This paper describes the assessment and treatment of a 73-yr-old aphasic patient, J. S., who had multiple language deficits. In particular, prespeech and speech-level perceptual processes were both found to be impaired. The availability of lip-reading information improved his performance on certain tasks of speech discrimination. Remediation based on the assessment findings was then undertaken. Therapy focused on auditory discrimination at a phonemic level, utilizing lip-reading, and was based on minimal pairs contrasts. J. S. showed improvement on tests of phoneme discrimination, and a trend of improvement was seen for the other auditory tasks. Performance on the prespeech tests also showed improvement following therapy. Performance on tests of naming and written word comprehension did not change, indicating that the effects of therapy were specific to auditory input and were not the result of spontaneous recovery.