In conclusion, the profoundly demented elderly failed to maintain the information processing component language use but retains the convention-dependent aspects of automatic processing.

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Human beings are known as “Homo sapiens” meaning humans who know or possess knowledge. Among related species, only Homo sapiens are known to have developed speech abilities. This probably came about because they were equipped with vocal speech organs as well as speech functions in specific areas of the brain. Since the latter half of the nineteenth century, Broca's, Wernicke's, and the left angular gyrus have been considered as the only neurological basis for speech and language activities. Recent studies focusing on the correspondence between lesions and symptoms by using either the PET scan or the functional MRI, however, have revealed that much wider areas of the brain also provide bases for linguistic abilities. It is necessary, therefore, to analyze and utilize the results of such research more fully in clinical practice.

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Recent research on speech pragmatics and understanding others might be of important use in improving communication intervention with individuals with high-functioning pervasive developmental disorders, particularly in improving social adaptation and preventing emotional disorders. Evaluating the effectiveness of intervention techniques from the point of view of new research suggests the possibility of improving training in communicative and conversation skills as well as reducing unnecessary confusion and anxiety on the part of patients. This paper suggests how such recent research might help improve clinicians' communication intervention in the following areas: 1) repairing breakdowns in communication between those with developmental disorders and those around them, 2) encouraging the use of effective communication strategies, and 3) providing those with developmental disabilities with opportunities for peer interactions among themselves.

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Evidence-based medicine (EBM) is currently considered to be a very important concept in the field of speech therapy in Japan. In addition, people working in clinical practice worldwide, such as general practitioners and clinical psychologists, have also been paying attention to the concept of narrative-based medicine (NBM), because of their sense of the limitations of EBM. This paper relates the concept of NBM to issues involved in providing support for mothers of children with speech problems. In particular, this paper reflects on the necessity of therapists reflecting on their personal relationship with the mother of children with speech difficulties. Issues which need to be reflected on include the therapist's personality, the therapist's style in relating to others, the types of mothers the therapist has difficulties relating to, the reasons for the therapist's difficulty in relating to certain types of mothers, and factors involved in the therapist's life experience such as clinical experience, gender, marital status, and relation with children. All of these factors are of importance from the perspective on clinical intervention offered by NBM which emphasizes the therapist's role in helping the mother create a new and therapeutic narrative of her relationship with her child with speech difficulties.

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This paper examines the positive effects of collaborative therapy upon the feelings and attitudes of patients and the family of patients with aphasia, motor speech disorders and mental disorders. The effectiveness of the following four aspects of the treatment process are analyzed: 1) the sharing of feelings through artistic activities, 2) training volunteer support people to be conversation partners, 3) the education of and exchange of ideas among professional support people, and 4) group therapy and aphasia peer circles. Based on this analysis, the paper attempts to substantiate the value of collaborative therapy's recognition of the role of patients in the treatment of communication disorders. In addition, it is argued that the collaborative therapist creates a positive environment for therapy by including patients, peers, family members, and volunteer and professional members of patients' support teams in the patients' treatment. Of special importance is the speech therapy's role in coordinating the training and support of all members of the team.

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