We conducted rapid reading training on an individual with aphasia who had difficulty in verb naming, using two-clause Japanese sentences in the form of "subject+ particle+verb" (e.g. "Hon wo yomu," which means "I read a book") in order to improve verb naming. His speech was characterized by verb anomia and semantic paraphasia, whereas his auditory comprehension of nouns and verbs was relatively intact and he showed no agrammatism. After 30 days of training using three lists, in which the individual repeatedly read the two-clause sentences aloud accurately and quickly, the following results were achieved: 1) the time required for reading aloud was shortened after 10 days of training, due to reduced self-correction associated with semantic paraphasia; 2) a negative correlation was found between the time required for reading aloud each sentence and the number of training days; and 3) in the TLPA verb naming test, the number of correct answers increased significantly, and the number of verbs induced by preceding nouns also increased after the training. These results suggest that rapid reading training with two-clause sentences promotes accurate and quick phonological retrieval of target verbs.

It is known that the communication disorders of aphasic individuals are strongly related to their language disorders. However, the relationships between communication ability and individual linguistic and non-linguistic functions, including intellectual functions, as well as the strength of the relationships, have not yet been clarified. In the present study, we investigated the linguistic and non-linguistic functions related to pragmatic communication ability in aphasic patients using the Communicative Abilities of Daily Living Japanese version (CADL) short form and the Western Aphasia Battery Japanese version (WAB). The results showed that there were significant correlations between the scores of the CADL short form and age, years of education, and individual subtests of the WAB. As a result of multiple regression analysis with CADL short form scores as the dependent variable and WAB subtest scores as the independent variable, auditory comprehension, writing, and construction of the WAB were extracted as significant subtests. In addition, the results suggested that subtests related to pragmatic communication ability differ according to differences in terms of number of months since onset and the aphasia type.

We report the characteristics of untranscribable jargon in a 68-year-old right-handed man with aphasia following a cardiogenic cerebral embolism. He presented unclear articulation in spontaneous speech at an early stage following the onset and fluently uttered something difficult to transcribe phonetically using Japanese characters. The patient maintained auditory comprehension ability at the levels from single syllables to short sentences. This case was characterized by the following three elements: (1) contrast between fluent untranscribable jargon at the conversation level in spontaneous speech and non-fluent utterance in clinical testing, (2) impairment of utterance monitoring, and (3) severe phonological processing disorder. At a later stage, the patient's articulation gradually became clear over time, and his problems converged to conduction aphasia with predominant symptoms of fragmented phonemes and phonemic paraphasia 6 months after the onset. The untranscribable jargon observed at the early stage in this case may be attributed to a severe phonological structurization disorder in addition to alalia and a monitoring disorder for spontaneous speech. These functional disorders are likely to have originated from cortical and subcortical damage to the left precentral gyrus, postcentral gyrus, and the superior temporal gyrus.

This study aimed to investigate the effects of perspective shifting on active and passive sentence productions in children with intellectual disabilities. The participants were 14 children with intellectual disabilities (ID), 14 children with intellectual disabilities with autism spectrum disorders (ASD), and 16 typically developing (TD) children. The study employed sentence production tasks in which the children produced active and passive sentences alternately replacing subject with object. The participants were divided into two groups according to production order, with one group beginning with active sentence productions followed by passive sentence productions, and the other, vice versa. Results showed that the performance level was significantly lower in sentence productions after perspective shifting for both ID and ASD children. On the other hand, TD children showed significantly lower performance in productions of passive sentences regardless of production order. These findings suggested that both ID and ASD children had difficulties in changing voice after perspective shifting. In contrast, 5-year-old TD children were affected more significantly by the complexity of sentence structure than perspective shifting, possibly reflecting their insufficient passive knowledge.

This study examined longitudinally the characteristics of utterances of 7 children with autism spectrum disorder (ASD) starting at 3; 0-4; 0, employing a story generation task. Seven typically developing (TD) children served as controls. The children were asked to make a story after hearing the introduction of a story, using a doll and miniature objects as props. Results showed that the two groups of children followed similar developmental paths with respect to spontaneity and structural aspects of utterance. In terms of story content, however, the children with ASD produced fewer story episodes and sequences of episodes, and expressed more utterances unrelated to the story than the TD children at the beginning of the observation. These differences disappeared and episode sequences grew with increasing age in both groups of children.

A cognitive-behavioral approach centered on speech rate control was used to intervene with a 10-year-old boy with cluttering symptoms. In the cognitive-behavioral approach, instruction focuses first on self-monitoring skills, and then moves on to instruction in speaking with reduced speech rate. After 6 months of intervention, the total frequency of disfluency in the memorized retelling task decreased significantly in this case, and his score on the Japanese Checklist for Possible Cluttering ver. 2 decreased from 21 to 9 points. We assume that the boy's ability to formalize language improved and the frequency of normal disfluency decreased after his realization that simplifying speech makes it easier for the listener to understand what is being said. On the other hand, no decrease in his speed of speech was in evidence in the measured data, a circumstance which needs to be interpreted with caution. The results of this study suggest that the self-monitoring skill instruction included in the cognitive-behavioral approach may have influenced the decrease in frequency of disfluency and contributed to improvement of the symptoms of cluttering; however, in the future we want to investigate for a valid method of measuring speed in speech with cluttering.

Critically ill patients undergoing mechanical ventilation often suffer from psychological distress due to the loss of speech. We present a tracheostomized patient who was able to produce intelligible speech with a combination of an electrolarynx (EL) and above cuff vocalization (ACV).
A 70-year-old man underwent a tracheostomy and required long-term mechanical ventilation due to tracheal deformation after lung cancer surgery. To enhance communication for the patient, we applied an EL and ACV. Speech intelligibility was evaluated by the 9-point conversational intelligibility test. The speech intelligibility score was 4 with the EL, and 4 with ACV, because the patient was only able to tolerate a low airflow rate (1 L/min). We subsequently applied a combination of the EL and ACV. The combination method increased speech intelligibility up to 2.5 and improved patient satisfaction as evaluated by the visual analog scale.
For EL users, voiceless consonants are difficult to pronounce and are one of the causes of poor intelligibility. Adding ACV to the use of EL might allow the patient to pronounce such voiceless consonants and possibly lead to improved speech intelligibility. Our findings suggest that it may be useful to use an EL together with ACV to communicate with tracheostomized patients.