About Aphasia 　Aphasia was also discussed in a special rehabilitation article in the Asahi Shimbun newspaper. As mentioned in the article, I have the impression that there are many aphasias that are overlooked or hidden. Let me take a hypothetical example of one of the many cases. 　Ms. A, a young woman, came to our clinic because she has a higher brain dysfunction and wants to work after obtaining a mental disability certificate. However, she had no higher brain dysfunction and had aphasia, which makes it difficult for her to understand people's names and phone calls. So, she obtained a physical disability certificate and found a job as an employee with disability. 　Mr. B, a young man...I didn't think he had aphasia because he could talk just fine. However, he had difficulty in moving his right hand and sometimes asked his family, "What is that? After evaluation, we found that he had higher brain dysfunction and aphasia. 　Ms. C., a woman in her 50s...is cared for at home by her family. She goes to a day service, but in the morning she is loud and confused, does not understand what she is saying, and fails to use the toilet. She also has higher brain dysfunction and aphasia. Because of the severity of the aphasia, her behavior and speech were confused, and she was thought to have a mental disorder or dementia, for which he was given antipsychotic medication. 　Generally, aphasia is usually identified during the process of going from an acute care hospital to rehabilitation, when the patient is explained by a doctor or receives rehabilitation from a speech therapist (ST). 　However, if the initial physician is unaware of the aphasia, the patient may pass through the ST evaluation and speech and language rehabilitation as is. At such times, other healthcare professionals may raise the issue at a team meeting or other meeting, and ST involvement may often begin, but the current rehabilitation process is in such a big hurry that it may not work. 　So, what conditions would make you suspect aphasia? Many people have aphasia, which is often combined with right-sided paralysis, so if you have a slight limp in your right hand, if you were unable to speak well for a while during the acute phase, if your speech is different from before the illness, if you have difficulty saying this or that, if you say something and then say, "What, what, what does that mean?" or who often mishear what is being said, or who talk a lot but have difficulty communicating. 　In addition to aphasia, there are many other possible causes, such as inability to move the mouth or tongue properly or higher brain dysfunction. There are people with aphasia who cannot communicate well, and therefore, they become verbally abusive; people who gradually stop speaking and become depressed; people who assume that silence is golden, and spend their time saying "Oh, oh, oh, oh, oh, oh, oh, oh, oh, sorry," and are left to assume that they and others do not have aphasia. 　An evaluation by an ST, a specialist in aphasia, is necessary.