Sophia Elbaz MS., CCC-SLP, TSSLD

Stuttering is a disorder of the communication process, affecting 5-10% of preschool children and 1% of school age children. It is characterized by dysfluencies in speech including repetitions and prolongations on whole words or certain sounds or syllables of words. For example, a child might say “What are you d-d-d-d-doing?” This is a part word repetition because the first sound of the word” doing” was repeated. A prolongation is when one gets stuck on a sound or syllable, such as “Llllllet go of me.” In addition, there may be silent pauses while conveying language called “stops”. This can happen in between words or in the middle of a word. For example, “I don’t (pause) want to go to school today.”, or “That was ex (pause) cellent.” Fillers in speech such as “um”, “like” and “you know” are also dysfluencies that may occur excessively in a child’s speech. Some or all of these dysfluencies occur periodically in most children, however when dysfluencies are more frequent and are accompanied by secondary characteristics such as, facial or neck tension, loss of eye contact or hand or head movements, a stuttering assessment by a speech language pathologist may be warranted.

Stuttering in preschool children aged 2-5 is a common developmental stage that can resolve on its own. Many times, it occurs when a child is experiencing a language spurt and the language demands are not in sync with the motor aspect of speech. However, when a child of this age is stuttering for longer than six months, has secondary characteristics accompanying the stuttering, avoidance of speech and/or a family history of stuttering, stuttering intervention is recommended by a speech language pathologist to prevent longer lasting stuttering patterns. At this age, parental involvement in the therapeutic process is a necessary component in efficiently managing the stuttering.

Stuttering intervention in school age children focuses on stuttering modification which promotes awareness and acceptance of the stuttering. Fluency techniques are provided as needed to help shape and produce a more fluent speech pattern. At this age, motivation is a crucial factor in the success of treatment.

There are multifactorial features and various theories as to the cause of stuttering. Some theories focus on neurological factors such as dysfunction of the cortical and subcortical areas of the motor control system. Abnormalities of inter-hemispheric relations and the neural mechanisms of speech-motor control may contribute to the speech dysfunction. Complex linguistic demands also may affect the preschool and school aged child. If a child is having difficulty processing language, the language produced may result in distorted speech containing dysfluencies. Genetics also play a role, as studies show people who stutter are three times more likely to have a first-degree relative who stutters. Environmental and psychological factors are also possible contributors; however, it should be noted that although anxiety can exacerbate stuttering, that in itself is not a root cause.

From preschool aged children and beyond, education for the parents of children who stutter is very important to foster healthy self-esteem in these individuals as they grow and learn how to navigate the world around them. The ultimate goal one could aspire to in therapy is for the child to realize that stuttering does not define the person, the person does.

Sophia Elbaz, MS., CCC-SLP, TSSLD is a speech language pathologist working  privately with children specializing in stuttering intervention. She is Lidcombe Program trained and has experience working with families of children who stutter. She also provides therapy to increase language and articulation skills.

How to Harness Psychology for Your Success

Weight loss drugs have burst on the scene with a frenzy. Take your injection of Ozempic, Wegovy, Monjauro, or Zepbound each week, and your weight will come off. It’s that simple.

But what if you’re my patient Janice?

Janice, who has struggled with binge eating in the past, had a flare up since her fourth child was born. Yes, Ozempic can help Janice lose weight. But it cannot help her deal with her underlying stress and disappointment at her husband’s lack of help. Will Janice’s weight loss with Ozempic solve her issues of loneliness and anger in her marriage? Unless Janice can confront these troubles directly with Mark, all the weight loss and injections in the world will not help her unhappiness with Mark. Unresolved sadness and anger eventually leads to the compelling urge to return to comfort eating and break-through bingeing.

Or what if you’re Melanie?

Melanie wants to get married like all her girlfriends. She believes losing weight will make her more “marriage eligible.” But, after losing some weight on Wegovy, Melanie became depressed. Not the reaction she was expecting! In her therapy, we discussed that, although she was feeling more attractive with the weight loss, she also realized how fearful she is of meeting a man and developing a committed relationship. “My parents had the worst marriage on the planet. I didn’t realize how frightened I am of repeating that history with a future husband. When I dropped some pounds and felt more hopeful to start dating, I also got in touch with a lot of worry about ever finding a loving relationship.” Fortunately, for Melanie, she has now brought these inner fears out to the light of day and can work to resolve them in her therapy.

Ozempic may be a step forward in resolving weight issues, but it’s only part of the picture of what healing looks like. If you’re an emotional eater who has depended on food to reduce your stress, numb your feelings, cope with depression, what will you do without the comfort and distraction of food once Ozempic has reduced your capacity to eat? Food, after all, is a “drug” that can help you detour, divert, and deny the undigested emotions that are gnawing at you.

To create your Comprehensive Personal Strategy and maintain your progress with weight loss, the psychological dimension of emotions that have fueled your overeating or bingeing in the first place needs to be addressed. Or you may be back “looking for love in all the wrong places.”

While on these drugs, it’s a perfect window of opportunity to address the psychological reasons and triggers that may have lead you to bingeing, eating compulsively, or finding yourself on a diet/weight gain cycle.

Key To Success: The Willingness To Feel

Sharon’s story is complex. Food, body image, and throwing up is woven into her history.

Sharon has been to many inpatient treatment centers, been prescribed a variety of medications, consulted psychiatrists, and has had multiple outpatient therapies. She came to therapy with me since going through another relapse. Nothing has sustained her recovery. Until now.

Sharon asks for my help to try Ozempic. Sharon began semaglutide injections two months ago, and twelve hours after the first injection, her urge to binge and purge lifted, she began eating normally, identifying when she was hungry and stopping when full. She began eating a variety of foods. She announces that she is now cured and has never felt better! The bulimia monster seems to have been driven away. Sharon is relieved and delighted. I am relieved and delighted. And yet…

And yet, I know that this relapse of Sharon’s bulimia was provoked largely because of her fear, anxiety, and denial that her mother is imminently about to die. She cannot face losing her mother which also means coming to terms with never having gotten what she needed from her. Changing her behaviors around food and losing weight is only part of the solution. But all the Ozempic injections in the world and all the weight loss she hopes for is not going to help Sharon with the emotional storm about to crash which she has pushed to the back burner with her consuming bulimia.

Anticipating the grief of her mother’s death is a deep hole within her that needs to be faced and spoken about, and Sharon needs to have the courage to feel and express her pain. People often “freeze” their grief by bingeing, purging, or starving. When there’s no excess food to keep numbing, the sorrow of grief will assert itself.

Now with Ozempic dialing down your hunger and your craving to emotionally eat, those unbidden feelings, previously numbed by food, will emerge to the surface. Emotions that are not “digested” will keep returning until they are dealt with. And we are not only talking about serious issues like grief and depression but also anger, loneliness, disappointment, frustration boredom, procrastination, – any uncomfortable feeling – can send emotional eaters to unwanted food.

The key to achieving success with the new weight loss drugs is to face the feelings that have been submerged behind your eating and to have the willingness and courage to feel your uncomfortable emotions.

Psychotherapy can be a vital component in the resolution of emotional eating, a place to work out anger, anxiety, depression, trauma, guilt, and grief. This can be a key ingredient for long-term and lasting recovery.

One crucial question a therapist may ask is, “After you lose weight with the semaglutide injections and are no longer obsessing about eating, what is the next issue that will come up for you?” This is a crucial question because you may have used food to push this “next issue” to the back burner. When asked this question, Emma offers, “Next up is thinking about divorcing my husband, but I’m really scared.” Jerry says, “Leaving my awful job, but I’m scared.”

Ozempic plus emotional exploration of your inner self can be the key to success. You can then learn to sink your teeth into life, not into your obsession with food!

Join Mary Anne and Bracha Banayan on February. 23 at 7:30 to discuss “Semaglutide and Emotional Eating” https://shorturl.at/ez3ey

Mary Anne Cohen is Director of The New York Center for Eating Disorder. www.EmotionalEating.Org.

Hamra speaks out at rally encouraging US. Representative Nadler to sponsor a bill.

Viral Influencer and Activist for Israel

Sarina Roffé

Damascus-born Abraham Hamra, an attorney and managing Partner at Cohen, Tucker, & Ades, PC, has become a widely known influencer, advocating for Jews in the face of growing antisemitism, misinformation about Israel and the Palestinian cause. His videos on the subject have gone viral as he argues in both Arabic and English, attracting a wide audience and millions of views.

Hamra was seven in 1994 when he arrived at JFK Airport with his parents, Rafoul Hamra and Shella Fatiha Hamra, and two younger siblings from Syria. In New York, their family grew, with two more children. After graduating from Magen David High School, Hamra attended Hofstra University, graduating with a bachelor’s degree in business administration, graduating Magna Cum Lade and then attended Pace Law School.

Anyone on any social media platform will see his pro-Israel videos pop up. He posts in both English and Arabic, but it is his Arabic posts that get the most attention. With millions of views, he has become an important influencer, and an activist for Israel in ways we cannot imagine. Using the logic of an attorney, his arguments bring the Israel Palestinian issue to the fore, creating a dynamic argument. Muslims are surprised to see posts in Arabic from a Jew. Many Muslims did not even know Jews had ever lived in Syria, much less for thousands of years. This confusion wasn’t exclusive for Muslims, some Jews and others in America were surprised to learn of this fact as well, that Jews had lived and were displaced from Syria in the 20th century.

For Hamra, the catalyst for speaking out, was when a Palestinian gang beat up a Jewish kid in broad daylight in Times Square in 2021. They were released with no bail and hailed as heroes. Hamra organized an online petition, getting 20,000 signatures, and helped lead a pressure campaign that led to the case being elevated to a federal crime, the plea deal rescinded and the assailants sentenced to prison.

A staunch advocate of Jewish justice, Hamra refers to DEI (diversity, equity and inclusion), as being weaponized and misused to attack the Jewish community. He is staunchly opposed to a two-state solution or even the offer of a two-state solution for Israel and the Palestinians. He notes that every Palestinian argument establishes itself as the minority and the Jews as the white majority when the reverse is the truth.

“I realized the game that they’re trying to play,” said Hamra. “So if I come into the picture, as a darker-skinned Jew, if I start speaking as a Jew from Syria, it is an easier way to get the message across and to completely punch a hole in the what they have been spinning. My very existence (as a Jew born in Syria) stands in direct contradiction to everything they’ve been stating.

“My argument is very clear. I’m from the Middle East. The Jews were in the Middle East from before Islam. If you believe the Palestinians – who never had a sovereign country–deserve a piece of land, then you must also believe that Jews deserve a piece of Syria, Iraq, Lebanon and Saudi Arabia, because all of these countries were all created during the same time Israel was created, and all these countries are proof of my Jewish life. If you’re stating that every popular minority population in an area deserves their own section of land, then the Jews should have gotten their own land in these areas.

“Jews are that minority that have been historically oppressed by the Arab majority. Right now, what you’re telling me is that standing in the way of peace is that the minority (Jews) giving more of its land to the majority that used to oppress it after they colonized their lands? There is no defense to that. When they’re talking to someone like me someone with an Israeli or Sephardic or Syrian culture their arguments falter. We should not give back one inch of our land.

Hamra argues that it is critical for the Jewish people to be strong, demand respect and not be taken advantage of. Hamra is often a speaker at conferences on antisemitism and Israel. He protested U.S. Senator Chuck Schumer and U.S. Representative Jerry Nadler for ignoring the Campus Antisemtisim Awareness Act, which currently needs to be re-introduced because Schumer failed to move it in for a vote.

So what does the future hold for Israel?

“Saudi Arabia, the United Arab Emirates and other Arab countries are starting to wake up to the fact that this war against the Jewish state is no longer a priority. I really do believe that tides are shifting the Palestinian cause is being abandoned by the Arab world because they no longer have the desire to fight Israel,” he said.

A genealogist and historian, Sarina Roffé is the author of Branching Out from Sepharad (Sephardic Heritage Project, 2017). She is researching a new book: Syria – Paths to Freedom. Sarina holds a BA in Journalism, and MA in Jewish Studies and an MBA.