This article summarizes recent trends and problematic issues concerning educational intervention in infants with hearing impairment in Japan from the perspectives of:
(1) Early identification and diagnosis of hearing impairment.
(2) Diagnostic techniques of hearing impairment, in particular Auditory Brainstem Response audiometry (ABR) and infantile audiometry.
(3) The range of educational provisions for infants with hearing impairment and their cooperation.
(4) Educational intervention techniques for infants with hearing impairment, especially language communication techniques.
(5) Home-based education and parental counseling assistance to parents.

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This study investigates the mechanism of language disorder through the analysis of the aphasic symptoms and speech dysfluency in the case of a 31-year-old right handed man, who suffered from transcortical motor aphasia (TCMA) caused by a sudden left medial frontal lobe infarction. Striking struggle and hesitation were noticed in his intentional speech.
The results were as follows:
(1) TCMA was associated with left-hand unilateral apraxia and agraphia, as well as transient dysphonia. This case's speech elicited from external stimuli was well preserved, and auditory and visual comprehension were normal.
(2) The speech dysfluency was observed in the more intentional condition of speaking, and the major characteristics of the dysfluency were abnormal respiration, strained blocking, prolongation, and repetition.
(3) Changes were observed qualitatively as well as quantitatively along with the course of his recovery. That is, abnormal respiration and strained blocking in the initial stage, prolongation and prosodic disturbance in the middle stage, and repetition in the final stage were the prominent features.
(4) These symptoms may be explained as a disruption of processes which control the initiation and continuation of the flow of speech. These are consistent with the defect of the speech starting mechanism. However, the change observed in therapy lends a support to Rubens (1975) who identifies the inability to propositionalize as an underlying deficit of TCMA. That is, the volume of the case's intentional speech had not increased substantially until the therapy which focused on planning of speech was undertaken.

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This study explored the capacity to appreciate metaphor in forty aphasic patients, focusing on the vocabulary of body parts: mouth, hands, and legs.
The test, examining the metaphoric use of body parts, was administered for those who were able to comprehend them. The test required the subjects to transfer body part vocabulary to parts of familiar objects and unfamiliar line drawings, and to map these vocabulary onto a car.
The aphasics' performance was analyzed by comparing the results of forty normal subjects on the same test. The results showed that the aphasics had difficulty in applying the well-known words of body parts to the parts of other objects as metaphor, the use of which is familiar in normal language. As the tasks became more difficult, random responses gradually increased. Though their performances markedly improved after instruction, significant difference was still found, compared with subjects in the normal group. It was also found that some of the aphasics' recognition problems. Therefore, in order to improve their metaphoric capacity, methods must be developed on the cognitive level as well as on the linguistic level.

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This paper reports the process of acquisition of gesture performance in a severe aphasic patient with apraxia due to subcortical lesions, reports on the factors facilitating gesture production, and discusses the relation of gesture disturbance and apraxia of this case.
The task required in training is to describe actions or objects illustrated in cards using gestures. The patient acquired gesture performance in the following processes: (1) Appearance of voluntary movement in a trial and error manner; (2) Use of body as cue for facilitating gesture production; (3) Acquisition of gross motor patterns; (4) Flexible use of gesture. In this sequence, the next stage seemed to be acquired gradually based on the previous stage. During the acquisition process, verbal cues which have direct connections with gesture had a strong effect on facilitating gesture production. But abstract cues, for example “What do you do with this?”, also have a certain effect on gesture production. This observation suggests that the problem of gesture disturbance of the patient lies not only at the motor level but also at the planning level.

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To evaluate the effects of the palatal lift prosthesis (PLP) for patients with velopharyngeal incompetence resulting from acquired neurogenic disease, velopharyngeal competence, motor speech ability and speech intelligibility were investigated in forty-four patients. The assessment of velopharyngeal competence was carried out using lateral radiographic cephalometric films with a contrast medium, soft blowing time, maximum prolongation time for the consonants /s/ and /∫/. The assessment of motor speech ability was carried out using maximum phonation time for the vowels /a/ and /i/ and oral diadochokinesis. The assessment of speech intelligibility was carried out using speech intelligibility test scores. These examinations were carried out prior to and after construction and placement of the PLP according to each patient's ability and the following results were obtained.
(1) After construction and placement of the PLP, velopharyngeal competence assessed by soft blowing time, blowing ratio, maximum prolongation time for the consonants /s/ and /∫/ improved immediately in many patients. Motor speech ability examined by maximum phonation time for the vowels /i/ and /a/ and oral diadochokinesis also improved in many patients.
(2) Twenty one patients improved soft blowing time remarkably with use of the PLP and ten of these patients (47.6%) demonstrated a 10% increase in speech intelligibility. These patients improved their articulation according to improvement in velopharyngeal competence with use of the PLP.
(3) Three patients in whom residual lumen size without the PLP was decreased after three to twelve months following the insertion of the PLP revealed improvement in ability of motor speech and articulation without the PLP.

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Adult normal speech and adult cleft palate speech were acoustically analyzed with respect to vowels. The purpose was to discover a possible correlation between the acoustic features of cleft palate hypernasality and the criteria for auditory judgements of hypernasality. Comparison was made between the results of the above analysis and auditory hypernasality judgements by speech therapists.
The results are as follows: (1) Different formant frequencies were found with respect to vowels and each formant between normal speech and cleft palate speech. (2) On an average, /i/ had lower second and third formants in cleft palate speech, while /u/ had higher values in cleft palate speech with respect to the second and third formants. (3) For some male cleft palate speakers, correlations were found between the acoustic analysis and auditory judgements with respect to the first and second formatns of /a/, the second and the third formants of /i/, and the first formant of /u/.

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