Dana Mason, a soft-spoken speech therapist, lines up three colored blocks in front of Claire, a vivacious 6-year-old temporarily distracted by a tremendous desire to go put on her Halloween costume.
But Mason persists, pointing to the blocks. "If these three blocks say `cat,' then how do we make them say `hat?' "
Claire studies the blocks, sitting on the living room floor in her Northwest Washington home. She removes the first block and puts another in its place. "Hat!" she says.
"That's perfect! Very good," Dana responds.
"Now can I get my costume?"
This is what it takes to help a child with a speech and language delay: patience, enthusiasm and knowledge. It's what Lori Ann Madhok and Eileen Haley believe many children with developmental problems of various kinds don't get -- and why they founded their own company, Out Came the Sun, to provide it. Claire is one of their clients.
Madhok is a developmental specialist, Haley a speech therapist. Typically, professionals in such fields work for government agencies or nonprofits, often minimally paid and bound by bureaucracy. But Haley and Madhok have broken new ground with a for-profit company that gets its revenue from a combination of public and private contracts. Their business will have about $350,000 in revenue this year, up from just $1,300 four years ago.
These are not your typical entrepreneurs, though. In fact, they don't even know what "revenue" is.
Ask Madhok and Haley how much money Out Came the Sun brings in each year and they squirm. They look at each other and laugh. They look back at you sheepishly. We should know this, they mutter . . .
"We pay people to do that," Madhok finally answers. "Call Brenda."
Indeed, Brenda Roper, their accountant, clears things up. "They're really more the creative types, aren't they?" she says.
But even if Madhok and Haley get nothing from the quarterly financial statements she shows them, Roper is thoroughly devoted to Out Came the Sun. "I've never seen another business like it," Roper says.
Their accomplishment is striking not only because Madhok and Haley are basically clueless about how their business really functions, but also because they have found an entrepreneurial niche in a field that is notoriously bureaucratic and unreliable.
Most children under 3 years old with disabilities or developmental delays are eligible for some kind of publicly provided therapy to help with speech, motor and cognitive development. And most of the therapists who treat such children are either employed by the city or county, or by a nonprofit group that works for the government under contract.
But often it's difficult to actually get this kind of treatment, especially in Washington, where services can be cash-starved and overcrowded.
"After my son was diagnosed, Children's Hospital gave me a list of agencies within the D.C. government to work with," said Brenda Brown, whose 4-year-old son, Jared, is borderline autistic. "That sort of began my nightmare."
Eventually, Brown hooked up with Out Came the Sun, which treated Jared intensively for a year, starting when he was 2. But she only connected with Out Came the Sun after months of fighting. She convinced the city that its resources were a morass of inadequacies -- not to mention a quagmire of mixed messages and missed appointments. "You fight them on the smallest things," Brown said.
Madhok and Haley met inside this system. In the early '90s, they worked for a publicly funded early intervention center in the city where children, none older than 3, were dropped off each day for treatment and, essentially, specialized day care. They suffered from cerebral palsy, HIV or other mental and physical problems.
Both women say helping children is a personal crusade they could never abandon, but neither was happy at the center where they worked. Their roles as therapists were subject to rigid bureaucratic guidelines, they say, and the families were hardly involved. Creativity in treatment was discouraged. Among therapists, there was more conflict than cooperation.
"A center-based program is very, very challenging," Madhok says with the circumspection of someone who has more to say, but does not.
Madhok and Haley dreamed about starting their own program, but did nothing, and eventually Madhok left to work with children at D.C. General Hospital. There, at one point, she went five months without a paycheck. She continued to talk to Haley about starting their own program.
Madhok had grown close to a 3-year-old girl from the center who had HIV. She applied to become her foster parent, and won custody in 1994. As soon as Tenisha moved in, Madhok registered the girl for a government therapy program.
Six weeks later, Tenisha died of bacterial meningitis. Six months later, the city called to arrange for Tenisha's therapy.
"That was it," Madhok recalls, her eyes red and watery. "That's when I went to Eileen and said, `We've got to do this.' "
They started Out Came the Sun with three clients -- all children from the program at D.C. General, which had closed. Three clients, no money, and no idea what to do about it.
"We had our own phone, and nobody called!" Haley says. And she laughs. She is excitable and earnest, like the quintessential first-grade teacher. She seems an unlikely match for Madhok, who is tall and striking and wears interesting earrings and paints her lips blue. But they profess undying friendship. They both get teary when they talk about it. It is an emotional business, this.
When Madhok and Haley decided to formalize the business, they went to the local Small Business Administration assistance office, where they were told to do a business plan, make projections, write it down. It wasn't for them.
"If we'd followed that line of reasoning, we'd still be sitting down at the SBA," Haley says. Instead, they hired a lawyer and an accountant and started cold-calling to sell their therapy services.
Eventually, Out Came the Sun began getting contracts from local hospitals, nonprofit programs and even the District, though the company is based in Silver Spring. Madhok and Haley had experience, they had passion and, if necessary, they'd work for very little. Their philosophy was this: They would work in the home, with the families, and together the therapists would plan an overall treatment for each child. They were hard to resist.
Now Out Came the Sun has five full-time therapists and works with another 20 on contract. Madhok and Haley are on the verge of several new contracts, such as one with Howard University Hospital, that will require even more employees.
These days, the partners do as much oversight as actual therapy. At Columbia Hospital for Women, Madhok takes great pleasure from watching two of her therapists evaluate a spunky little girl named Arica. Born 13 weeks premature, at 1 pound, 12 ounces, Arica is now a year old and running through a battery of cognitive and developmental tests flawlessly. She grabs what she wants. She stands on her own. She finds the toy.
"She's my little miracle girl," says her mother.
Madhok, and everyone else in the room, is entranced.
Like other business owners, the founders work crazy hours, day and night. There are things they hate about the business, such as scheduling and conflict resolution. But while they don't make as much money as most entrepreneurs hope to, they are well paid for the industry: each is making more than $50,000 a year.
So are they therapists or entrepreneurs? They can't really say. They don't really care. They own the business because that's the only way they can help children the way they want to.
"There's no doubt about it," Haley says. "This is the catbird seat in terms of doing what's necessary to accomplish what you want."