A bilingual speech therapist who “loves to talk,” Fergie Cantos helps students at P 186, a District 75 school in the Bronx, make themselves understood.

Many people think children come to speech therapy only for physical impediments like stutters or lisps. What are other reasons a child might need speech therapy?

I’m there to help students who have some type of communication breakdown. Sometimes people will say, “But that student speaks so well, he talks all the time, why does he need speech?” It might be expressive: Maybe they don’t know how to correctly formulate sentences or ask questions, or they don’t have enough vocabulary. Or it might be receptive: Does the student understand what they’re being spoken to about? Do they understand the questions you’re asking? With those students, people assume they’re not listening or they’re defiant and misbehaving. But maybe they’re not processing language.

Tell me about your students.

I have about 25 students, and I meet with each two to three times a week, sometimes individually and sometimes in a group. With my youngest students, we’re working on social skills so they’re able to communicate effectively with their peers and be understood. We do a lot of play — learning should be fun. They practice using picture symbols to request more or to ask for help. With some students, we also work on feeding. I have one student who’s 5 who’s drinking from a bottle and doesn’t eat anything at school, so I’m working with Mom and with his paraprofessionals to move him from a bottle to a cup. With my older students, we’re working more on comprehension, retelling and answering “wh” questions (who, what, when, where and why); learning the skills they need to use in the classroom. I use a tool called the Expanding Expression Tool, where there are different categories that correspond to colors. They tell me what something looks like, what you do with it. It works for every age because you can make it into a game or a song, and it helps with describing and writing.

What is it like working with nonverbal students?

We’re there to help kids communicate, and we need to make sure we’re providing opportunities to communicate, even when they’re nonverbal. They can use pictures, or a yes/no board; you don’t even need a device. It can be challenging to get an assistive technology device for a student because the process is long. And you can’t just give a student a device and expect them to use it. It’s very important to train teachers and paras, too. During the pandemic, I had to navigate working with a nonverbal 6-year-old and her family. I thought, “They have the device, and I don’t. How am I going to teach them?” A big thing I did was send Mom a lot of the same workshops I was taking. I needed her to help me and teach herself how to use the device so I could help the student. It worked marvelously. If I asked the student questions, she would look for the icon and give me the answer, and Mom was able to use it at home. Now she’s verbally requesting “eat” and “iPad.” Her first word was “iPad!” Mom was thrilled.

What distinguishes a certified bilingual speech therapist from a speech therapist who is bilingual?

Most importantly, we evaluate new students. We need to rule out whether they’re experiencing a language difference — maybe they just haven’t learned the language — rather than a language disorder. With my bilingual students, I speak to them primarily in Spanish because that’s their native language, that’s where they’re more successful. But I feel it’s important to give them vocabulary in both languages.

How do you explain to students what you’re there to do with them?

I’m very real with them from the first day: I’m your speech teacher, and we’re here to work on these goals. My older students this year are diagnosed with an emotional disability, and they were very challenging and defiant. But they’re going to respect honesty. We built a relationship really quickly. At my previous school, all my students were nonverbal. To have the opportunity to work with these verbal kids who are having a hard time, to have conversations with them — I’m learning as I’m going and it’s really cool.

— As told to Rachel Nobel