Understanding Melatonin Imbalance & Sleep Disorders in Children with Autism

April 29th, 2015

Many children diagnosed with autism spectrum disorder (ASD) experience irregular sleep patterns, commonly in the form of delayed sleep onset, frequent nighttime awakenings and reduced sleep duration. These problems occur in 40 to 80 percent of children with ASD, compared with 10 to 20 percent of typically developing children.

Because many children with autism cannot maintain sleep during the night, they experience impaired alertness, behavioral issues and exacerbation of their ASD symptoms during daytime hours. Not surprisingly, the result often is a high level of parental stress and impaired parent-child relationships.

What’s the Root Cause?

Recent research suggests that circadian rhythms – internally generated activity cycles based on 24-hour intervals – appear to be abnormal in children diagnosed with autism. This has been linked to irregular levels of melatonin, a neuro-hormone synthesized from serotonin and located in the pineal gland, the endocrine gland that produces melatonin.

  • Normally, melatonin levels rise at night and return to baseline in the morning, during daylight hours. In children with ASD, however, it appears that diminished melatonin secretion occurs. This impairs the natural biological tendency for sleepiness during the night and wakefulness during the day.

Sleep irregularities are very common in children with ASD. The most common related issue appears to have a behavioral basis, as in the case of children who have not learned appropriate ways to get to sleep or stay asleep. They may stall or refuse to go to bed or complain of sleeplessness. The second most common issue seems to be related to circadian patterns; for instance, delayed sleep, the inability to fall asleep or wake at a desired time, or irregular sleep/wake patterns.

Final critiques of research on this issue indicate that behavioral sleep problems in children with ASD may be the result of the related challenges of impaired circadian systems and/or irregular melatonin levels.

  • Studies have tested melatonin levels in the blood of children during 24-hour cycles. Results showed that children with autism demonstrated profound sleep disturbances compared with typically developing children. Researchers conclude that the pineal gland may be damaged in children with ASD.

Implications for School Psychologists

As a school psychologist, you can take a lead role in working with children and families who face melatonin-related sleep disorders. It has been found that these youngsters may experience impaired cognitive abilities, as well as low adaptive skills. Thus, they may exhibit a decline in perceptual and verbal competencies or deficits in typical activities such as eating, toileting or practicing good hygiene – all of which are essential to healthy functioning in a school environment.

  • Be aware of the issue. With consistent teacher feedback, screen students for sleep problems and provide the right support. Ongoing teacher/psychologist collaboration is critical.
  • Psychological interventions will vary based on individual manifestations of sleep dysfunction. Behavioral modification strategies, parent education and medications are more commonly used with elementary aged students. Cognitive-behavioral therapy and emphasis on relaxation techniques may be more appropriate for adolescents.

The Cobb Pediatric Therapy team is made up of experienced therapists who can provide you with the latest developments and updates to enhance your school-based psychologist career – as well as employment opportunities in the Atlanta area and beyond. Contact us today to learn more.

Happy Occupational Therapy Month!

April 21st, 2015

April is National Occupational Therapy Month, an observance that was begun in 1980 and corresponds with the timing of the American Occupational Therapy Association (AOTA) Annual Conference & Expo. This year’s conference was held April 16 – 19 in Nashville.

What are you doing to celebrate your career and showcase your profession – not just this month but throughout the year? You’re part of an impressive team of occupational therapists in the United States: more than 100,000 strong and growing. It’s estimated that this number will increase by 29 percent, or about 32,800, between now and 2022.

Be creative as you live the theme of Occupational Therapy Month: “OT: Living Life to its Fullest” all 12 months of the year.

Share the Message

Use traditional and social media to promote occupational therapy and how it helps people of all ages to live life to the fullest.

  • Raise awareness at school. Post updates on bulletin boards, in your school newsletter and on its website and social media platforms. Include photos, which as the old saying goes, are worth a thousand words. Check with school administration to make sure children’s photos can be used for media purposes. Offer to do a presentation on school-based OT at a faculty retreat or PTA meeting.
  • On social media, link to the AOTA Times Square video on YouTube. In a series of billboard images, it tells the compelling story of how “OT helps me.” For instance, a young student is portrayed, noting that “OT helps me succeed in school.”

Hold a Backpack Educational Event

As the school year winds down, spring is the perfect season for an event to educate students, parents and school personnel on backpack safety. As lockers and classrooms are cleaned out for summer vacation, everyone from the tiniest preschooler to the principal and varsity coaches will be lugging their stuff home. Help them to do it safely – and take this lesson with them as they plan for future years.

  • Have a weigh-in. You need at least one scale, a weigh-in sheet, handouts, and charts illustrating the suggested maximum backpack weights for different body weights. (No more than 10 percent is the general guideline.) Remember, the same principle can be applied to heavy purses and briefcases, so parents and other staff members also can benefit.

If you’re looking for more ideas to promote your profession or advance your school-based OT career, contact the experts at Cobb Pediatric Therapy Services today. We’re experienced recruiters, but we’re also therapists. We offer this unique skillset and experience to helping you achieve your lifelong career goals.

Happy Occupational Therapy Month!

A Speech Therapist’s Review of Mobile App, Soundable

April 17th, 2015

The social word game Soundable is a winner on two counts.

It’s a fun way for students to learn the International Phonetic Alphabet – and it’s an effective means for you to practice transcription and phonics use, as well as mastering your own finesse with IPA.

Launched in 2014, Soundable is the product of collaboration between Tactus Therapy Solutions, a leader in iOS apps for speech therapy, and LessonPix.com, whose SoundFinder ™ technology powers the game.

Soundable has a unique twist: It’s a great tool for people who struggle with spelling. At first glance, it looks like Scrabble or Words with Friends – until you notice the funny IPA letters on the tiles. Last but not least, it can be downloaded for free or at a cost of $1.99 for an ad-free upgrade.

What’s not to like?

How Soundable Works

Soundable replaces normal letters with sounds, using IPA characters. You create your account with a user name and password on your Facebook login in, then find friends and start playing. From there, Soundable is set up similarly to any Scrabble app, with IPA phonemes replacing letters.

  • If you don’t want to play in IPA, you can easily switch to using phonetics. Either way, your skills will improve. Your students who use Soundable will quickly begin to build words more accurately and easily.
  • If you’re unsure of a word’s composition, you can search it in Soundable’s Look Up feature. You can look up words in the dictionary and appeal words that you think should be added. There’s even an Appeal feature.
  • You can opt for a short or long game. In the short version, you play till the first person reaches 200 points. In the long version, play continues until all the tiles are gone.

“Fantastic for Brushing Up on Your IPA Skills”

Speech-language pathologists who have piloted Soundable note that it provides a great way to network with other therapists, as well as being excellent for honing your IPA skills. Their comments include:

  • “Intuitive. Super easy to use, and the layout will be familiar to anyone who has played physical or app-based Scrabble games.”
  • “The features are simple but great. It’s quite helpful being able to quickly switch between IPA and phonics, look up words, appeal words to account for dialectal differences, and play short versus long games.”

Are you interested in learning more about available tools and apps to optimize your effectiveness as a school-based therapist? Whether your goal is to grow in your current role or take your career to the next step, the expert team at Cobb Pediatric Therapy Services can customize a solution for you. Contact us today to learn more.

Using Remind in the Classroom to Text Students and Parents

April 15th, 2015

Geared toward K through 12 professionals, Remind is a free communication tool built for educators. It enables you to safely interact with students and parents regarding important therapy information, updates and activities.

The developers of Remind have worked closely with educational administrators and teachers to design key product features based on privacy and security concerns.

Formerly known as Remind 101, Remind is currently used by 20 percent of U.S. teachers, and it takes only about 15 seconds to sign up.


Remind Announcements allow you to instantly message a group of students or parents. They receive a text message, email or push notification on the app.


The Remind Chat feature is brand new, and those on a waiting list will be the first to get it starting this month. Learn more about it at www.remind.com/chat.

Chats let you have safe, simple, one-on-one conversations with students and parents. It provides an option in addition to Announcements for making timely connections. Using Chat, you can:

  • Reach students on any device. They don’t need a smartphone. They can reply via text, email or the app.
  • Manage communications by setting Office Hours. You also can easily pause and resume your Chats. Only you can initiate a Chat, unless you adjust your settings to allow others to do it.


You can send a message and watch as your students and their parents respond. Remind quickly summarizes all this feedback for you.

Additional Benefits

Among the additional benefits that make Remind valuable as a therapy tool are:

  • All phone numbers are kept private. Messages are not sent from personal cell phone numbers. Students and parents do not have access to your number. They can opt themselves into messages.
  • It’s a great time saver. You can schedule Announcements directly to students’ and parents’ phones and get instant feedback using the Stamps feature. You also can attach files, schedule events, and send voice messages.
  • Text messaging is an asset. Educators have seen increases in homework completion, test scores, student participation and overall motivation as a result of incorporating test messaging into their Remind strategy.

To stay ahead of the latest developments in school-based therapy – and take your career to the next level – consider working with the recruitment team at Cobb Pediatric Therapy Services. We not only know therapy, we are therapists. Contact us today to learn more.

What is the Mobile App Candy Count and How Can it Help Occupational Therapists?

March 27th, 2015

We’ve all tried it because it’s so much fun: Counting the number of gumballs or candies in a jar in hopes of winning a prize.

The Camigo Media LLC app Candy Count provides a fun, interactive way to teach important concepts to toddlers, including sorting colors, counting and arranging numbers, and comparing quantities. Preschoolers and kindergartners also can benefit from the app, which may be downloaded for $1.99 for your iPhone or iPad.

How It Works

Candy Count is easy to use, as it focuses on creating an optimal learning environment. Students begin by shaking the phone or tablet to empty sweets out of a bag. Then they work on guessing the winning number. They must first identify the color and then match sweets to the right bag. Categorization is a skill that babies begin mastering at a few months of age, but Candy Count offers a new way of challenging children in this area.

  • Once bagged, sweets must be counted. Then, bags are ordered from those containing the most sweets to those containing the least. Along the way, questions are asked to test students’ understanding of quantities.
  • You can change quantity and color options. By default, the app allows counting up to five, but you can increase this as high as twelve. Color modifications are also offered. These change-ups help keep children engaged, providing continuous new things to learn.

Candy Count is also available as a free download. The free version has a restricted number of color and number options but otherwise is identical to the $1.99 version.

“Definitely Worth the Buy!”

Reviewers who have given Candy Count a trial run concede that the app is a great way to get your younger students excited about counting, categorizing and comparing. Each time a child selects the right answer, they are rewarded with a sprinkle of brightly colored stars on their screen. Between the sparkle and the sweets, it presents an irresistible learning experience for little ones whose attention spans are generally limited.

“I thought Candy Count was a terrific app, just right for older preschoolers and kindergarteners. It teaches skills in a fun and entertaining way … They get to play with candy on the screen and come away without sticky fingers or a sugar rush. Awesome!” noted the iPhone Mom.

And as noted by another satisfied user, “This app has adorable colors and graphics and a really cute game for kids. The makers did a fantastic job with the quality of the game and made it really fun for kids to play. Definitely worth the buy!”

Are you looking for additional tools and resources to build your school-based therapy practice? Or perhaps you’re seeking to take your therapy career to the next level. Let the therapist recruiters at Cobb Pediatric Therapy Services partner with you to realize your ongoing goals. For more information, read our related posts or contact us today.

Cobb Pediatric Therapy Services Selected as a ‘Top Workplace’ in Atlanta

March 24th, 2015

ATLANTA – Cobb Pediatric Therapy Services is pleased to announce that it has been selected as one of The Atlanta Journal Constitution’s Top Workplaces in Atlanta for the fourth year. The pediatric staffing firm, which is based in Kennesaw, Georgia, ranked 38th in the small business category, which included employers with 149 or fewer employees in the region.

The Top Workplaces are determined based solely on employee feedback. The employee survey is conducted by WorkplaceDynamics, LLP, a leading research firm on organizational health and employee engagement.

“It is an incredible honor to receive this recognition,” said June Whitehead, Owner and CEO of Cobb Pediatric Therapy Services. “We have an amazing team of therapists and supporters, and I stand amazed and grateful. I want to thank all of them for their continued confidence in Cobb Pediatric Therapy Services. We could not have earned the Top Workplace award for a fourth time without them.”

The Atlanta Journal-Constitution published the complete list of Top Workplaces on Sunday, March 22, 2015. For more information about the Top Workplaces lists and WorkplaceDynamics, please visit www.topworkplaces.com and www.workplacedynamics.com.

Founded in 1989, Cobb Pediatric Therapy Services has been providing a range of therapy services for children, including speech language pathology, occupational therapy and physical therapy to school systems across the United States for 26 years. The firm currently serves Alabama, California, the District of Columbia, Georgia, Florida, Maryland, North Carolina, South Carolina, Texas and Virginia.

Reviewing Top Mobile Apps for Speech Therapy | Magical Concepts

March 20th, 2015

Concepts are critical building blocks for early learning. Research shows that understanding of basic concepts is essential for academic success and high-level thinking ability. Magical Concepts by Virtual Speech Center, Inc., is a language therapy app that traces learning progress with more than 60 concepts for both individual and group therapy.

How it Works

Magical Concepts was created by a certified speech language pathologist who wanted to make drilling with flashcards more fun and motivating. Students are welcomed to the app by Mago the Magician who encourages them to work hard. From there, they go on to earn stars for each correct response and when they accumulate enough stars, they’re rewarded with a fun magic shows.

The basic concepts featured include:

  • Above/below
  • Angry/sad/happy/surprised
  • Around
  • Apart/together
  • Behind/in front
  • Big/small
  • Bottom/top
  • Clean/dirty
  • Closed/open
  • Hot/cold
  • Crooked/straight
  • Day/night
  • Different/same
  • Far/near
  • Over/under
  • Short/tall
  • Thick/thin
  • Upside down, next, to … and more.

Using Magical Concepts, you can work with students locational, temporal, numerical, descriptive, social-emotional and other conceptual words. More than 2,000 photographs are provided to illustrate the concepts.

Outstanding Features

Magical Concepts allows you to import the names of all your students, creating settings that best meet the needs of each one. Other noteworthy features include:

  • The ability to create reports based on sessions completed, so you can easily report progress to parents, teachers and others.
  • Visual and auditory feedback; for instance, different tones are used to indicate whether or not responses are correct. Repeat buttons are available for verbal instructions.
  • The flexibility to work on concepts with more than one student at a time while collecting data for everyone.
  • User-friendly settings including auto or manual scoring, cards presented in order or randomly, and the ability to enable or disable rewards and allow automatic page advancing.

Thumbs Up

Speech pathologists who have piloted Magic Concepts agree that it’s well worth its $9.99 price tag for download on your iPhone or iPad. As noted by one satisfied user, “It has wonderful data collection features, tracks multiple students at a time and can be used with older children, too … You can select ‘all’ or specifically pick which concepts you want to work on for each student. Students work toward a magic show reward and you can adjust the number of questions that need to be completed to earn the reward. This is a comprehensive basic concept app with excellent customization features.”

As you realize your professional goals as a school-based therapist, consider partnering with a recruitment firm that knows your specialty and has the resources, market intelligence and contacts to take your career to the next level – or advance in your current role. Read our related posts or contact Cobb Pediatric Therapy Services today.

Tips for the Classroom: Proper Letter Formation When Writing

March 16th, 2015

Attention to mastering handwriting benefits every student, including those with learning disabilities related to reading, writing or nonverbal learning, and those with attention deficit hyperactivity disorder.

Labored handwriting can create a drain on the mental resources a child needs for higher-level aspects of writing such as attention to content, elaboration of details and organization of ideas. Handwriting is the basic tool used in most school subjects for note and test taking and doing classroom and homework, so poor abilities in this area can have a pervasive overall effect on academic performance.

Forming Letters: Some Suggestions

When working with students on proper formation of letters, here are some tips you can follow:

  • Teach letters in developmental order. This helps boosts children’s confidence as they sharpen their handwriting skills. Teach capitals first and then lowercase letter. Present them in small groups of similar formation. Students can then master the easier groups before moving on to more difficult challenges.
  • Use multi-sensory techniques: You can help children develop their writing skills through explicit, multi-sensory, play-based instruction. They can move, touch, feel and manipulate real objects as they learn the essential habits and skills for handwriting, or you can use music to promote movement and memory.
  • Use a continuous stroke to teach consistency. Children should learn a consistent way to form a letter every time they use it. Although some letters, such as f and t, require lifting a writing utensil from the paper to make a second stoke, try to teach formation using a single continuous stroke whenever possible. For instance, work on b starting at the top with a vertical stroke, then looping to the right without lifting the utensil.
  • Focus initially on motor pattern rather than legibility or size. It’s helpful to begin with large movements, such as forming letters in the air. Use a sweep with the entire arm, not just the hand. This practice emphasizes learning the motor patter with correct formation of the letter, rather than writing it on perfectly on paper.
  • Teach similarly formed letters together. Use an instructional sequence that accounts for both ease of formation and frequency in words. For example, c, a and d all start with the same loop and can be taught in one group. I should be taught before y because it’s simpler to form and is needed more often to write words.
  • Separate reversible letters. Children appear less likely to confuse verbally similar letters such as b and d if they’re learned one of them will before introduction of the second one. In addition, it can be helpful to teach formation of these letters differently; for instance, b starts at the top and d starts with the loop.
  • For children at early stages of reading and spelling, integrate handwriting with instruction in letter sounds. While students are practicing writing a letter, they also can be saying the sound it makes.

Assessing Handwriting Skills

Your assessment of students’ handwriting progress should encompass:

  • Execution: Correct and consistent pencil hold, posture and letter formation.
  • Legibility: Readability of letters, as well as spacing within and between words.
  • Speed: This is important as children advance beyond the first few grade levels, so they can effectively use writing in a variety of tasks.

The expert team of specialists at Cobb Pediatric Therapy Services offers a full spectrum of resources and expertise to help you build your school-based therapy career. Read our related posts or contact us today to learn more.

Tips for the Classroom: Learning Diphthongs

March 13th, 2015

Children often struggle with diphthongs, as it can be difficult to glide form one vowel sound to another. This happens naturally to most people, but can cause deep frustration to those who encounter this particular speech challenge.

Here are some tips for diphthong therapy in your classroom:

Pucker Up and Smile

“Oi” is a back-round to high-front diphthong in reference to how it is produced inside the mouth. It’s common for youngsters to have difficulty with the glide part of “oi.” When given verbal or visual cues, they’re often able to produce this diphthong in isolation. However, once in a word, the glide is deleted.

  • Start with vowel words. Then work toward words where consonants follow the vowel. For example, begin with “coy” and progress to “coil.”
  • Use a non-speech exercise. Have students make a pucker with their lips, then retract them for a smile. This oral motor movement gets the lips and tongue into position for accurate production of the “oi” diphthong. Use a mirror so children can see what they’re doing.

The Taffy Cue

Here’s how to progress from “aw” to “long E” when working on diphthongs:

  • Have students practice the “aw” sound and then hold it and add “long E.” Tell them to imagine holding a piece of taffy between their hands, held together by their pointer fingers and thumbs. Then have them envision pulling the taffy apart, stretching your fingers and hands.
  • After a child can produce the “aw” and “long E” sounds, have them practice in syllables. It goes like this: “aw-E, aw-E, aw-E …” Then practice syllables that end in vowel combinations, such as “boy, loy, moy, poy” and “toy.” Advance to words with an ending consonant: “boil, loil, moil, poil” and “toil.” Some of these are nonsense words, but it doesn’t matter. The point is to get students to progress from a consonant to the diphthong and then end the word with another consonant.

More Tips

Make sure your students have a clear understanding of diphthongs by explaining that some letters make a more complicated sound when used together. Emphasize that you need to move your mouth around in different ways to make various sounds.

  • Write diphthong letter combinations on the board and pronounce the sounds they make. Emphasize related mouth movements.
  • Teach each diphthong individually or in pairs. Leave plenty of time to practice each before moving on to another.
  • Cover these diphthongs: “oy, oi, oo, ou, ow, au” and “ew.”
  • Make a diphthong chart. Each time you teach a new diphthong, add a column to a large wall-mounted chart. Encourage students to come up with a list of words that contain the diphthong. You may want to write them on cards and Velcro them to the wall chart. This allows for plenty of practice later, when students can take turns sorting them into the appropriate columns.
  • Practice in pairs. Divide children into pairs and instruct each student to make up three sentences using diphthongs. Then have them pair up and read each other’s work. Remind them to correct their partners’ sentences gently in order to minimize hard feelings and foster teamwork.

As you continue to advance your speech therapy career, consider working with a professional recruiter from Cobb Pediatric Therapy Services. Whether you’re seeking your next opportunity or identifying your plans for growth within your current school or organization, we can help. To learn more, read our related posts or contact our team today.

Occupational Therapy Apps: Shoe Tying 1

February 27th, 2015

The Accelerations Educational Software app Shoe Tying 1 combines a systematic teaching and video modeling approach to help your students master a basic skill that poses difficulty for many. The app is available for download on the iTunes store at a price of $4.99.

The app breaks shoe tying down into individual video steps that students can master one by one, building their confidence and cooperation. You teach them to tie, beginning with a shoe off their foot and progressing to working with it on their foot as their fine motor skills improve. Shoe Tying 1 also teaches the language associated with various steps of shoe tying.

Since shoe tying is a moderately complex fine motor skill, success at this activity demonstrates that a student has the cognitive capability to learn many other daily living and vocational skills. The app is excellent for a variety of learners encompassing:

  • Young children.
  • Children with autism and other learning disabilities.
  • Children with traumatic brain injuries or other cognitive issues.

Helpful Features

You can easily control presentations to your students using Shoe Tying 1. The app enables you to assist and fade assistance as needed till your student is independent. Additional helpful features include the ability to:

  • Replay steps and sequences in video and image formats.
  • Overcome issues associated with poor observational learners including those with representational and memory problems.
  • Provide a consistent, non-threatening model that focuses on the most critical information while minimizing unnecessary distractions.

Shoe Tying 1 comes with an integrated help system including a Teaching Guide, Using App instructions and information on how and why video modeling works. The help system is backed by helpful web resources.

Increase Teaching Effectiveness

Therapists who have piloted Shoe Tying 1 agree that the app makes teaching shoe tying easier, quicker and more effective. One OT noted that, “I would use this app with children with autism spectrum disorders, motor planning issues, intellectual disabilities or learning disabilities … The use of video provides a consistent model, the ability to repeat all or part of the video facilitates memory and the option to easily pause the video at any time allows the child to practice simultaneously.”

Are you interested in additional resources to make your school-based therapy practice more effective and enriching?

What about your career path?

The Cobb Pediatric Therapy Services team of experts are more than just recruiters; they’re therapists themselves. To learn more about us, read our related posts or contact our experienced team of recruiters today.