The recovery process of a severe aphasic patient who received speech therapy for 9 years is reported. The patient was a 63 year old, right handed male, who suffered from right hemiplegia and constructional disorder. The patient could speak only a few residual words. Although therapy to improve his linguistic functions was conducted for the first 3 years, no improvement was observed. Moreover, the patient could not make use of alternative communicative means.
The training method was changed after 3 years. We adopted PACE (Promoting Aphasics' Communicative Effectiveness) which is based on pragmatics. This therapy started with the cooperation of his family members and other patients. As a result, the patient improved his daily communicative ability and has been able to convey even information or requests which are not visually present or are past occurrances. The patient has also developed motivation to communicate. This therapy suggests that a total communication approach such as PACE could be effective in communication training for a severe chronic aphasic patient.

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This study investigated autistic children, with behavior problems which were considered to be the effect of environmental factors. The relation between language acquisition of autistic children and their environment is discussed from the point of view that the behavior problems of autistic children result from interaction between their behavior and the environment. In this discussion, the environment was broadly interpreted, including intervention in the therapy room.
Discussion was centered on the following two points: (1) Many behaviors of autistic children are explained as social and developmental ones; (2) The distortion in socialization including objects in the environment, is a reflection of distortion of interpersonal relationships of autistic children. Objects are not opposed to humen being, but are related.
In addition, I make several suggestions for ST: (1) how to communicate with autistic children; (2) active interaction with the environment; (3) avoiding stimuli which are too strong; (4) steadiness of communication and an active “set” to communicate.

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