Episode 3: Behind the Scenes of the Clinic | With speech therapist Esther Sperling

00:01 Speaker 1 What is communication, anyway? At what age do we really start communicating with our children, and how do we do it right? What should raise red flags for us when it comes to our children’s communication, and how do we actually get to see a speech-language therapist? A behind-the-scenes look, with a collection of excellent tips for every mother. Welcome to a conversation with speech-language therapist Esther Sperling. How can we turn our lives into lives of shlichus, full of meaning? I’m Chani Moskowitz, a shlucha in Kharkiv, Ukraine. In this podcast, we’ll meet different women who bring their sense of shlichus to a variety of fields and, through it, help each of us find and refine our own shlichus in the world. Because living the lives we were created to live is as good as it gets. Shlichus as a way of life. We’re starting now. Today we have Esther Sperling with us, who is also my cousin.

00:59 Speaker 2 On shlichus.

01:00 Speaker 1 Yes. So I know you well, but introduce yourself. First, the basics, so everyone can get to know you, and just as importantly, what you do. What is this field for someone who’s never heard of it and isn’t familiar with it? The microphone is yours.

01:15 Speaker 2 Okay, so, baruch Hashem, I’m married and a mother of four. I live in Kiryat Malachi. I’m a Chabad woman and I’ve been a speech-language therapist for over a decade.

01:28 Speaker 1 Time flies.

01:28 Speaker 2 Yes, time really flies. What is speech-language therapy, exactly? It’s a field that involves identifying, assessing, treating, and advising on everything connected with communication. Imagine two people sitting and talking to each other. We have the speaker. Let’s look at that person for a moment: there’s their thought, what they want to say, their choice of words, and how to say them. Then there are the actual words as they reach the speech organs, and how those organs work. After that, there’s how it all reaches the listener, how the listener hears it and interprets the words. Besides the words themselves, there’s also all the subtext, facial expressions, and intonation. We work with all of those areas: hearing, communication, and language. Whether someone has enough vocabulary, whether they can retrieve the words they want. In terms of articulation, whether they can produce all the sounds. Whether their speech is fluent. Speech-language therapists also work with eating and swallowing.

02:37 Speaker 1 Wow.

02:37 Speaker 2 Yes. I hope I covered everything, because it really is a very, very broad field. Speech-language therapists work with a range of ages and in a range of settings, from early childhood, literally from birth, through adulthood. Some of it has to do with development. The area I work in is child development. I work with young children, very young children, sometimes even before they turn one.

03:09 Speaker 1 Wow.

03:09 Speaker 2 Yes, yes. When there’s some concern and parents come in, or they see other professionals who refer them.

03:15 Speaker 1 Later you’ll tell us more about all of that—what age to seek help and so on.

03:19 Speaker 2 Yes, more or less. I can go into it a little. So, child development covers very young children up to around school age. I work in child development, doing assessments and treatment and working with a multidisciplinary team, and I also work at a communication daycare center.

03:37 Speaker 1 Wow.

03:37 Speaker 2 That’s a very interesting area too. So that’s it, broadly speaking.

03:44 Speaker 1 How did you get into the field? Why? Of all the fields in the world, how did you end up there?

03:48 Speaker 2 Wow, it was really siyata d’Shmaya. Hakadosh Boruch Hu led me there. I knew I wanted to do some kind of therapeutic work, mainly with children, but I didn’t know exactly what. I knew about speech-language therapists in the context of treating stuttering, but nothing beyond that. I really hadn’t been exposed to the field. I almost went to study animal-assisted therapy, but for various reasons it didn’t work out. Hakadosh Boruch Hu arranged things, and I ended up in speech-language therapy. It opened up an amazing world for me. Really.

04:21 Speaker 1 It’s a whole world. Wow.

04:22 Speaker 2 It really is.

04:24 Speaker 1 What do you love most about this work?

04:27 Speaker 2 I love that you can really change lives. Sometimes you give a parent a piece of advice or a new perspective, shine a light on something they can do or change, and you can already see changes and see the children developing. So there’s the work with the children, and I also really love guiding parents. I love being able to work with a team and look at a child holistically. I’m not looking only at the child’s language, but at what might be causing things and how they show up. Sometimes motor issues come into play, and we can think things through together as a team. There’s so much to it.

05:13 Speaker 1 Wow. Communication covers so much. A child can come in with what seems like a small communication problem, and treating it can open things up for them—really change their life.

05:22 Speaker 2 Right. Right. And it’s not just articulation. People sometimes think, “Oh, you only work on the sh sound.” No. It’s so much more than the sh sound.

05:31 Speaker 1 Yes, because when people hear “communication,” what comes to mind? The sh sound, the s sound, and all that.

05:33 Speaker 2 Wow, there’s so much that comes before that. Much more basic things. Do we want to communicate? Does a child want to communicate? How does the child communicate? As I touched on earlier, how does the child manage it? Do they have the vocabulary? Can they get their message across properly? Can they pronounce the words? That last part is the articulation everyone knows about.

05:54 Speaker 1 Among other things.

05:55 Speaker 2 Yes.

05:56 Speaker 1 So let’s get practical. As a mother, what should raise a red flag for me? When should I come to you? If I see this, this, or this? What kinds of things?

06:07 Speaker 2 So what’s important to know? Communication is something natural. It’s meant to develop, to feel pleasant and enjoyable. We want that connection. So when we see that a child isn’t very interested in connecting, that they don’t seem motivated to connect, and you have to work really hard to engage them—or something about the interaction isn’t enjoyable for them, they don’t enjoy being together and prefer to be alone—that’s a concern. They’re less responsive when someone speaks to them, they only want things that interest them intensely, and they’re really absorbed in their own world and only want that world. That’s a major red flag, and it’s worth contacting a child development center. There are other areas too. For example, drooling: if a child drools a lot. If they use objects in unusual ways, if their language isn’t developing enough, if they want to say something but get stuck, and you see they aren’t progressing and are very frustrated. By then, we’ve reached a point we’d rather not reach. We want to seek help earlier.

07:17 Speaker 1 What age are you talking about when you say a frustrated child? What age?

07:20 Speaker 2 It depends. It also depends on the child’s level of understanding—whether they realize people don’t understand them and whether they can express themselves in other ways. But if parents feel that a child can’t express themselves, even before the age of one, a child starts expressing themselves with gestures, pointing a finger or reaching out their hands.

07:41 Speaker 1 Right.

07:41 Speaker 2 And smiling if they like something, or looking at an object they want. They have ways to express it. If parents see and feel that something isn’t right, don’t wait. Reach out. Child development services start treating children from as young as two days old—not in the area of communication, perhaps in other areas—but there are trained eyes that can assess things, and you really can reach out at any age.

08:06 Speaker 1 It’s always better to go in and find out nothing’s wrong than to miss something.

08:08 Speaker 2 Yes. We don’t want to overwhelm a system that’s already overwhelmed, but you can also seek advice. There are hotlines staffed by professionals, and you can ask there too. You know, some people will say, “No, it’ll pass. I was like that too, Grandpa was like that too…”

08:27 Speaker 1 “You’re worrying too much.”

08:27 Speaker 2 “It’ll pass eventually.” Exactly. “Why are you so worried?” If a mother feels something’s wrong, go. Go. You’re not feeling it for no reason. And if they tell you, “No, everything’s fine,” then great. Maybe there are one or two things you can focus on—

08:40 Speaker 1 Yes.

08:40 Speaker 2 And maybe that will be enough. But it’s worth checking. Don’t just stay in that place of saying, “No, it’ll pass on its own.” Some things might pass on their own, and some things might be part of typical development. But if it doesn’t feel right to you, or if you understand your child but people outside the home don’t, or if there are things the child can do in some settings but not in others, ask. It never—

09:04 Speaker 1 Yes.

09:05 Speaker 2 It never hurts to ask. And if more is needed, you can get actual help too.

09:10 Speaker 1 Right, there are also those cute mispronunciations. Like “a type of approach” and all those things that everyone gets excited about and imitates the child saying. So presumably that’s not something that sends you to a speech therapist.

09:23 Speaker 2 It depends. It depends on the age and how many there are. The first thing I say is: open a notebook, or a family WhatsApp group, and write them down. Later it’s really fun to look back and remember. But I’d reinforce them less. What do I mean by reinforce? It’s lovely to hear them, but repeat what the child said correctly. I say that about all mispronunciations. If a child mispronounces a particular sound or word, just repeat it correctly and show them you understand. And that actually brings me to—

09:55 Speaker 1 The next question.

09:56 Speaker 2 The next question, yes.

09:58 Speaker 1 So, Baruch Hashem, there’s a child who... I don’t see any particular problem. He’s developing more or less normally; nothing is setting off alarm bells for me.

10:08 Speaker 2 Mm-hmm.

10:08 Speaker 1 But what can I do? You know, things can be good, and they can always be better. How can I help him improve, or make sure there won’t be a problem later? How can I prevent communication difficulties that might come up down the road? Golden tips for every mother.

10:25 Speaker 2 I’ll try. First, I want to say what age I’m talking about. I mean right from birth. I have a video of my baby girl where I’m talking to her the day after she was born, and you can see her listening. And when she doesn’t want to listen, she just—

10:40 Speaker 1 Wow, wow.

10:41 Speaker 2 Turns her head away. Maybe I’m reading too much into it because I’m so immersed in this, but—

10:46 Speaker 1 She was born to a speech therapist.

10:49 Speaker 2 Yes, but really, from the very first moment you can talk to a child, and you should talk to a child.

10:56 Speaker 1 They actually say to start while the baby is still in the womb—

10:57 Speaker 2 Right.

10:58 Speaker 1 To talk to the baby before birth.

10:58 Speaker 2 Right. So that’s something—

11:00 Speaker 1 Wow.

11:00 Speaker 2 In recent years, research really has shown this. As Chabad women, we already know that the Rebbe says to pay attention to what you see and hear during pregnancy—

11:07 Speaker 1 Right.

11:07 Speaker 2 Because the baby in the womb hears. There’s a great deal of research on—

11:09 Speaker 1 Wow.

11:09 Speaker 2 On the effect it has. And then, when the baby is born, sometimes we’re so busy with the practical side of things. It’s such a shame, because there are golden moments there. You asked for golden tips—well, these are golden moments. Even on maternity leave, even if you’re very busy or tired, you can talk to your baby. It doesn’t come naturally to everyone, so you don’t have to go overboard. But take even a few little moments when you can, while changing a diaper or giving a bath.

11:35 Speaker 1 That could be so much fun.

11:36 Speaker 2 Right. Those are moments of shared enjoyment, of connection. That connection is so important, and you can build such a good connection from that age. It makes a difference. So talk to the child and put what they’re experiencing into words: “Oh, your diaper’s full. That doesn’t feel nice. Let me change it for you. Oh, you’re so dirty. Let’s go have a bath. There, the water feels nice. Wait, we’re letting the water cool down.” Things like that. Just say out loud what we’re thinking. You don’t need to overwhelm the child—whatever feels right for you. But really put their experience into words. If you see the baby suddenly scrunching up their face and looking uncomfortable, say it: “That doesn’t feel nice, does it?” Or, when they’re a little older, “Are you angry? I didn’t give it to you. You’re angry, aren’t you?” Put it into words. I don’t have to offer an immediate solution, but—

12:30 Speaker 3 Yes.

12:31 Speaker 2 Really put into words what the child feels, what they’re experiencing, what they want. Later, we also want to expose them to words for what they see. For a child to develop language, they first have to develop understanding so they know what an object is. After all, why is a table called a “table”? In a sense, it’s an arbitrary choice—though in Hebrew it isn’t. Hebrew has—

12:55 Speaker 3 Lashon Hakodesh.

12:56 Speaker 2 Yes, Lashon Hakodesh is different, but in a sense—

12:59 Speaker 3 Technically, yes.

13:00 Speaker 2 We don’t know the connection between the word “table” and the actual object. We have to make that connection for the child, so they know that “table” means this thing. The more we expose them to the word, the more firmly it settles in their mind. Then, if I say, “Bring me the doll from the table,” they’ll understand which thing is the table and which is the doll. We do this naturally when we talk about objects, but sometimes we need to be more deliberate. Sometimes we think we’re using a word, but... Just yesterday I had an example: a girl didn’t know the word “kettle.” Her mother said, “What? But she sees it every morning. We make hot drinks, and she knows what it is.” I said, “Yes, but think about what you actually say to her.” The girl is almost six. How do you say it? “I’m heating water. I’m putting hot water in for you.” She hadn’t actually used the word “kettle.” So sometimes it’s worth stopping to think: Wait, does he even know this word? Maybe I need to use it a little more. It’s also important to take opportunities to play together. Play is a whole world unto itself. The development of play actually runs parallel to the development of language. So yes, play with your children. I’m not saying that mothers who aren’t into sitting on the floor and building things have to do that. Find what works for you, because it’s important that it feel natural and pleasant too. But find those moments of shared play at the child’s level, and you can always expose them to a little more. So that’s play. Another really important thing is that when a child starts making sounds, repeat them back and give them meaning, even if you’re thinking—

14:44 Speaker 2 “Oh, I’m not sure that’s really the word he meant.” What does it matter? Give the child credit for meaning the word, and encourage him. Say he wanted his bottle and said “doo.” It sounds nothing like it, but you saw that he meant the bottle. “Oh, you want your bottle? Here’s your bottle. Your bottle has milk in it.” I said the word “bottle” four times and connected the word to the object for him. I also connected what he said—or how he showed me what he wanted—to the actual word. I really gave him that encouragement. The more we encourage them, the more they’ll try, and then it becomes a self-reinforcing cycle: Okay, I tried, and they understood what I meant. I’ll try again. And then it takes hold. Yes, it really is a self-reinforcing cycle, and the child tries more. Of course, it also depends on his level of understanding and other things, but with typical development, it really can—

15:41 Speaker 3 Amazing.

15:42 Speaker 2 Give him a boost and help him a great deal. And I say you don’t always have to sit down specially to play. Each mother should find her own balance, but do it in the course of everyday things too. Going to put on a load of laundry? Take a child along and talk to him about it. Let’s sort the laundry by color. What’s dark? What’s light? Look, this is dirty, and this is less dirty, but it doesn’t smell nice. You can really work on these things with them. What do we do first? We sort. That’s for somewhat older children. We can really talk through the process: First we sort the laundry, then we put it in the machine. Now we’ll put in the detergent. Let’s smell it—what does it smell like? Now let’s start the machine. Let’s press the button. Look how it spins. Okay, I’ve been talking a lot here about what we can say. Now I’ll move on to when we want to hear the child speak, and we’re already anxious. I want him to say something. With him too, just as we said it should feel natural for us, we want it to happen naturally, because communication, again, is something natural. So I’ll start with what’s helpful and then talk a little about what isn’t. At the first stage, if he can already answer yes or no and I’m sure he can tell me whether he does or doesn’t want something, we can move on to a choice question. I give him two options, and at first they should be right in front of him: “Do you want an apple or a banana?” Then, going back to what we said about understanding, it makes that connection again between the word and the object. It helps him, and maybe he’ll start saying the word, or something close to it. Or at first he’ll—

17:23 Speaker 2 Even if he just points, reaches his hand toward it, or looks in its direction—something that lets him start expressing what he wants. And of course, as we said earlier, encourage him for every response and show him that we understand him. It doesn’t matter whether he responded with just a look, a point, or a sound. That’s one stage. Later, of course, you can ask a few questions, but you can also give the child room. Children imitate us. So if I come home and tell them about my day at work—what happened, a problem I had, how I tried to solve it, and how I felt—children will eventually imitate us. We can relax and really give them their turn to speak, instead of constantly saying, “Say it, say it. Tell me, tell me.” If we set a personal example, it will happen. Another thing that’s best to do less of is that knowledge quiz: “What’s this? What’s this?” Especially when Grandma comes over. “Show Grandma that you know.”

18:26 Speaker 4 Of course.

18:26 Speaker 2 “Show her,” yes. So, to start with, you can also bring videos. I tell people they can bring videos to assessments and therapy sessions with me, too. If he’s more comfortable at home and manages to express himself there, that’s great. Less of the “What’s this? What’s this? What’s this?”

18:42 Speaker 4 Less of that.

18:42 Speaker 2 Less of that. Children come to me whose whole vocabulary—yes, all they know how to say—is “What’s this? What’s this? What’s this?” We talked about imitation. They imitate us.

18:51 Speaker 4 Wow.

18:52 Speaker 2 Yes. So we really prefer to describe things to them. Oh, look, I’m going back to the tips a little. “Here’s a banana. Oh, do you want me to peel the banana for you? Do you want to eat the banana?” Stay more with describing what’s happening, and less with “Oh, what’s this? What’s this? What’s this?”

19:13 Speaker 4 It’s also the most natural way.

19:15 Speaker 2 Yes. Again, describing everything doesn’t come naturally to everyone, but sometimes it’s a matter of becoming aware of it and making a small shift.

19:22 Speaker 4 Yes.

19:23 Speaker 2 Or, say a mother notices her child is having trouble with verbs. She can write herself a note on the... I always say, put a sheet of paper on the fridge. Write down a few words that you really want your child to know, and make a point of exposing him to those words more often.

19:43 Speaker 4 More consciously.

19:43 Speaker 2 Yes, yes, a little more consciously.

19:45 Speaker 4 Wow. Let’s go back to the practical side for a bit.

19:48 Speaker 2 Okay.

19:48 Speaker 4 And talk about the red flags. Say something raises a red flag for me.

19:51 Speaker 2 Mm-hmm.

19:53 Speaker 4 In practical terms, who do I turn to? Is there funding for this, or is it only for the wealthy? How does it work?

20:01 Speaker 2 So, boruch Hashem, here in Israel—not everywhere, but here—we have health funds. If there’s a concern, you go to the pediatrician, who can give you a referral. The first thing to do when there’s any suspicion or concern is a hearing test, to make sure everything is working properly and the child can hear. If he doesn’t respond to his name, it doesn’t necessarily mean he has a communication difficulty; it could be a hearing difficulty. So that’s the first thing, alongside seeing the pediatrician. And again, don’t be afraid that the child is too young. You can consult a pediatrician at any age, and of course you can consult other professionals. Then you can go for an assessment. Usually, they send forms—a questionnaire for the parents and one for the kindergarten teacher or caregiver—to the child development center. There, they consider whether the child needs to see any professionals, and which ones. The waits for appointments are long. Yes, I—

20:57 Speaker 5 Oh, that’s true for everything.

20:58 Speaker 2 Absolutely. Yes, but this really is something that—

21:00 Speaker 5 Takes patience. I think it’s so important to stress how much this matters, because sometimes parents get discouraged before they even start. They think about the bureaucracy and the waiting lists and ask, “Why do we need this?” But when you know how important it is, then okay, you’ll wait another month or two.

21:18 Speaker 2 So on the one hand, I say yes, be patient while you wait for an assessment. On the other hand, it is important to come when the child is young, because there’s a window of opportunity: the brain is still flexible, and you really can change things. You can do a great deal. We really see that when we work with children at a young age—even before their first birthday, as I mentioned—change is possible. Of course, it all depends on what’s typical for their age. I wouldn’t expect a one-year-old to pronounce sounds like “sh,” and I wouldn’t be alarmed if a two-and-a-half-year-old couldn’t say “sh” either. But that’s why it’s important to have a professional who can assess what’s appropriate for the child’s age, what isn’t, and what needs attention. I mean, we don’t expect a child to be born and immediately walk, right? We all know there are stages.

22:05 Speaker 5 Yes.

22:06 Speaker 2 Language development has stages too. A child learns one sound and then another, and then joins them together. We know that, according to developmental norms, certain sounds emerge at certain ages, so we don’t worry if a child can still acquire them naturally. What’s more important to notice is whether the child is generally understood. Am I the only one who understands him, or do other people understand him too? Is he content with how well people understand him, or is he frustrated? Even if he’s within the normal range, we’ll think it through. If a child is frustrated because people don’t understand him, even though he might still be developing “by the book,” we’ll consider it and give him the help he needs.

22:44 Speaker 5 It’s interesting that you mention what’s within the normal range. I think parents of a first child often feel quite lost about that, because they aren’t familiar with it. So they immediately ask friends and sisters: “How old is your child? At what age did your child start saying this?” Do you think that’s a recommended step before seeking professional advice—just to get a little perspective on where my child falls within that range?

23:07 Speaker 2 Look, that’s something we naturally do with everything.

23:10 Speaker 5 Yes, that’s true.

23:10 Speaker 2 We want to hear from others and see for ourselves.

23:12 Speaker 5 The reason I’m asking is that sometimes other mothers give advice that isn’t professional, and—

23:16 Speaker 2 Absolutely. Absolutely. So you can do that as a starting point. It’s a natural conversation among mothers, and that’s fine. One very important thing to remember is that there’s a great deal of variation between children. There’s a norm, but that norm is a range. In certain areas of development, the range is very wide. One child can start walking at a certain age and that’s normal, while another can start much later and still be fine. It’s still within the range. So comparing your child to others all the time isn’t necessarily helpful. You can get a sense of things. I mean, if something is far outside the range, people around you will probably say something. But if you have a feeling about it before then, or you consult a well-baby clinic nurse and she says it doesn’t seem quite right—

24:06 Speaker 5 So talking a little with other mothers to get a general sense of where my child is—that’s normal. But take it with a grain of salt, and if I have even the slightest concern, why not ask a professional?

24:18 Speaker 2 Absolutely, yes. We also have the option of looking things up—we all use Google these days—instead of just accepting the answer, “It’ll work itself out, it’ll work itself out.” Again, I really believe in mothers’ gut feelings. If everyone has told you it’s fine and you still feel it isn’t, consult a professional. Really. I do want to point out that lately there have been all sorts of consultants. Some of them can help, but there’s a difference between a consultant who studied for six months, or studied one very, very specific area, and someone who studied the profession in depth. There’s a reason speech-language therapy takes three and a half years to study, and the same goes for other professions. It’s in-depth training in how to assess a child. Seeing a child for forty minutes isn’t always enough, but what I observe, the things I look for, and the questions I ask you aren’t random. There’s a whole framework to the assessment. It isn’t a quick fix. I think our generation really wants that quick fix.

25:30 Speaker 5 To ask a question, get an answer, and feel reassured.

25:32 Speaker 2 Magic. What, we’ll go to a speech therapist and she’ll work magic? It’s not magic; it’s a process. Honestly, that taught me a lot, because I’m part of this world too, and I wanted a quick fix, just like that. It taught me so much about processes. We start something, and it’s a process. Sometimes we move up in little steps, sometimes there are sudden leaps, and sometimes we actually have to stop to see how far we’ve come. That process is a very, very significant part of it. And within the process—we’re getting into other things now, but they’re super important—there’s the professional, and there are the agents of change, the people who actually bring about the change. I always say I’m not a dentist. I don’t put in a filling or treat a tooth, and then the child goes home and the tooth is fine. Not at all. In therapy, we sit down and think about the goals: the goals I see as a professional. I also ask the parents, “What goals matter to you?” Maybe there’s something specific that matters to me right now because of how things are with Grandma, or because the child is frustrated by something particular. We set the goals together and work toward them. The parent is a full partner in therapy, because the parent is an agent of change and can carry it over into everyday life. And between us, forty minutes a week—which is usually a standard therapy session, not to mention therapies that take place more often—forty minutes a week isn’t enough.

26:58 Speaker 5 Right.

26:58 Speaker 2 It isn’t enough. We need to take what we’re doing and bring that change into everyday life, and practice with the child. So it’s important for parents to know that too. We come to therapy knowing we’re going to go through a process, and that’s a good thing. It’s not, “Oh no, we’re going to have to go through a process.” Not at all. It’s a good process, and I often hear that it affects the other children at home too.

27:17 Speaker 5 Wow.

27:18 Speaker 2 And the parent suddenly starts noticing things. It isn’t just treatment focused on one specific thing—not on pronouncing the “sh” sound, and not on vocabulary.

27:25 Speaker 5 Not just on the “sh” sound.

27:26 Speaker 2 Right.

27:28 Speaker 5 Esther, there are so many myths in this field. I’d love to hear from you what’s true—maybe it is true, maybe it isn’t.

27:37 Speaker 2 I’ll try to bust a few.

27:39 Speaker 5 People always say girls start talking earlier than boys and develop language faster. If you have a boy who’s behind, well, he’s a boy—you know, boys are late. What do you say to that?

27:50 Speaker 2 That particular myth I can’t really bust, at least not entirely. Yes, girls do have a bit of an advantage and develop a little faster than boys. That’s in terms of producing speech—we’ll hear them talk more. When it comes to understanding, though, development appears to be similar. We girls just want to get out what we have to say.

28:14 Speaker 5 So there’s a reason people say girls start talking at that age.

28:17 Speaker 2 But that doesn’t mean that if a boy is late to start talking, we say, “Oh, it’s fine, we don’t need to do anything.” No. The difference isn’t big; it’s about a month. At a young age, a month is significant, but that’s the sort of difference you see in when they start producing words. I’m talking about a very young age, when they’re first producing words. Not acquiring them, sorry—acquisition refers to understanding. It’s in producing words that you see the difference. So there is some truth to it. People try to think about why: whether we expose girls more to games that call for conversation, or encourage them more, because... It’s a question, but there is something to it. Yes.

28:59 Speaker 5 Okay, so you didn’t bust that one.

29:02 Speaker 2 No.

29:03 Speaker 5 Another thing. Often there’s this milestone people call age three. In my mind, with boys, it’s before the upsherin and after the upsherin. You know, the little boy with long hair who still stumbles over his words and says all sorts of funny things—he still sounds like a baby. With girls, there isn’t that same clear dividing line at age three. But people still say, “Well, up until age three it’s normal.” You hear that myth a lot. So is it a myth or not?

29:30 Speaker 2 Let’s bust that myth loud and clear. It’s long, long before age three. Again, there are stages of development, but many language skills develop before age three. By the time a child reaches three, they should be understood almost all the time—not only at home, but outside the home too. They should have enough language to speak in sentences and describe things they’ve seen and experienced. So don’t wait until age three. Look into it well before that.

30:02 Speaker 5 Wow. Okay. Some people say, “Oh, speech therapy is so cute. She plays with the child; it’s just a nice bit of quality time.” I’m sure that’s not true, but tell us why and how.

30:20 Speaker 2 Yes, and actually, when I hear that, I think of someone saying, “What? She’s just playing with my child? That’s not enough! What’s so cute about that? What am I coming to therapy for? I want her to do something, to get my child talking.”

30:30 Speaker 5 What did I pay for?

30:31 Speaker 2 Exactly—what did I pay for? Well, first of all, play is the way to reach a child. Sometimes play is the means, and sometimes play itself is the goal. As I said earlier, the development of play and the development of language run in parallel. Sometimes the goal is the child’s play, or how the child plays. Or, if we’re talking about communication, can the child play with me? Can they pay attention to the different parts of the game, to its sequence? There’s so much in play itself. A lot of parents look at it and say, “Wow, I didn’t realize play was so significant.” Suddenly they see there’s more they can do, and each person takes that into their own life. But yes, we do play with the children, and we’re proud to play with them, because that’s the way.

31:20 Speaker 5 Wow. So the parents are actually present during—

31:23 Speaker 2 Therapy?

31:24 Speaker 5 Therapy. Or could they get in the way, and is it better for them not to be there? That’s interesting.

31:27 Speaker 2 With young children, absolutely they should be there, because they’re the agents of change. We want them to be partners in therapy and to take it home with them. Sometimes it’s harder for a child when there are two authority figures in the room, or for other reasons, and then the parent waits outside. But that’s usually with much older children. I try to make sure that even—

31:47 Speaker 5 It depends.

31:47 Speaker 2 Yes. Even when that happens, after a few sessions I try again to have the parent come in. Because it’s just not the same if the parent hears about it from me at the end, versus experiencing it, being involved with us and seeing the examples. It makes a difference.

32:03 Speaker 5 We tend to think that as long as a child isn’t talking, they don’t really understand us either. You know, people talk in front of children about all kinds of things. I wouldn’t talk about them in front of a five-year-old, but in front of a two-and-a-half-year-old, you can talk about anything. They don’t understand a thing. So—

32:20 Speaker 2 I’d completely bust that myth. Really, as we discussed, a child understands from the very beginning. They don’t always show that they understand, and we don’t always know just how much they understand, but they do understand. Beyond that, they sense how we’re feeling. I mean beyond language. They can sense when we’re tense. As a mother, I’m sure you know that if you’re tense, even if you haven’t said anything, or you’ve tried to be perfectly calm and say, “Oh, what’s the big deal?”—they sense it. They pick up on it. So again—

32:49 Speaker 5 So understanding and speaking don’t develop at the same pace at all.

32:51 Speaker 2 No, not at all. On the contrary, understanding develops earlier. It’s the foundation for expression, and it needs to be there as the foundation.

32:58 Speaker 5 Right. Let’s move on to a subject we could honestly spend an hour on by itself: bilingualism. Say the father speaks English and wants to speak English with the child, and the mother says, “No, no, no, no, no. I don’t want it to hurt their Hebrew. I don’t want it to cause a delay. Children growing up with two languages are delayed.” I saw this in our family: the children spoke Russian and Hebrew, and people kept telling me, “You should know, if your children start talking late, that’s completely normal because they have another language.” There are so many myths just around this. So tell us the truth.

33:35 Speaker 2 In the past, people really did think that way. So whoever tells you that is someone familiar with the views that used to be—

33:40 Speaker 5 Outdated.

33:41 Speaker 2 Yes, they’re not very old. I can’t give you an exact number of years, but maybe a decade or two back. And now we know, both from research and from what we see in practice, that it doesn’t actually cause harm. I should qualify that: it doesn’t cause harm when the exposure is consistent. In other words, when Dad speaks one particular language, Mom speaks another, the caregiver speaks another, and Grandma speaks another—it can even be five languages at once—it doesn’t cause harm. If anything, the opposite is true. We’re born with flexible, open minds, and when we learn one language, we become very set in it. There are sounds in other languages that I’ll never manage to pronounce, because—

34:23 Speaker 5 Right.

34:23 Speaker 2 Well, I don’t know about never, but right now I can’t even distinguish some of them, because we’ve become so attuned to certain sounds. Even with English—and someone just recently demonstrated a sound in Amharic for me—I had to listen really carefully. I told her, “I can hear something, some difference.” So someone who’s exposed to more languages actually has an advantage. We see that it gives them an advantage both linguistically and cognitively. When children who are bilingual or multilingual, rather than monolingual, are given cognitive tasks, we see that they have an advantage. Of course, I’m talking about consistent exposure in everyday life, as we said earlier: natural exposure in different day-to-day situations. Another important point is that in the past, a lot of immigrant families were told, “No, the child is having difficulty with language, so speak only Hebrew with him.” But the parent didn’t know Hebrew, so the child was actually being exposed to language that wasn’t natural or sufficiently correct. Today we see that it’s more important for parents to speak to their child in the language that comes naturally to them, because the bond between parent and child, and that spontaneity and naturalness between them, are so important. We don’t want a parent to have to stop and think about exactly which word to use. No. If you need to tell your child something and you want that connection, it’s so basic and so important. So research shows that bilingualism or multilingualism is a cognitive advantage, and it also preserves that natural connection with the parent. I never make the decision for parents. I tell them, “Think it through. Really think about what suits you as a family.” If there are grandparents who only speak Russian—and there are many—and it’s very important to us

36:10 Speaker 2 to expose the child to Russian.

36:14 Speaker 5 Every language is a gift.

36:15 Speaker 2 Right. But there are all sorts of other factors too—emotional and, again, family factors, like grandparents and so on. That’s very significant.

36:22 Speaker 5 Yes, it’s interesting. I also see that when a child knows two languages and translates things for himself, it develops the mind so much. Because every language has words that don’t exist in exactly the same way—

36:31 Speaker 2 Exactly.

36:31 Speaker 5 in the other language. Meanings.

36:33 Speaker 2 Absolutely.

36:34 Speaker 5 And even if you can’t translate it because there’s no word for it, you still have it in your mind.

36:37 Speaker 2 That kind of richness.

36:38 Speaker 5 Yes, absolutely. It really develops the mind.

36:40 Speaker 2 Yes, and it also builds flexibility. Think about it: he has to figure out whom he’s speaking to and which language to use. That’s also... In short, it’s good.

36:47 Speaker 5 So many abilities.

36:47 Speaker 2 It’s good—

36:48 Speaker 5 Yes.

36:48 Speaker 2 when it happens naturally.

36:49 Speaker 5 Yes, not by force.

36:50 Speaker 2 Not by force.

36:50 Speaker 5 If it’s there, it’s a bonus.

36:51 Speaker 2 Yes.

36:52 Speaker 5 I have an interesting question. It isn’t directly related to your field, but it seems like the natural thing to ask. One day you discovered this field and dreamed of becoming a speech therapist, and here you are, working in it. Wow—ten years. And sometimes there are younger girls—actually, not necessarily younger; sometimes even at a later age—who have a dream like that. We look at women from the outside and think, “Wow, she’s a speech therapist, and she fulfilled her dream.” It looks so simple: she studied and did it. And I’m sure it wasn’t like that. Obviously it was a process, with stages and effort. So as someone who did fulfill her dream, what tips can you give someone who has a vision like that for herself? “I wish I could be like that.” Usually it comes with all our excuses: “If I had all the time in the world, if I had all the money, if this, if that...” How do you actually do it without all those “ifs”?

37:47 Speaker 2 I can share that, in my case, I started studying just two weeks after my wedding.

37:54 Speaker 5 Wow.

37:55 Speaker 2 The program had already begun. I got married a few days after classes started, missed the first two weeks, and then joined. In the middle of the second semester, I had to go on bed rest during pregnancy—to the point of being hospitalized. And there was no Zoom or anything like that. You couldn’t study remotely. Either you came in, or you couldn’t continue studying. So I lost that semester and later went back. I try to think back to why it seemed so obvious to me that I would return. I can’t reconstruct why. But I was very, very motivated: yes, I was studying, I wanted this, and I wanted to treat people. Even though I didn’t know the full scope of what it involved, what it really was. It was only the very beginning. But there was the motivation—and I don’t know how to rank it alongside the motivation, but siyata dishmaya, help from Above, comes first. When we want something, we always need to daven for it, because it really... it won’t happen without help from Above. Sometimes we’ll see that help openly, and sometimes we won’t. Looking back today, I see that it was help from Above: the fact that I wanted it so much, that I went back at all, and that it seemed obvious to me that I would. That wasn’t just me.

39:03 Speaker 5 Yes.

39:03 Speaker 2 It was really guidance from Above. So daven for it. If you want it, think about how you can do it and what paths are open to you. In my case, the studies were genuinely challenging. There were so many hours of classes, hours when you had to be out, and then studying at home afterward. You really have to consider whether it’s right for you. Do I have someone who can help me? Can I afford it right now? That applies to any field; I’m not talking only about my profession, I’m talking—

39:31 Speaker 5 Of course, yes.

39:31 Speaker 2 I mean, these are the points that mattered in my case, and baruch Hashem, it happened. It wasn’t all calm and easy. No. It took a great deal. And then you have to establish yourself in the profession. You say, “Wait, I’ve studied so much, but where’s the recipe for actually getting started?” No—here too, it’s what we said about a process. My development as a therapist is also a process: learning how to really see the person I’m treating, understand more, work out what they need, and then actually help them make progress. Again, these things take time.

40:06 Speaker 5 I think just knowing that you’re taking on something challenging, and not being afraid of that. And if it’s your dream, and you know this is the good you have to bring into the world, and that this is your shlichus, then...

40:16 Speaker 2 Absolutely. Absolutely—keep that in mind, and it really pushes you forward. I can tell you that, in another area of my life, I kept wanting to go to a class. I’d say, “I can’t manage it, I can’t manage it, I can’t manage it.” So I said, “Okay, I’ll bring the class to me.” If I can’t get out once a week, the class will come to my home. And it isn’t easy. Honestly, two hours before the class, I’m thinking, “What have I done to myself? The house is such a mess; I can’t let anyone in here.”

40:42 Speaker 5 An opportunity to tidy up.

40:43 Speaker 2 Listen, that’s one of the benefits. The house—

40:45 Speaker 5 That’s the trick.

40:46 Speaker 2 Suddenly, every week—

40:46 Speaker 5 You invite people over, and...

40:47 Speaker 2 Exactly, exactly. Suddenly the house... So first of all, there’s that practical benefit. And after the class you say, “Wow, how could I even have thought of giving this up?”

40:56 Speaker 5 Yes. Basically, when you’re sure something feels good to you, that it feels like something worthwhile to do—

41:01 Speaker 2 Something that matters to you.

41:01 Speaker 5 Yes. How does the saying go? I once saw—I think the Frierdiker Rebbe said it—how do you know when it’s the yetzer hara? It’s not always easy to identify what’s the yetzer hara and what might be the yetzer tov. It can dress itself up in all kinds of ways. When it stops you from doing something good that you know is good, that’s the yetzer hara, whatever excuses it comes with. So when you feel you have something good to give the world, and this is where you belong, find a way to really do it and see it through.

41:25 Speaker 2 Right, because there are plenty of excuses.

41:27 Speaker 5 Always, of course.

41:27 Speaker 2 Absolutely. Starting with, “No, I can’t, I’m a mother now,” or “I only just got married,” or “No, it’s not the right time.” But if we truly want to, then... We’ve just passed the date associated with “Lechatchila Ariber,” the Chabad idea that you have to leap over the obstacle and do it—overcome the difficulty and simply get started.

41:46 Speaker 5 Jump into the water.

41:47 Speaker 2 Yes.

41:48 Speaker 5 Beautiful. Wow. Esther, you grew up in a home devoted to shlichus. We’ll let everyone in on that.

41:53 Speaker 2 Yes, we’ve already talked about it.

41:54 Speaker 5 Part of my childhood was spending Shabbos at your house. Your parents were shluchim in Maccabim-Reut.

42:03 Speaker 2 Right.

42:03 Speaker 5 A beautiful community, and—

42:05 Speaker 2 Two communities, yes. Both gorgeous.

42:07 Speaker 5 Wow. So what do you think growing up there gave you? We always say that every woman is a shlucha. There are the shluchim, so to speak, with the badge—that’s what the Rebbe would give out. He would say that everyone is a shliach, and then there are the shluchim whose entire day, around the clock, is devoted to shlichus. So what did you take from growing up in a home like that, and how do you see yourself today in the work you do? Although, as we’re talking, I’m thinking, wow, this profession is shlichus from beginning to end. But still, how can every mother who gets up in the morning, gets the children out the door, and goes through her daily routine feel like a shlucha, be a shlucha—wake up a shlucha and go to sleep a shlucha?

42:47 Speaker 2 That question is a whole life’s work.

42:48 Speaker 5 Yes.

42:49 Speaker 2 So...

42:50 Speaker 5 Every question is...

42:50 Speaker 2 It really is. First of all, I’m deeply grateful to my parents and to the Rebbe that I grew up on shlichus. Looking back today... Of course, I didn’t see it then. When you’re living inside something, you can’t really see it. But we truly lived with an awareness that every moment I’m there is amazing and meaningful, and that I’m giving to others. We lived with the question: Does someone need me right now? Can I help someone? Can I help them without their realizing I’m helping? Is there another way I can give? There are the basics of Yiddishkeit that everyone wants, and then there are things that go a little beyond that. What can I give, and how can I do it? It develops so, so much sensitivity.

43:34 Speaker 5 A gift.

43:35 Speaker 2 Absolutely, it’s a gift. Then, when I got married and realized that going on formal shlichus, as you described, wasn’t quite right for us as a family, I thought, wow. As the children started growing up, I began to understand what it meant and how valuable it was. I said, What? I’m not going to give my children that? And suddenly I understood that, again, as you said earlier, everyone is a shliach. Just because I’m not going to a particular city or place doesn’t mean I’m not one. I can truly be a shlucha anywhere. I go to a store to buy something. I’m a shlucha in who I am, in the way I conduct myself and behave. Am I making a kiddush Hashem, or, G-d forbid, the opposite? In the way I dress, what I project, how I speak when I arrive somewhere. And I want to say something very important: I came to understand that shlichus begins, first and foremost, at home. There were times when I was very involved outside the home, in the community, and I really needed that realization: our shlichus begins at home. We set a personal example for our children. The relationship between my husband and me is significant. So shlichus really does begin at home. It’s not just a—

44:48 Speaker 6 Slogan.

44:48 Speaker 2 A slogan. Not at all. It matters so much, and from there you can reach outward. But first of all, it really begins within our own home.

44:56 Speaker 6 Yes.

44:57 Speaker 2 It begins within our own home, and that connects very closely to my profession. We’re talking here about work that changes lives. Every woman who works in a therapeutic profession really sees that. So that giving, that thoughtfulness, and that flexibility come into play here too.

45:20 Speaker 6 It’s also important to say that the fact that your work is shlichus doesn’t make it any less of a job. I mean, it’s your profession, and it’s shlichus. If you had all the money in the world, you’d keep doing it because your heart is in it and you want to give. But when we go to a professional, I really think it’s important not to say, “Oh, could you do me this little favor on the side too?” just because her work is shlichus. We have to remember that the professional in front of us is a shliach, but this is also how she earns a living.

45:44 Speaker 2 That’s a very sensitive and important point.

45:46 Speaker 6 For a lot of professions, I think.

45:47 Speaker 2 For a lot of professions. You’re absolutely right. In our field it comes up very strongly, and people have been talking about it a lot lately: shlichus won’t pay for the groceries. I can choose where I volunteer, but when I’m doing paid work, yes, there is compensation for it. I can tell you that it was very hard for me to make that shift, because I come from a world of shlichus, of just giving.

46:12 Speaker 6 You need me.

46:12 Speaker 2 How can I accept payment? Yes, they need me. How can I possibly accept compensation for that, let alone money? And then think about how to set my rates when I go into private practice?

46:22 Speaker 6 It’s hard.

46:22 Speaker 2 How can I? Wow, it’s a big shift, but it’s a good one. It’s another process we go through in life: recognizing that there’s this kind of shlichus, and there’s shlichus that is also a job.

46:32 Speaker 6 And that’s shlichus too.

46:33 Speaker 2 It’s shlichus in every sense.

46:35 Speaker 6 Yes.

46:35 Speaker 2 Absolutely.

46:36 Speaker 6 Wow, that applies to so many things—also from the perspective of people who go to professionals, remembering that—

46:42 Speaker 2 Right.

46:43 Speaker 6 They deserve compensation for their studies, their work, their experience, and all the knowledge they bring. And they’re shluchim. Because everyone is a shliach.

46:50 Speaker 2 Think about it... Exactly. Absolutely. You see a professional, and she sees your child for a short time. But you’re not paying her just for that time. You’re paying for all the knowledge she’s acquired and continues to acquire, because she’s constantly learning more.

47:04 Speaker 6 We’re always looking for professionals with as much experience as possible. Why?

47:07 Speaker 2 Exactly. Why? Exactly. Because their perspective encompasses so much. So it’s not, “What? She only saw him for half an hour?” No—it’s, “Wow, she saw him with all those years—”

47:19 Speaker 6 The comparisons she can draw.

47:19 Speaker 2 Behind her. The knowledge, the experience, all of it...

47:23 Speaker 6 Wow, that’s an important point.

47:24 Speaker 2 People don’t always understand that—not until they get a little glimpse behind the scenes, at what goes into the work. And that’s true of all sorts of professions. When you go to a professional, you benefit from their entire background and experience.

47:37 Speaker 6 Yes. Very important.

47:39 Speaker 2 Very.

47:40 Speaker 6 Esther, it’s been such a pleasure talking with you. A few words to close?

47:45 Speaker 2 Wow, it’s really been interesting and enjoyable.

47:48 Speaker 6 Fascinating.

47:48 Speaker 2 Yes. I think one of the most important things is to remember that we are our child’s parents. Every parent is the parent of their own child. You are the most significant person in your child’s life. You’re the one who can make a change. The fact that you can make a change doesn’t mean you’re to blame for what happened to your child. Some parents have a very hard time with that: “It’s my fault. It’s because I didn’t do this or that.” No. There are things a child is born with—

48:16 Speaker 6 Wow, that’s important.

48:17 Speaker 2 With their own challenges and abilities. We need to look at both sides: What are the child’s strengths, and what areas need strengthening? And know that, ultimately, we as parents are the most important people in our child’s life. So let’s seek advice, take action, and do what we can. Let’s not sit with our arms folded and say, “I’m keeping an eye on it; we’ll see,” or “We’ll see if he makes progress.” Do something. There’s the saying, “Think good and it will be good.” I say: Do good too. Don’t think that thinking alone will bring about good.

48:49 Speaker 6 Yes.

48:49 Speaker 2 Oh, wow, that sounds presumptuous.

48:50 Speaker 6 The obligation to make an effort.

48:51 Speaker 2 Yes, so presumptuous. I really don’t mean to challenge it. It’s such a powerful Chassidic saying. I’m saying that sometimes we take it to mean, “Let’s just think.” Thinking is important, but action is no less important. Yes, just as you said.

49:02 Speaker 6 Make a vessel for the blessing: think good, and go get treatment so that good can come.

49:06 Speaker 2 Yes.

49:06 Speaker 6 So that Hakadosh Boruch Hu can bring down upon us the—

49:08 Speaker 2 And with joy. A relationship with a child should be enjoyable. Truly. If it isn’t enjoyable, we need to take action so that the enjoyment can be there. Children are a source of joy. That’s not a myth.

49:22 Speaker 6 Yes, that’s the best way to sum it up.

49:23 Speaker 2 It really is.

49:23 Speaker 6 Thank you so much, Esther. It’s been fascinating and a pleasure.

49:26 Speaker 2 My pleasure. With Hashem’s help, when a child comes to any of us, may we be the right shlucha or shliach to help that child. That takes siyata diShmaya too.

49:32 Speaker 6 May everyone find the...

49:34 Speaker 2 Yes. When a child comes in, I say, “With Hashem’s help, may I succeed in helping this child. May Hakadosh Boruch Hu help me help them.” Because it isn’t just me. I mean, I’ve done my part, but I keep coming back to siyata diShmaya. It’s so clear that there are children you connect with less easily, or things don’t click as readily. You need siyata diShmaya to succeed in helping someone, to carry out our shlichus well.

49:53 Speaker 6 Wow. May we be blessed with the right matches between...

49:55 Speaker 2 Amen, amen.

49:56 Speaker 6 Thank you, Esther.