Rachel Friedman: My life has become one big therapy marathon.
Dovid Friedman: Look, Yossi has delays. Is all this therapy really going to help?
Teacher: Yossi is progressing but not as fast as we’d like. Maybe an outside perspective can offer ideas.


By the time Rachel Friedman settles herself and her kids, she’s flustered. “I’m sorry,” she keeps apologizing. “Maybe Chayala and Berry can sit in the waiting area?” Looking guilty, she hands lollipops to her three-year-old. “Here, Chayala, take Berry to those chairs. Yossi, take off your coat.”

“No! Me want coat.” Rachel backs off.

“Me want lolly!” Yossi grabs them from Chayala. Rachel looks embarrassed.

“We don’t grab!”

She hands him one and returns the others to Chayala.

Chayala’s lip trembles. “I wanted the r-e-e-e-d one….”

I try to put Rachel at ease. “It’s okay, the kids are tired after their long day.”

She looks grateful, but guarded. “This is Yossi. He’s five.”

“Hi, Yossi. Do you want to color with Chayala while I talk to your mother?” Yossi takes the crayons, but looks blank. I repeat, “Go sit with Chayala.” This time he goes.

“Yossi attends SunnyTrails Kindergarten,” Rachel continues. “His therapists recommended an eval.”

“Does Yossi have a diagnosis?”

Rachel shakes her head. “No. He struggles with language processing and verbal expression. He also has sensory issues and OT stuff — fine motor, gross motor, low tone. He gets speech and OT at school.”

“How is he doing?”

“I guess okay.” She seems to struggle before continuing. “He can’t process new information, has a hard time communicating. And he can get difficult behaviorally.”

“What do the therapists say?”

“Umm…” Again the struggle. “They say the window of opportunity is closing, and if we don’t fix him now, he’s doomed. They each give me ‘just ten minutes’ of follow-up every night, and I better do it if I want him to be normal.

“And I should practice with him, every moment! Take him to the park and have him find different items. While I stand parked in one spot with the other kids. Sure, no problem.” She crosses her arms. “And I should hire private speech and OT and ABA after school and implement a sensory diet every two hours and then I wouldn’t have such a hard time!”

“Rachel, listen. You’re riding a unicycle while juggling all your kids and Yossi’s needs simultaneously. But you can’t function on your own. Get off the unicycle and onto a tandem bike! Get your husband and the school team involved. Talk to them and pick one or two goals only to work on.”

Rachel’s voice rises. “No, we need to work on everything. Otherwise…”

“Otherwise you’ll have failed your son. Is that what you were going to say?”

“I’m not the one who says it… the therapists.…”

“I’m a therapist too, and I say you need to choose one goal. And that’s not even the first step. The first step is a calm and functioning environment for you and your entire family.”

“More pressure, thanks.”

“Not pressure. You work, you have three little kids, one with extra needs. If you and your kids eat and sleep, that’s a huge accomplishment. It also makes it possible for therapy to be effective. But we need to work in realistic, bite-size pieces. So pick a goal. Let me know next week.”

Yossi has poor language processing skills. He cannot follow instructions easily.

Yossi needs to be spoken to in short, easy sentences.

There are in fact “windows” of time when the brain is primed for development in certain areas. Once the “window” passes, improvement is possible, but it takes significantly more work and is less natural.

Originally featured in Family First, Issue 586. D. Himy, M.S. CCC-SLP, is a speech-language pathologist in private practice for over 15 years. She is the creator of the Link-It reading comprehension and writing curriculum for elementary school students and directs continuing education programs for speech-language pathologists and educators.