suffered from being painted a really nasty institutional gray, but otherwise it was an acceptable room. Long and narrow in shape, it had a sunny south-facing window on the far end that overlooked the trees in the hospital courtyard below. On the right-hand side of the room was the one-way mirror with an observation room on the other side. Usually there weren’t any observers, but located in there was also a video camera that recorded all sessions. On the left-hand side of the room was a low set of shelves running the entire length of the wall. These contained a small selection of playroom items commonly used in therapy – puppets, toy cars, plastic people and animals, paper, crayons, pens, plus a Playmobil dollhouse, a Fisher-Price garage, and part of a Playmobil hospital set. A Dick Bruna alphabet frieze had been put up on the wall above the shelves along with four large posters of Dick Bruna’s popular rabbit character, Miffy, displayed at rakish angles. Their bright primary colors and imaginative arrangement against the gray walls in the long, narrow room gave me the feel of being amid the cheap and cheerful decor of a student dormitory.
I always carried my own box of materials with me, the same box I’d taken out to Quentin, and I set it on the tabletop. Drake immediately settled into the chair opposite, putting Friend on the chair beside him. Friend was so enormous that he actually sat taller in the chair than Drake.
Drake proved an enthusiastic companion. If he was lonely or frightened at being separated from his family, he didn’t show it. His expression was bright-eyed and animated; his whole body wriggled with anticipation.
“So what do you think about all this?” I said. “Do you like being here?”
He nodded eagerly.
“What’s been your favorite part?”
He gestured with his hands. I had no idea what he was trying to communicate but he did so fervently, then looked up at me with expectancy.
“You know what I think, Drake? I think it would be so much easier if you used words. I really do want to understand what you are saying. I want to know all about what you like to do and the things that happen when we aren’t together. I’m really, really interested. But we need words for that, don’t you think?”
Drake nodded.
“Your mom has told me you use words with her. I’m thinking it would be helpful if you used words to talk to me, too. So that’s what you and I are going to do in here together. I’m going to help you to start using words. You see, my special job is working with boys and girls who find it hard to talk. Just like you. Just exactly like you. So I’m very good at helping people start to talk again.”
This seemed to please Drake enormously. He nodded enthusiastically, as if I were suggesting just the best idea in the world.
I was struck yet again by his physical presence. He was such a gorgeous kid. His features were so symmetrical and well formed, his eyes so vibrant. I was even growing accustomed to his unusual hairstyle. It was part of him, part of what made him seem so ethereal, like a lost angel.
“Because I’ve worked with lots of other boys and girls who’ve had trouble talking, just like you, I know how hard it is to get started. I know it can be scary when you’ve been used to not talking. But usually it’s just the first time that’s hard. We’ll work together. I’ll be right here, helping you. And I know you can do it.”
Again, the wholehearted nod.
I reached into my box and pulled out a set of cards I’d made. They were about five by seven inches in size and made from magazine pictures I’d cut out and pasted. Each showed a clear, appealing picture of common items: a car, a cat, a dog, a man, a child, and so on. I chose one that was very popular. It was a close-up of a little red-haired boy and a black cat. The boy was holding an ice cream cone and as he licked it on one side, the cat, long pink tongue extended, was reaching out to lick it on the opposite side of the cone. Children never failed to respond both to the inherent humor in the picture and to the almost universal desire to share experiences with animals.
Drake laughed noiselessly and pointed to the boy and the cat and then looked up to assure himself that I too was seeing how funny it was.
“Yes, that’s a good picture, isn’t it? What’s happening? What’s this?” I asked, pointing to the cat.
He gestured, tapping his finger against the picture.
“Yes, what is that? What’s it a picture of? What animal is this?”
He was exhaling, pushing air out quite audibly but it was nowhere near a word. Just breath.
“What is this? What animal is this?” I continued pointing to the cat. My experience in getting elective mutes over this first hump of speech was that I had to provide an opportunity to speak early on in the session and then pleasantly but persistently keep at the request, ignoring the silence that was thrown up; indeed, never allowing the silence to develop any kind of potency. So I continued to ask, rephrasing the question repeatedly, tapping the picture, pointing to it, staying forever on task.
Right from the onset, Drake appeared to make a genuine effort. He exhaled. He made noisy breathy sounds that didn’t approximate words, but nonetheless appeared to be authentic attempts.
Because he was so young and because he did seem to be working hard, I didn’t want to stress Drake too much by becoming more insistent, as I often did with older children. So I changed tactics. “Is this a dog? Is this boy sharing his ice cream cone with his dog?”
Drake grinned and shook his head.
“Is it a dinosaur? Is the horse eating his ice cream cone?”
Again, the cheerful shake of the head.
“Is it Friend?”
Drake laughed noiselessly and shook his head hard.
I went on through half a dozen other absurd possibilities until Drake seemed almost unable to control his hilarity at this funny game. Then I said, “What animal is it?”
He opened his mouth wide and leaned down close to the picture.
“What animal is this? Come on. Let’s use the word.”
He kept his mouth wide open.
I made my voice suddenly intense. “What animal is this?” Not anger, just focused no-nonsense intensity.
Drake got the message immediately. His laughter dropped away abruptly and he stared at the picture. Reaching over, he clutched Friend around the neck. His body began to rock slightly back and forth in the chair. His eyes remained fixed on the picture.
“What animal is this? Here. Now, Drake. What animal is this?”
Deep, noisy respirations.
“What animal is this?” I tapped the card more insistently. “Tell me what we have here. What’s this?”
He started to cry. This too was almost noiseless. He didn’t even whimper, but huge tears formed and rolled over his cheeks.
“I know it’s hard,” I said. “It’s hard and it’s scary when you haven’t been used to talking, but only the first time is so bad. Once this is over, it won’t be this hard again. What animal is this?”
A long moment of intensely expectant hesitation.
