Katerina Melitsopoulou, an Inwood speech therapist, sits on a small red chair with four-year-old Brenda Alcantara, imitating everything from leaping monkeys to slithering snakes. As they act out the “Dear Zoo” book, Melitsopoulou jumps up pointing at the ceiling to show that the giraffe is “too tall” and bares her teeth in a roar to depict the lion as “too fierce.” They send every unfit pet back, placing a letter in a shiny red mailbox, until the zoo finally delivers a puppy.
With her next client, three-year-old Billy Sanchez, Melitsopoulou reads “Goodnight Moon,” which she calls “a staple of speech therapy.” Then they catch multihued fish so Billy learns to pronounce colors.
Both children are bilingual Spanish speakers with speech delays. It’s not unusual for bilingual kids to speak later than their monolingual peers, but if speech problems are not addressed, they can cause cognitive and social delays, says Catherine Crowley, director of the Bilingual Extension Institute at Columbia University’s Teachers College. “The child will have difficulties in school interacting and comprehending,” she says.
Speech therapists in Washington Heights and Inwood see a definite need for their services, intensified by the fact that many families speak Spanish at home. Children cared for by their grandparents during the day often lack interaction with their English-speaking peers. Some therapists see an increasing demand; others point out that there’s not enough awareness of free programs that could help. Meanwhile, some parents wouldn’t mind seeing more local therapists to choose from.
Alcantara’s mother, Ana Herrera, who speaks little English, says her daughter was speaking gibberish as a toddler and their pediatrician recommended therapy. Sanchez’s mother, Yahaira Estevez, a bit more communicative in English, took charge herself. “Billy was a year and a half and he wasn’t speaking, so I talked to our doctor,” she says.
Melitsopoulou, fluent in Spanish and Greek, has had a 16-year speech therapy career, and opened her Inwood office in 2008 because she saw the need in a neighborhood where half to two-thirds of her clients are bilingual. She started as a solo practitioner in one room and quickly expanded, hiring more therapists and renting additional space. “So far I have been able to accommodate everyone who came,” she says proudly.
But Olga Terlitsky, a Washington Heights parent whose son Ellee spends lots of time with his Russian-speaking grandparents, says that when she looked for a speech therapist in the area, she found limited choices. Moreover, her pediatrician believed that children learn when they’re ready, she says, so she waited until Ellee was almost 5.
“He wasn’t directing us,” she says of her doctor. “Ellee wasn’t following instructions; he was in his own little world.” She’s not sure whether his speech delay was caused by his exposure to both English and Russian, but his progress has been remarkable, she says about her now 6-year-old. “Ellee now talks and tells stories.”
Terlitsky has been happy with Stella Heracleous-Kyprianou, a speech therapist so bubbly she can get the most withdrawn children to chatter, but she would like Ellee to continue his therapy in a group setting.
Heracleous-Kyprianou, who started her first Logopedica center in Astoria 10 years ago and later opened a second office in Washington Heights, says she has noticed that uptown parents raise fewer concerns about kids’ speech delays than those in Astoria, though both neighborhoods are highly bilingual.
“In Astoria they’re more aware,” says Heracleous-Kyprianou, adding that many Astoria parents introduce their children to therapy before they turn two. “Here, kids get their screenings when they are a little older – three or four years old, when the delay is more obvious. But we want to act as early as possible.”
Sometimes parents realize their children still struggle with words while their peers speak in full sentences. Many kids’ speech delays surface only when they start school and get placed on Individual Education Plans, which essentially categorize them as special ed students even though they may not have learning disabilities.
Crowley says that bilingual children and those from poor families face higher risks of being mistakenly placed in special ed when they don’t need it. The most commonly-used standardized tests that determine whether children have language problems are only 57 percent accurate and don’t reflect cultural nuances, she adds.
“Research shows that bilingual kids have smaller vocabularies; kids from poor backgrounds are shown to have a smaller vocabulary. So they will score lower on tests,” says Crowley, adding that in some ethnic communities, youngsters are taught not to speak up but to keep quiet.
“Children from certain cultures don’t focus on labeling or telling stories,” she says, emphasizing that standardized test provide a flawed measurement of their intelligence. Yet the Individual Education Plans will follow them through school, lowering their curriculum requirements and not engaging them to their full potential.
The special ed graduation rate in New York was a shocking 18 percent in 2006, Crowley says, increasing to 23 percent in 2009 and barely over 30 percent now. “The teachers’ expectations for children with disabilities are different,” Crowley explains. “Research shows that who you learn with matters. If you’re in the class with low achievers, you will be a low achiever.”
According to Department of Education data, 21 percent of English language learners, or one in five, get placed on Individual Education Plans.
Both Melitsopoulou and Heracleous-Kyprianou say that for bilingual kids, therapy begins in their dominant language. “You have to give them credit for everything they know in the other language,” Melitsopoulou says. “You expect code-mixing, like ‘Mommy I want leche’ instead of ‘Mommy I want milk.’ When I see this happening I repeat the same sentence in both languages correctly.”
Melitsopoulou works with many Committee of Preschool of Special Education referrals, with good results. Most kids are exposed to English in their schools, she says. “You can see how they start using more and more English words during the school year, and at the end, they often prefer to speak English.”
If they start therapy early, children may not need Individual Education Plans, Heracleous-Kyprianou says. She tries to address the problem before kids start school by working with a local pediatrician to identify children with speech delays and by holding information sessions at childcare centers to educate teachers about free state programs.
English language learners under three are eligible for the early intervention program, which sends therapists to children’s homes. If kids need therapy after three, they continue at speech centers like Heracleous-Kyprianou’s in Astoria. If they are still behind in pre-K, they receive an Individual Education Plan. To qualify for a program, the children are evaluated by two or three independent child psychologists, many of them bilingual.
Heracleous-Kyprianou believes uptown parents often don’t realize such programs exist. “They need to know they’re available and free,” she says. “There’s a lot of kids around here, but there’s no awareness of what to do.”
Crowley says there aren’t enough bilingual speech therapists and that the city and state are seeking funding to train more. “We definitely need more bilingual Spanish speech pathologists who understand how to distinguish a disability from normal second language acquisition,” she says.