Vertical and lateral integration are two important nervous system integrations that affect the development of oral behaviors. There are three progressions in the vertical integration process for speech nervous system development: R-complex speech (ritualistic, memorized expressions), limbic speech (emotional expressions), and cortical speech (reasoning or logical expressions). Multimodality loss of language (aphasia) due to stroke results in deficits in auditory comprehension, speaking, reading, writing and mathematical calculation, but not in intellect. Characteristics common to aphasias are reduction in available vocabulary and release of lower speech center response (limbic and R-complex speech). A second type of cerebral infarct commonly affecting linguistic abilities is head trauma, producing cognitive-linguistic deficits, rather than aphasia. Symptoms might include impulsivity, reduced attention span, reduced retention for new learning, egocentric orientation in expression, and release of lower-level speech responses. The assessment of written language of those with neurogenic communication disorders is usually dictated by the degree of motor and visual involvement. However, in cases where residual abilities are demonstrated, informal assessment should entail observations of writing mechanics, spelling, punctuation, syntactic complexity, and pragmatics. Remediation for those with neurogenic disorders should be structured in the following way: (1) prewriting (tracing and copying); (2) writing words; (3) writing sentences; and (4) writing sentences in paragraphs--keeping in mind that writing should be facilitated through continuous, patient-appropriate stimuli which encourage self-monitoring and discovery of linguistic constructs. (HOD)