根拠に基づいた言語訓練―失語症とその他の高次脳機能障害

Evidence-based practices:Aphasia and other higher brain function disorders

　失語症およびその他の高次脳機能障害の領域における，根拠に基づいた言語訓練(以下EBP)について述べた．はじめに欧米を中心とする訓練効果研究の歴史について概観した．2番目に，訓練効果研究の2つの方法論，すなわち群研究と単一事例研究における，それぞれの特徴・問題点について述べた．3番目に，内外の文献における，実験データに基づく言語訓練研究の占める割合について報告した．最後に，われわれ言語聴覚士にとって，EBPの検証が必須の課題であることを述べるとともに，複雑な高次脳機能障害の領域においては，単に「根拠」が直ちに数値化されないという理由によって，リハビリテーションサービスが医療・介護保険の適用外となって打ち切られることがあってはならない，と提言した．

　In this paper evidence-based practice in aphasia and other higher brain function disorders is discussed.　First, previous studies about the efficacy of training are overviewed.　Second, issues pertaining to methodologies, i.e. group study and single subject experimental design, are addressed.　Third, the results of evidence-based studies about the efficacy of training from a number of published papers within the last several decades in America, Europe, and Japan are reported.　Finally, it is emphasized that developing evidence for the efficacy of training, especially in higher brain function disorders including aphasia, is very important, although also very difficult.　The most essential claim of this report is that rehabilitation services must be provided to individuals with higher brain function disorders for as long as they wish, even if the evidence for the efficacy of training can not be obtained in statistical terms.