Cesar Rodriguez smiles at his kindergarten teacher as she cuts up a pancake for his breakfast. He looks up at her with dark, intelligent eyes framed by long lashes, and lifts an index finger as if to make an important point.
However, instead of words, a singsong of nonsense syllables tumbles from his lips.
"Eee oh flu flu fla," the 5-year-old said.
Occasionally, a recognizable word emerges from the hash of sounds, but most of Cesar's thoughts and feelings do not make the transition into language. Then his teacher asks him if he wants some milk.
"Flah flah oh ee mik, " Cesar responds.
"Milk! Good language, Cesar," special education teacher Haviva Kierzenblat said. Cesar and five other children in his Harbor City classroom have an elusive disorder called aphasia, which is generally defined as the inability to process language. The youngsters attend President Avenue Grammar School, where the Los Angeles Unified School District has a special class for pre-kindergartners and kindergartners with language disorders.
The federal government estimates that aphasia affects 1 million Americans. The problem is commonly seen in stroke victims, but the language-processing centers of the brain can also be damaged by head injuries, infections and exposure to toxic substances, such as lead.
Symptoms come in many forms and appear at different stages of development. Some aphasics are mute. Others, like Cesar, speak in a hodgepodge of undecipherable syllables and use convoluted syntax, such as, "I home go will."
Aphasic children are generally of average or above-average intelligence, but they simply do not have the ability to process language normally. If their condition is diagnosed early enough, their language skills can be improved, and the youngsters can eventually join regular classrooms.
In Kierzenblat's classroom, there are bouquets of dried flowers on the windowsill, and the music of Mozart plays as the children eat breakfast. A yellow pathway decorated with giant letters of the alphabet meanders around the classroom floor, and in one exercise, each child stands on a letter and bends down to trace it.
The curriculum for aphasic students is similar to that taught in a regular classroom, except there is more emphasis on language skills. A typical day might include breakfast, art activities and language exercises.
When the youngsters are ready to enter the first grade, they will be either mainstreamed into a regular classroom or transferred to a special education class at another school, said Kelly Romack, a coordinating specialist for the speech, language and aphasia programs in the Los Angeles Unified district.
The district has had a language program for about 20 years, and President Avenue Grammar School has had a language disorders class for about 10 years, officials said. Youngsters are screened by psychologists and speech experts before being placed in the program.
Many smaller districts also offer language disorder classes. San Gabriel Valley parents who believe their children need such assistance should call their school districts for information.
Teaching aphasic children requires a lot of patience and concentration, as well as the ability to withstand frequent setbacks and to find satisfaction in small victories, Kierzenblat said. She recalled that when she met Edwin Coronel, an affable 4-year-old with a broad, seemingly fixed smile, the boy was completely nonverbal.
"He only knew how to cry, so I said to him, 'If you can cry, you can talk.' "
Kierzenblat spent two months teaching him a handful of words such as red , blue and moon. Then he contracted an infection and missed two weeks of school. When Edwin returned, he had forgotten all the words and the teaching process had to begin again, Kierzenblat said.
"When he came back, I was sad that we lost the words, but I was happy that we had at one time brought out the language," Kierzenblat said. "We did it once and we can do it again."
For all the disappointments, there are also victories. One day, the children sat down for a lesson and one girl, Mayra, was absent. Kierzenblat asked the children if Mayra was at school or home.
Cesar held up his index finger and proclaimed: "No. Mayra at home."
A brief silence fell on the classroom. It was the first sentence Cesar had spoken in his life. Cesar beamed, and the class burst into applause, Kierzenblat recalled.
When speaking to the children, Kierzenblat speaks in simple sentences so they can process the language. The children are generally responsive if the instructions are easy, but she often has to repeat herself.
"I don't get frustrated, I get challenged," said Kierzenblat, 25, who has a master's in education from USC and is in her second of year of teaching at President Avenue. "Frustration keeps me from moving forward, and I don't have time for that. These are some of the most curious, enthusiastic and enterprising kids I have ever seen."
Irma Rodriguez, Cesar's mother, said that although her son appeared to be normal, she sensed early on that something was wrong. She took him to several pediatricians who said Cesar was "just a slow starter and would probably grow out of it." After years of visits to doctors, Cesar was diagnosed as aphasic.
"I worry about him," Rodriguez said. "If he were ever abused, he would not be able to tell me about it. I need to feel totally confident about the people he is with. Haviva's class is a safe, secure place for him to go."