Functional articulation disorders are classically corrected through remedial speech therapy. The corrected articulation can be a “carryover” into daily conversation.
This study reports a case of a six year old boy with this disorder. The plosive letter/k/ was replaced by/t/. Despite correct articulation in speech training sessions, the subject had great difficulty using/k/ in his daily conversation. Assessment of the patient's personality, including P-F Study, revealed a problem with interpersonal relationships. With conventional repetitive speech exercises continuing, the author broadened therapy to include social activities. Successful “carryover” of corrected articulation followed improvement in self esteem and enhanced interpersonal relationships.

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(1) This report describes aphasic patients taken from 4, 794 chronic stroke patients hospitalized in Nanasawa Rehabilitation Hospital, of whom 1285 (26.8%) were aphasic and 632 (13.2%) severe aphasic. The data also suggests a sex difference in the incidence of aphasia.
(2) This research investigated the recovery process in 131 severe aphasic patients and revealed that receptive language abilities improved slightly whereas expressive functions remained severely impaired without showing any improvement. Only 10 cases recovered to a great extent while 69 cases showed slight improvement and 52 cases did not show any notable improvement.
(3) The current language tests of aphasia are nearly unable to evaluate the rate of recovery from severe aphasia such as global aphasia or severe Broca's aphasia where there is slight improvement in communicative abilities. A new test which can evaluate severe aphasic patient's retention of skills for communication or the recovery process in communicative abilities should be developed.

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A therapeutic approach for severe aphasics has been developed over the last twenty years. In this paper, we discuss the clinical aspects of treatments of severe aphasic patients based on the investigation of therapeutic records in our institution and one case study of severe Broca's aphasia.
The investigation reveals that stimulation approaches and/or approaches for a particular impairment of language were used with eighty percent of severe aphasics, and that gesture, picture drawing and/or PACE were chosen for thirty percent. Speech pathologists seem to select the most appropriate approach for severe aphasics from the viewpoint whether the content of task is verbal or nonverbal and whether the aim is improvement of language or of communication.
The results indicate that few tests that evaluate severe aphasics are useful in selecting an approach. Nonverbal approaches such as gestures or picture drawing training have their own limitations in use with severe aphasic patients. It seems to be important to accumulate the details of a number case studies.
The case study of Broca's aphasia that used gesture training suggests that gesture training may improve “symbol formation” and activate communicative behavior.

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This study first reviews the literature regarding psychosocial approaches to aphasia rehabilitation. Second, it emphasizes the significance of incorporating counseling in aphasia therapy, which contributes to (1) helping clients and their family members increase autonomy and acceptance, (2) facilitating communicative abilities of clients and their family members, and (3) promoting therapist's ability to communicate with others through training in counseling. Third, I discuss methods of incorporating counseling in aphasia therapy. Finally, I propose rethinking the framework of aphasia therapy: that is, a counseling perspective, the goal of which is clients' autonomy and acceptance, should be added to the previous two goals of improving communication and scientific study. The training in counseling should be a prerequisite for aphasia clinicians.

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I discussed how to organize the logic of intervention for severe aphasia. Four points of view are necessary. First, I proposed a concept of “to revive” (which means that patients and their family begin to live again) as a basic point. The process of interventions must be organized to harmonize aphasia with living again. In order to this, three other points of view which emphasize the patient's individuality are necessary: (1) “duality” of communication, or conveyance/affectivity, (2) patient's own history or communication as a event which manifests his history, (3) relativity of the norm of communication.

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This paper speculates about the developmental foundation for symbolic development in developmentally retarded infants from the perspectives of both the formation of child-object context and child-others context. It also suggests some problems in early intervention from the viewpoint of enhancing the ability of a child's symbolization.
As for our intervention for enhancing children's object manipulation skills, we try to promote children's active exploratory manipulation. In these activities, a child comes to recognize the double knowledge of the conventional meaning of objects and the meaning in the substitution for other objects.
In child-others social context, we should try to elicit the child's attention getting behavior, for example, promote showing off to others in addition to showing objects to others in give and take games. Children should be conscious of playing together with others and playfulness in such social interactions above all else.

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This paper reports on group therapy for early habilitation in Down's syndrome children, cognitive and language development of 4 patients who were treated in the same group at the same place, and prespeech training.
The results were as follows: (1) Normal infants acquires prespeech behavior before age two, but Down's syndrome children required three years. (2) Compared with their speech recognition, the development of speech expression was delayed and indivudual differences were great. (3) Even if they had speech in their daily lives, they were not able to use it for demands and responses. They had to depend upon body language for a long time. (4) Before they could understand something's name in a picture, they had to be able to match a picture to another picture.
These results suggest the following: During the prespeech training, the most important task was to let Down's syndrome children acquire basic behavior, which consists of attention to objects, common use of objects, exchange of objects with other people, step by step. Usually, ordinary children gain these skills by two years of age. Consequently we should adopt visual matching and gestures in prespeech training, and use the merits of group therapy.

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In the past 20 some years, sign language which was originally developed for the deaf, has recently been used to teach the speech and language handicapped. Most of the reports are of cases signs are taught as one of the alternative modalities subsidizing expressive ability.
Here, however, Makaton sign language is used as a means of visual stimulus during speech and language group therapy for Down's syndrome children during the period of meaningful speech emergence. This study observed whether signs and visual stimuli can be associated with the developmental process of children's “symbolic functioning” in play, “manipulation functioning” of fine motor mobility and “attention span”.
In conclusion, after 36 sessions of training, the Makaton trained group showed a developmental pattern nearly identical to the control normal children's group in all three areas mentioned above, wherereas the Down's group without sign language training remained unchanged.
These results indicate that using visual cues during speech and language therapy is beneficial for stimulating the fundamental cognitive ability necessary for language development of young Down's syndrome children.

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Severe speech and language disorders are one of the salient symptoms of autistic children who show little improvement even when other symptoms improve. From the degree of mental development and speech acquisition, autistic children can be divided into three subgroups: Retarded without speech, Retarded with speech, and Fairly developed.
In recent years, alternative non-vocal communication systems are being utilized with children who could not acquire oral language through traditional speech imitative training and great outcomes have been reported. However, many issues surrounding the effective use and the limitations of this approach remain unsolved.
This paper examines what kind of children are the best candidates for this approach, the training process of a five year old boy and several issues for future research.

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