Masazumi MITANI

Aphasia and other higher brain dysfunctions can occur as a result of cerebrovascular accidents or head trauma. In rare cases, if a woman has aphasia and also presents with auditory agnosia, she suffers from a double disability consisting of inability to speak using speech sounds and inability to understand what she hears. The life-world of the woman with this double disability is described and is discussed from a medical anthropological perspective. The research consisted of four semi-structured interviews conducted between June 2023 and January 2024 and recorded with an IC recorder for approximately nine hours. Taking into account that the interviewees had aphasia and presented auditory agnosia, the interviews were conducted using speech-to-text transducers, electronic memo pads and paper A4 notebooks to minimize the burden on the woman as much as possible. The recordings were made verbatim and reviewed by the woman to check for misstatements and factual errors. The interviews reveal that the woman face discrimination from medical doctors, speech-language pathologists or persons in general because they do not fully understand the symptoms of aphasia and auditory agnosia. As local communities and civic associations are not bound by the rules of the Government or prefectural governments, the participation of the woman may have changed the way they are treated inside civic associations. The woman is not concerned about their disabilities and are willing to use ICTs and other aids to actively engage in society. Mutual inclusion of the woman and civil society organizations seems possible in the future.

The workshop "What kind of broadcasting methods are easily understood for persons with auditory agnosia?" was held for persons with auditory agnosia as well as their assistants and speech-hearing therapists. The workshop was attended by 26 persons with auditory agnosia, 26 assistants and therapists. During the workshop, participants were divided into groups after the verification of their understanding of language sounds. According to the verification, the responses of persons with mild auditory agnosia and nondisabled were accepted as valid opinions, and those with severe disabilities as reference. In the workshop, the following criteria were established: (1) use of the human voice, (2) use of multisensory integration, (3) attachment of a chime, and (4) repetition of the same thing by male and female announcers. When asked to listen to a prototype disaster information according to the criteria, nondisabled significantly chose "suitable as the same thing for both men and women", but there was no significant difference among those with auditory agnosia. When asked to choose subtitles for video of actual disaster scene, nondisabled found it easier to understand "subtitles that transcribe all statements and highlight only the important parts in yellow," but for other persons, no significant difference was detected.

How would persons with auditory agnosia respond to a broadcast without chimes for alert? To answer this question, two experiments were conducted: one with natural voice recordings made for “reading novels” without chimes, and the other with "visual stimuli and single digit arithmetic" without chimes. A total of 100 people participated in the experiment, 65 of whom had auditory agnosia and 35 of whom were non-impaired or unaware of their disability (henceforth, "nonimpaired"). The results of the experiment without chimes, and the previous experiment with chimes, found significant differences between the non-impaired and severely impaired people subjects with and without the chime. Assuming the non-impaired persons understood the linguistic meaning with a minimum score or better, about 25 % of the mildly- and about 25 % of the severelyimpaired subjects understood the linguistic meaning without chimes, whereas in the experiment with chimes, more than 50 % of the mildly- and about 25 % of the severely-impaired subjects understood the natural voice linguistic meaning. It was demonstrated that with the addition of chimes, more persons with auditory agnosia can understand the linguistic meaning of a disaster broadcast.

The emergency disaster information is understood when it is read aloud by a speech-sound following an alerting chime. At that time, are auditory agnosia who have difficulty recognizing speech-sounds able to grasp disaster information? To answer this question, I conducted two audio-visual experiments in which 74 persons with auditory agnosia and 42 persons without auditory agnosia were asked to answer the question of a speech-sound task created in multimedia DAISY format. As a result, correct answers were obtained in the first half of the experiment, even though the subjects had difficulty recognizing speech-sounds. However, mistakes were noticeable in the second half. From these results, it was found that if multisensory integration is used, persons with auditory agnosia can grasp information even with ordinary speech-sounds, however, it becomes difficult to grasp speech-sounds over time.