Depression Management: Understanding Emotional Development

November 25th, 2015

Depression Management: Understanding Emotional Development in Children

As a school-based therapist, part of your responsibility is accurately identifying students who show signs of depression – as well as making their loved ones aware and helping to steer them in the proper treatment direction. Accurately diagnosed, depression can be successfully managed. But left unattended, its consequences can be devastating or even fatal.

Signs of Depression

Children with symptoms of depression show behaviors that cause them severe distress and can manifest as problems in social relationships and difficulties at school. Watch for:

  • Intense sadness, irritability, anger or grouchiness. Sadness may be expressed through frequent bouts of crying or tearfulness.
  • Loss of interest in friends or daily activities that they formerly enjoyed. Difficulty with relationships may intensify into extreme emotions or hostility.
  • Hopelessness, persistent boredom, guilt, or low self-esteem or energy.
  • Extreme sensitivity to rejection or failure.
  • Frequent complaints of feeling ill, especially with a stomach or head ache. High absenteeism.
  • Unusually poor concentration or academic performance.
  • Talk of running away from home or resorting to suicide or other self-destructive behavior.

What You Can Do

When compared to their peers, students suffering from depression are not only more prone to being self-destructive, but they also are more likely to have unprotected sex or become substance abusers.

All children are naturally sad sometimes, but when their symptoms last for an unusually long time and interfere with their normal functioning, it’s time to step in and take action. Learn to identify their cries for help – and when they need immediate attention from you and/or other mental health specialists.

  • Actively observe the behavior of students whom you suspect may have depression. Consider how they behave alone and with peers, inside the classroom and on the playground.
  • Provide resources. Work with teachers, parents and other adults significant in the lives of your students. As you guide them down a treatment path, you can utilize and offer resources such as, the American Academy of Child & Adolescent Psychiatry at, the National Association of School Psychologists at www.nasponline,org, and the National Institute of Mental Health at

For additional resources to add to your school-based therapy toolkit, or to take your career to the next level as you plan ahead for the future, contact the Cobb Pediatric Therapy Services team. We’re therapists ourselves – and we can assist as you realize your ongoing career goals.

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Speech Therapy Apps: Spaced Retrieval Therapy

November 20th, 2015


As you stay current with apps available to enhance your speech pathology practice, keep an eye on Spaced Retrieval Therapy, offered by Tactus Therapy at an affordable price of just $3.99.

Intervention for Memory Deficits

Spaced retrieval therapy (SRT) is a proven effective intervention for semantic, procedural, prospective and recent episodic memory deficits. To perform SRT, a therapist selects several functional targets, then focuses on one at a time until a maintenance level is achieved. The speech language pathologist asks a question to elicit the target. If the client answers correctly, the time interval is increased and the question is asked again. If the answer is incorrect, immediate correction is provided and the question is repeated at the last correct interval time.

You can apply SRT to functional information that will make your students more independent and as a result, successful both in and outside the school setting.

About Spaced Retrieval Therapy

The Spaced Retrieval Therapy app puts this scientific method to address memory impairments right at your fingertips. It is an enhanced interval timer with independent data tracking and prompts. It automatically increases the time between prompts with correct responses and decreases it with incorrect ones.

Spaced Retrieval Therapy:

  • Tracks time intervals and responses for up to three targets at a time.
  • Works in the background so you can use other apps while training.
  • Prompts on screen when it’s time to repeat questions.
  • Automatically tracks performance accuracy and interval data.

Last but not least, you’ll see better outcomes for your students, thanks to the app’s evidence-based techniques and principles.

“It Really Just Works”

SLPs who have tried Spaced Retrieval Therapy give it high marks for making their jobs – and the lives of their clients and their loved ones – easier. As noted by a representative from, “there are thousands of apps in the App Store, but there are only a handful that are as effective, as functional, and as flexible as Spaced Retrieval Therapy. We foresee the increased usage of Spaced Retrieval Therapy because of its simple and easy-to-use interface. It really just works.”

To stay current with tools, technology and developments in the field of speech language pathology – or take your career to the next level – consider partnering with the expert team at Cobb Pediatric Therapy Services. Read our related posts or give us a call today.

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What are You Thankful For?

November 13th, 2015

What are you Thankful For?

Gratitude may be one of the most overlooked tools that we all have access to, every day. When November rolls around, with Thanksgiving and the holiday season to follow, we naturally tend to focus more on all we have – versus what we want. Why not set a goal of making gratitude a year-round habit, starting right now?

As a school-based therapist or psychologist, what are you thankful for?

Your responses will be numerous and varied. Commonly, they include being thankful for family, friends, your health, pets, your home, and your career. You also may cite:

  • Your support team: This may include colleagues and staff who go the extra mile or step up to help with paperwork, testing and other matters that contribute to the overall success of your practice. And what about your supportive administrative team and school district?
  • Your students: Every accomplishment and achievement, no matter how small, is reason to give thanks. Enough said!
  • The resources available to you: Thanks to the Internet and plethora of blogs and other social media sources, you never lack for ideas or inspiration. Here’s just one link for speech language pathologists:

The Benefits of Gratitude

These scientifically proven benefits of gratitude will motivate you to give thanks, regardless of the season. Gratitude has been shown to:

  • Aid in fostering new relationships: Not only does saying “thank you” show good manners, but it also can help you develop friendships. Thanking a new acquaintance makes them more likely to seek an ongoing relationship.
  • Improve physical and psychological health: Grateful people experience fewer aches and pains and report feeling healthier than other people. They also are more likely to exercise and have regular check-ups. In addition, gratitude reduces numerous toxic emotions, from envy and resentment to frustration and regret. Leading gratitude researcher Robert A. Emmons, Ph.D., has completed multiple studies confirming that gratitude effectively enhances happiness and relieves depression.
  • Help you sleep better: Writing in a gratitude journal for just 15 minutes before bed will help you sleep longer and more soundly.
  • Build empathy and reduce aggression: Those who show gratitude on a regular basis are more likely to behave in a prosocial manner, even when others are less kind, as noted by a recent University of Kentucky study.
  • Enhance mental strength: Gratitude not only plays a major role in reducing stress, but also in overcoming trauma. A study of Vietnam War veterans showed that those with higher levels of gratitude experienced lower rates of post-traumatic stress disorder, and gratitude was a major contributor to resilience following the 9/11 terrorist attacks.

An additional resource available to you year-round is the expertise and guidance of the expert team at Cobb Pediatric Therapy Services. We are school-based therapists ourselves, and we can help as you build your practice or take your career to the next level. Read our related posts or contact us today to learn more.

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OT Tips: Is W Sitting Really BAD for Children?

November 6th, 2015

Mother and daughter sitting on carpet, talking and laughing

Children often W sit – in other words, sit on their bottom with both knees bent and their legs turned outward like a letter W – and this is okay, but only for a short period of time. When W sitting becomes a habit and is done for continuous, prolonged periods, it can have long-ranging, negative health effects.

Why Not W Sit?

Many children prefer to W sit. They do so without even thinking about it – in order to compensate for weaknesses in their hips or trunks. The added stability of the position lets them play in an upright position, without worrying about falling over.

Problems arise when children W sit for extended lengths of time. W sitting can:

  • Increase the risk of a child’s hip or leg muscles becoming short and tight. This may negatively impact their coordination, balance and, down the road, the development of gross motor skills.
  • Raise the chances of hip dislocation. This is even more likely if a child already has hip dysplasia, which may not even be formally diagnosed.
  • Make it difficult for a child to reach across their body to perform tasks that involve using both hands or crossing their arms from side to side. This could eventually affect a child’s ability to perform writing skills or other school-critical tasks.
  • Hinder the development of a hand preference. This may result in difficulties with coordination later in life.
  • Make it hard for a youngster to shift their weight from side to side. This ability is critical in standing balance and when learning to run and jump.
  • Prevent a child from developing strong trunk muscles. In a W sitting position, the trunk muscles don’t have to work as hard to keep the body upright.
  • Aggravate muscle tightness. The W sitting position places the hamstrings, hip adductors, internal rotators and heel cords in an extremely shortened range.
  • Add to existing neurologic concerns. If a child has heightened muscle tone; for instance, hypertonia or spasticity, W sitting will feed into related abnormal movement patterns.

An Ounce of Prevention

The easiest and most effective way to correct W sitting is to prevent it from becoming a habit in the first place. Anticipate and catch it before a child even learns to W sit.

  • Teach children to assume alternate positions. Don’t scold them for W sitting, but rather, suggest other ways for them to sit, such as long sitting, side sitting, or sitting on a small bench. These positions allow youngsters to better use both hands at the same time, shift their weight more easily from side to side, and use the back and abdominal muscles to maintain an upright position.
  • When playing with a child on the floor, gently but firmly hold their knees and feet together when they are kneeling or creeping. Although they may initially resist, it’s important to consistently make this correction.

As a school OT, it’s up to you to work with parents and other members of the academic team to prevent potentially harmful practices such as W sitting. If you need additional support or resources for your school-based OT toolkit, read our related posts or contact the specialized team at Cobb Pediatric Therapy Services today.CPTS_CTA_View Available Employment Opportunities Apply Today


Using Brain Breaks to Overcome Fidgeting Children

October 30th, 2015


During a typical school day, kids spend a lot of time sitting. At the same time the focus on test prep and scores grows, many schools have cut back on recess and even PE time. As a result, many children spend an increasing percentage of their time being sedentary.

Movement matters. Not only does being seated for long periods of time make it tough for kids to get enough physical activity, but it also makes it harder for them to pay attention and learn. As noted by pediatric occupational therapist Angela Hanscom in the Washington Post: “Children naturally start fidgeting in order to get the movement their body so desperately needs and is not getting enough of to ‘turn their brain on.’ What happens when the children start fidgeting? We ask them to sit still and pay attention; therefore, their brains go back to sleep.”

The Benefit of Brain Breaks

Regularly incorporating short movement activities into the instructional day will help keep those young brains wide awake and ripe for learning. Even if your school can’t add in more time for recess or PE, it’s easy to give students brain breaks throughout the day.

  • Brain breaks are short, energizing bursts of activity that boost blood flow to the brain. This helps students to better retain information. It can be as simple as taking five minutes to stand up, stretch and run in place next to their desks, or take a short, brisk walk around the building. Research has shown that brain breaks increase students’ on task-behavior and the amount of physical activity they get each day.

More Examples

There are numerous examples of effective brain breaks that you can use with your students. Consider what will work best for you. You may want to allow students to take turns choosing an activity, or use the “therapist’s pick” method at least part of the time, so you don’t wind up repeating the same “popular” activity over and over again.

A word of caution: To avoid students becoming overstimulated during brain breaks, you can use these tactics:

  • Have students find a “brain break sport” which is their own bubble of space where they routinely go when it’s break time. This way, things stay organized, and it’s easier to transition back into instructional time.
  • If kids get too rowdy, step in. Sit them down for the remainder of break time. Gently but firmly help them to self-regulate their behavior.

For additional innovations and resources to enhance your school-based therapy career – or to advance it to the next level – reach out to the team at Cobb Pediatric Therapy Services. Read our related posts or contact us today.

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Speech Therapy Apps: Speech FlipBook Standard

October 27th, 2015

Mobile Apps in the Classroom | Cobb Pediatric Therapy Services

Called a “must have in elementary schools” by one speech-language pathologist who tried the Tactus Therapy app, Speech FlipBook Standard provides a fast, easy way to create single-syllable word lists. Its recorded voice makes it easy to listen to word breakdowns by sound, work on blending sounds, and hear accurate pronunciations.

With its more than 2,300 recordings of words in natural speech and 125 phonemes and clusters, you can use Speech FlipBook when working with students in the areas of reading, phonological disorders, apraxia, articulation, minimal pairs, dysarthria and auditory processing.

It’s a worthwhile investment at 9.99, available for download to your iPhone, iPod touch, iPad or iPad mini. Speech FlipBook also comes bundled in Tactus Complete Therapy Toolkit 2.0 and Tactus School Therapy Toolkit.

Additional Benefits

Speech FlipBook enables you to turn on and off any sound in any position and control the shape of words. It features all Standard American English vowels and consonants, as well as more than 250 sets of homophones.

  • Sounds are arranged in a hierarchy for apraxia. The app enables you to record and play back productions to build self-monitoring, which also is highly effective when working on articulation or dysarthria.
  • Word lists are instantly generated. You can pick exactly the sounds you want in each position of a word and specify syllable shapes, as well as easily find minimal pairs and rhymes.
  • To assist students with reading, use Speech FlipBook to strengthen sound letter-correspondence. The app also is helpful in improving phonological awareness, blending and segmenting.

“Definite Gains in Therapy”

Another therapist who completed a trial run of Speech FlipBook said she “absolutely loved” the app because “it is so versatile and can be beneficial to students that are in general or special education. Primary classrooms can use it for phonological awareness skills, special education teachers have a quick, customizable tool to address specific weaknesses in early literacy skills, and speech therapists have a great tool for articulation and apraxia therapy.”

The Cobb Pediatric Therapy Services team stays on top of the resources and tools you need, as well as career trends and developments, in school-based therapy. Why not partner with us as you advance your career and build your practice? To learn more, read our related posts or contact us today.

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Tips for School Psychologists: A Guide to Supporting Homeless Students in the Classroom

October 20th, 2015


The heartbreaking truth is: Each year, close to 1.4 million children are homeless, with the number of homeless students in U.S. schools increasing every year.

For many of these children, school may be the only place they can turn for structure and stability in the midst of their uncertain daily lifestyles. As a school psychologist, you play a central role in advocating for their rights and addressing their needs.

Homeless students are of every race, gender and background. Ninety percent live in single-parent families, most often headed by their mothers. As defined by law, homeless students are those who lack a fixed, regular, adequate nighttime residence. Some states define them as those who move three or more times within a single school year.

Issues of Homeless Students – and How to Intervene

Support and opportunities should be provided to meet homeless students’ basic needs, as well as improve their social, psychological and academic competence.

  • Start at the beginning. Homeless students often do not get enough to eat, or get adequate sleep at night. They also tend to have more health issues including upper respiratory and ear infections, skin diseases, and common cold symptoms. Many do not receive adequate medical or dental care. Start by establishing services at school to meet these basic human needs. This might include serving breakfast as well as lunch, providing extra clean clothes, and offering a shower room, nap room, and such essentials as toothbrushes, hairbrushes and essential school supplies.
  • Work to boost attendance. Obstacles to school attendance for homeless students typically relate to frequent moves in and out of temporary housing. Up to 45 percent of homeless children do not attend school on a regular basis. Not surprisingly, up to half of them show developmental delays and only one-third of them read at grade level. Everyone on their educational team needs to become actively involved in interventions that will boost their academic success.
  • Provide classroom structure. Make sure that homeless students have their own work space and materials. Teach them to organize their work area constructively. Remember, this may the one place that gives them a sense of consistency in their lives.
  • Communicate with parents, your district liaison and with new schools when a child moves. Establishing contact with parents gives you an idea what’s going on outside of school for these students, and it may help everyone to feel more connected, thus increasing attendance and academic achievement. The 2001 No Child Left Behind Act, which entitles homeless children to a free education, also requires school districts to appoint a liaison to work with students and families, as well as serve as a resource for educators. Be sure to stay in touch with this liaison. If a child does switch schools, take whatever steps are necessary to ensure the proper transfer of records and background information, to facilitate a smooth transition.

Additional information on supporting homeless students is available from the National Association of School Psychologists.

Cobb Pediatric Therapy Services has the resources you need to optimize your school-based psychology career or take it to the next level. Read our related posts or contact us today.

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Fun with Fall: Five Fall Activities for Children’s Occupational Therapists

October 13th, 2015

Cobb Pediatric Therapy Services | Fun with Fall

Fall officially began September 22, when day and night were of equal length and the sun appeared to cross the equator.

In addition to this being a terrific science lesson, it marks a wonderful time of year to provide your OT students with sensory input to help ensure continued success in school and at home. Try these activities to keep your students engaged as the calendar turns to autumn:

Ah, Fall Leaves

Remember when you used to jump in those neatly raked piles of colorful, crisp leaves as a child? Well, this time-tested activity hasn’t lost its attraction or its value. Try:

  • Raking: Raking leaves into piles is great heavy work for children. It helps to provide proprioceptive input to their muscles and joints, which increases body awareness and strength.
  • Playing hide and seek: Hide familiar objects in leaf piles and have children try to find them. This enhances tactile input and works on discrimination skills.
  • Leaf rubbings: Have children create works of art by making rubbings of large leaves. Place each leaf under a piece of paper and have them color the paper, transferring the image of the leaf onto it. Students can use small or broken crayons to facilitate a tripod grasp.

How About a Nature Hunt?

Provide students with tongs or tweezers. Have them pick up acorns, pine cones and leaves. This will work on building grip strength and improving precision.

Progress with Pumpkins

Everybody loves fall pumpkins. Did you know that they also are great tools for building sensory input?

  • Carve them: Have students carve pumpkins – with assistance, of course. This facilitates fine motor skills and provides a great wet tactile activity. Let children scoop out the insides and play in the mess. Picking out pumpkin seeds to toast helps to work on pincer grasp, while providing a healthy snack at the same time.
  • Bowl with them: Bowling with pumpkins provides children with heavy work through lifting, as well as enhancing their object manipulation skills as they roll the pumpkins toward a target.
  • Use them to race: Have students compete in a pumpkin race. Have them run through obstacles if desired. This will assist them with motor planning and agility, as well as vestibular and proprioceptive input.

Biking & Walking

Fall bike riding is an excellent way to provide children with movement. It also works on bilateral coordination and balance. In addition, try:

  • Wagon pulling: This is a great form of proprioceptive input through heavy work. You can intensify this by placing items in the back of the wagon.
  • A fall scavenger hunt: Make a list of common autumnal items and have children look for them. Have a race to see who can find the most objects. This works on both visual perceptual skills and discrimination.

Fantastic Finger Painting

Finger paint is a great medium to provide students with tactile input. Have students make tree trunks by putting brown paint on their palms and forearms and pressing it onto paper. They can then use various autumn colors to “finger print” leaves onto their tree branches.

As the school year progresses, do you need more tips or resources to enhance your school-based practice and plans? If so, or to learn more about taking your OT career to the next level, read our related posts or contact Cobb Pediatric Therapy Services today.

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5 Minute Fact Sheet on Mood Disorders

September 30th, 2015

Mood disorders in children and teens have been recognized for decades – though they can sometimes be difficult to pinpoint. This is especially true in young children or others who may have difficulty describing how they feel.

Generally caused by chemical imbalances in the brain, mood disorders also may be triggered by environmental factors, as in the case of seasonal affective disorder. Students with mood disorders often are either depressed, manic, or alternating between the two.

A Tough Diagnosis

Often, mood disorders go undiagnosed because their symptoms can mimic the normal emotional and behavior patterns associated with growing up. This is particularly true in adolescence, when hormonal changes, peer pressure and rapid physical and cognitive development occur. But left untreated, mood disorders can lead to serious academic and lifestyle problems including school failure, extreme irritability, substance abuse, risky or self-injurious behavior, or even suicide.

Recognize the Signs

It’s normal for everyone – including children and teens – to occasionally feel sad or depressed as the result of upsetting events. With the right love and support, these feelings generally resolve themselves. Symptoms of mood disorders occur or reoccur over an extended period of time and interfere with normal activities and relationships.

Look for these symptoms:

  • In preschoolers: A somber, almost ill appearance; frequent complaints of physical ailments for which no medical basis can be found; lack of enthusiasm or tearfulness for no justifiable reason; spontaneous and unexplained irritability; frequent negative self-statements; self-destructive behavior, or anhedonia.
  • In elementary, middle and high school students: Disruptive behavior; academic difficulty or declining school performance; frequent peer problems; increased irritability or aggression; suicidal threats; anhedonia; statements that they hate themselves and everything around them; excessive sleep; rapid, unpredictable emotional swings; racing thoughts; increased interest in problematic activities such as overspending or drug use; grandiosity and inflated self-esteem; greatly increased or decreased sex drive, or uncharacteristically poor judgment.

Mood Disorders are Treatable

The good news is: Mood disorders are treatable. You can help your affected students by knowing the signs of mood disorders and where and how to get appropriate care.

  • Schools that provide prevention and early intervention-focused services are better equipped to help students with mood disorders. This should include educational programs for students, parents and staff, as well as collaboration with community agencies for referral and follow-up purposes.

Specific treatment should be recommended, after thorough evaluation by child mental health specialists. This treatment should be based on:

  • A student’s age, overall health and medical history.
  • The extent and severity of the condition.
  • The specific type of disorder.
  • The students’ and parents’ tolerance for specific medications, procedures and therapists.
  • The prognosis or expectation for the course of the condition.
  • The opinions and preferences of parents and students, in collaboration with mental health professionals.

Treatment for mood disorders may include medications, psychotherapy or family therapy. Regardless of the specific treatment plan, communication between home and school is critical. Counseling, community referral information and collaborative support must be ongoing. Working together, an involved team of adults can help ensure the ongoing mental health and well-being of every student.


For more information on mood disorders in children and teens, resources include the Depression and Bipolar Support Alliance and the National Association of School Psychologists.

Cobb Pediatric Therapy offers additional resources in this and other areas to enhance your school psychology practice and career. Contact us today to learn more.

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Ending Impulsive Behavior in the Classroom

September 25th, 2015

A student who behaves impulsively can disrupt a whole class or throw an entire therapy plan off track.

Now that you’ve gotten to know this year’s students a bit, you’re probably beginning to sense those who may pose this challenge – so now is the time to take proactive steps and nip the situation in the bud.

Basic psychology dictates that behaviors that are rewarded tend to reoccur. The opposite also is true – so be sure to reward and promote self-control, not impulsivity.

It’s very simple in theory, but can be a huge hurdle to overcome in terms of practical application. Here are some helpful tips:

Identify problematic themes.

These may include difficulty taking turns, over-interpreting others’ remarks as hostile, personalizing actions excessively, or misreading social clues.

  • Role play hypothetical situations. If possible, involve supportive peers. Then, identify and practice positive alternative responses.
  • Encourage students to “think out loud.” This helps you to gain insight into their reasoning style, and the process will slow them down before they react. You’ll get a better grasp on how they see the world, which will enable you to restructure inaccurate perceptions. Teach your students’ teachers and other involved adults how to do this, in order to provide ongoing practice both in and outside the classroom.

“Stop. Think. Talk. Do”

This technique is central to many cognitive behavioral interventions. Its purpose is to slow down and minimize impulsive responses by teaching students to:

  • Stop before acting impulsively.
  • Think about the case and effect relationship of their intended behavior.
  • Talk – or verbalize to themselves or others what they are about to do.
  • Then do the chosen behavior. 

Keep classroom rules clear and simple.

In order to follow classroom rules, students must first understand them. Don’t take this simple fact for granted.

  • Define and review the rules on a regular, ongoing basis.
  • Implement a classroom behavior management system.
  • Actively reinforce desired behaviors.
  • Use self-monitoring and self-reinforcement during times when students are working independently. Start with brief periods of time and gradually increase them as your students demonstrate success.
  • If necessary, develop contracts with individual students and their parents to reinforce specific behaviors.
  • Set hourly, daily, weekly and monthly goals based on the needs of the specific student.
  • Provide frequent feedback, as well as a changing array of rewards and privileges. Students may “burn out” on one repetitive system, so be sure to change it up periodically. For instance, allow students to earn points toward a weekly raffle for the display of positive behavior.

Do you need assistance in establishing an effective system to monitor and control impulsive classroom behavior? The experts at Cobb Pediatric Therapy can assist with this and other challenges that you encounter on a day-to-day basis in your school therapy career. To learn more, read our related posts or contact us today.

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