Every now and then, one of Sheela Stuart’s young patients comes to her with his wrists and ankles bound, a discreet blanket covering the shackles. She isn’t so concerned with what he did. She’s trying to discover what he can’t do.

As a speech therapist for 35 years — the past 14 at Children’s National Medical Center, where she is chief of hearing and speech — Dr. Stuart has treated kids with all sorts of issues. A small subset are sent by the District court system, usually after the prodding of Lawrence Huebner, an education lawyer who advocates on behalf of kids who are having trouble in school.

Dr. Stuart tries to find out whether the kids’ problems — skipping school, joining a gang, committing crimes — have their roots in a very basic issue: Do they have undiagnosed language problems?

“There are only two ways to participate with the world: physically and through communication,” Dr. Stuart explained. “When you can’t communicate, you’ve only got one means.”

Huebner said: “Just visualize if you can’t understand what a teacher is saying to you, what a police officer is saying to you. Someone is giving you instructions on how to stay out of trouble, and you do not understand what they’ve told you, because you’ve gotten to an age where you’re embarrassed and have found a way to pass, to appear as if you understand. Sheela analyzes these kids and finds a way to help them.”

Dr. Sheela Stuart, chief of hearing and speech at Children's National Medical Center, with a patient, DeAndre Covington, 17. (John Kelly/The Washington Post)

Dr. Stuart said these kids are often “long-term, experienced physical participators. What I’m doing with them is pressing the button on one of the most sensitive areas they feel incompetent in.” (To help break the ice and put the kids at ease, her therapy dog, Elle, is often a part of the sessions.)

Often, the kids have delayed language. They haven’t been exposed to complex language at home, though they may possess street language. In a therapist’s words, they are functional in basilect, the lowest form of language, and possibly even in mesolect, the most common range of language, but they suffer in acrolect, the more formal language we need to excel in school and official interactions.

Some kids stutter, too, making it even harder to communicate with the world.

On a recent morning, Dr. Stuart asked 17-year-old DeAndre Covington to count to 25 with her. They did this slowly and deliberately, a reminder that DeAndre can often head off his stammer by being methodical in his speech. It’s a trick that works. Dr. Stuart also works with DeAndre to create narratives, helping him use different vocabulary words and parts of speech.

“He used to stutter all the time,” said his mother, Detoria Smith. “It used to be he didn’t want to talk. Now, he’s more talkative than ever before.”

His mother had been trying to get him help with his stutter, but it wasn’t until a year ago, when a judge ordered DeAndre to be evaluated, that he was able to see Dr. Stuart.

“Everything’s cool now,” DeAndre said. He’s in high school. He had a job over the summer. He thinks he’d like to become a firefighter.

“You’ve got these other skills now that you’re developing,” Dr. Stuart said. “You don’t need to go back there.” She means back to his troubled past.

Dr. Stuart said: “When you’re a speech therapist, that’s what you want to do: fix somebody so they can talk, so they can be them.”

A gift for Children’s

After DeAndre and his mother left — to have lunch in the hospital cafeteria and then take the first of three buses that would get them back to their home in Northeast Washington — I told Dr. Stuart that if I hadn’t known beforehand I wouldn’t have been able to tell that DeAndre stuttered.

She smiled and said, “You just gave me the biggest gift.”

You can give a gift, too, a gift to a hospital that works with the neediest members of our community.

With my columns this year, I’m trying to give you an idea of the range of things Children’s does. Keep in mind that whether it’s speech therapy or chemotherapy, many of the patients will be from poor families. They will have inadequate insurance. They will depend on the hospital’s uncompensated care fund.

That’s what I hope you will donate to. Whether it’s $25 or $250, every penny you give goes to pay the bills of poor, sick children. You can make a tax-deductible donation by going to or sending a check (payable to Children’s Hospital) to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390.

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