Wednesday, December 30, 2009

Dismounting from the horse

Photograph used with permission from Bart Hickman at Bart's Photography

There are several different ways to dismount from a horse. These pictures show my favorite method because the child has to motor plan how to first put weight on the withers (the horse hump in front of the rider). Next, swing that right leg behind, shifting weight onto the left foot while at the same time moving the arms to face that person on the right (not shown) .

This method also provides much sensory (tactile/touch) deep pressure stimulation as the child slides along the horse's barrrel down to the ground. I encourage the side-walker (the person assisting on the other side of the horse) to encourage eye contact as the child is facing her and moving downward.

In the above picture, the child is stepping onto steps. But if the child is willing to jump off (with some assistance, as shown) its a great way to work on balance and the bilateral coordination to jump. It also helps those kids with gravitational insecurity get used to movement while off the ground.

Sometimes I have my kids turn around on the horse to face me and then jump. I hold their hands, count to 3 and prepare them for a jump landing.

There are other ways to dismount which I won't get into here since they are rather advanced.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Tuesday, December 29, 2009


alanna said...
I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.
December 28, 2009 11:45 PM

Thanks, Lucy. comments are most appreciated!

Saturday, December 19, 2009

Preparing the Child with Autism to Ride

I love checking out the youtube videos to see what other therapists are doing. I like how this therapist, most likely an occupational therapist is taking the time to give the little boy deep pressure and process what is going on before having the horse start walking.

Thursday, December 17, 2009

Vacation yeah!

I will be away from work for 3 weeks taking a very much needed vacation. Winter is very tough because I already live 45 minutes away, but with bad weather many kids cancel. Then the facility rearranges my schedule and I end up working very few hours, not worth the commute. In addition, I end up inside a small, noisy, crowded indoor (heated) arena where my kids become even more distracted and overloaded. I need to analyze whether or not to take the winter off.

On another note. My editor has given me a list of photos that I need of young children doing various activities such as ring stack, wheelbarrow walking and using a pincer to pick up cereal... If anyone out in cyberspace has a young child of the right age and take a photograph doing what I need, you can have your child's photo in a best selling book (I hope best selling).The book is a parent's guide to developing hand skills and to be published by Therapro, Inc.
I am especially looking for photos of non Caucasian children to add more diversity. If you can help me thanks sooooooo much.

Weight bearing on weaker hand during activities

A three year old who has the objective of improving protective reactions when falling did very well standing on top of the horse for 2-3 minutes while horse was stationary. He leaned a bit to his stronger left side so this was an excellent activity to make him aware of both sides, strengthen and balance.
I am attaching a youtube video a mom made a few weeks ago.The little girl has increased tone in her right hand. My goal is to promote using it as an assist and weight bearing. She did quite well yesterday giving high 5s with it. I have a game where when they give a high 5 I make an animal sound, so they want to do it repeatedly.You can't see it in the video but after the camera stopped rolling she did quite well bearing weight on the withers with her right hand while reaching for a pin with the left. But I did have to assist her.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, December 14, 2009

Fun with the Whoopee Cushion

An OK day. I find that I really click with some kids and not so much with others. One little girl with cerebral palsy does not cooperate when asked to change positions and will lean against me at any opportunity. Yet, when I do my best to limit my hand contact to shoulders and hips or nothing- she will just slide off the horse or hang her arms and legs in an awkward position as I try to get her to move her legs and rotate her trunk. The mom tells me that her previous therapist- a PT got her to do all of these things independently. On a more positive note- a new client showed me how she can post repeatedly in order to make the whoopee cushion sounds and a child surprised me by tolerating prone on his belly over the horse barrel (superman position) in order to touch my squeaky ball.
Got a nice holiday gift of sweet items- I'm not a big sugar eater but love to be appreciated!!
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Sunday, December 13, 2009

Jane--anne said...

Dear Barb, thanks for the link to my blog. The Canadian UN are very helpful volunteers. And very kind to donate not only their time to my hippotherapy program, but also their money.I am very gratefull to them.

I am happy to link and give information about such an important program.

Thursday, December 10, 2009

Wednesday, December 9, 2009

Pictures on Sleeve

I made a "bunny" a while back out of a can- adding plastic ears and fur around it. Children can insert the paper veggies inside the bunny's mouth. I sewed some velcro to this sleeve so that children can pull off the picture to feed the bunny. I want the children to practice pulling this sleeve onto their arm to improve dressing skills. This sleeve is rather large for my little kids but seems to work OK over the bulky jackets.
I hope to try this out on the little boy with autism who I planned this for. Most of the clients canceled today after driving one and a half hours in bad weather. It was only drizzling near home, but got worse and worse as I drove.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Sunday, December 6, 2009

Socially Curious and Curiously Social

Some of the children I work with have Asperger's syndrome, ADHD, PDD-NOS or a non-verbal learning disability. Many of them will grow up to have difficulties understanding social thinking and successfully developing social skills. Check out the book review I wrote on amazon on the new book Socially Curious and Curiously Social. Written for young adults- it really explains how to navigate the social world.

Monday, November 30, 2009

Craving Vestibular Stimulation

An almost three year old I work with is terrified of changing his position to sit facing sideways or backwards and won't reach at all out of his base of support to touch toys on the mane, croup or at his sides. He was also upset when I stopped the horse to try basketball and placing hoops over the cone for some hand activities. So we trotted over and over again. He said "fast", "more", "fast please" and "go please" whenever we slowed down and then cried when the session ended because he wanted more. It was nice to see him asking for what he needed but sad that he is so gravitationally insecure. I was mostly inside on this wet and dreary day and it was rather exhausting!
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Wednesday, November 25, 2009

Spring Toy to Promote Reaching

I discovered this toy in the arena. It is sort of a doll with a baseball head and the feet are attached at the end of a spring. I had been wishing for a toy like this so that the children could have something fun to pull while reaching on the mane. This was more fun than telling children to touch the pony's ears or mane. It also worked well when held on the croup so that children rotated to reach and pull on those feet (shown on left side of photo).

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, November 23, 2009

Whooppee Cushion to Promote Posting

This whooppee cushion caught my eye while shopping. Like all of my activities there is a lot of trial and error but so far two children loved posting up and down in order to make the weird sounds when sitting. The horse joined in making his own sounds along with it-so it was quite a funny scene. It also works well as just a weight bearing cushion while a child sits facing sideways opening the palm while bearing weight on the cushion.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Friday, November 20, 2009

Therapies in the Schools Conference Success!

I spoke for 3 hours straight (with a sore throat) but think the audience enjoyed my presentation about evaluating, treating and designing objectives for students with severe to profound disabilities. I gave a short plug for hippotherapy. I am always spreading the word about how children both benefit and enjoy hippotherapy.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Wednesday, November 18, 2009

Weight Bearing on Weaker side

This little girl's right side is weak so I love to have her bear weight on it while facing sideways. I help her open up her palm and maintain the position. I have the horse walk uphill so that gravity helps put weight on that right arm. I sing songs like "If Your Happy and You Know it" to encourage touching the tail, giving high fives, touching my head with that same right arm while her left hand is busy grasping the handle. She also did a pretty good job of maintaining the quadruped position, another great way to make her use both hands as she grasps the handle. Actually the quadruped position is just overall great for endurance, building core strength, balance and motor planning.
The mom took this picture and put it on her blog.
Since I am not allowed to show identifiable pictures from work, I blurred her beautiful face and background.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, November 16, 2009

Tactile Activity

One of the other therapists left out a container filled with rice and little hidden animals in it so I decided to use it. My children love new activities. One child squatted while removing the toys and stood on top of the horse to insert them into the small basket I held up high.
Another child who loves fine-motor activities tolerated one hip externally rotated with the other abducted while facing backwards as he searched for the toys to put into the basket. The basket was attached to the handle so he had to do nice trunk rotation to insert them. I love when my kids will face backwards and rotate toward the front of the horse to insert objects in containers. This same child also tolerated long leg sitting, stretching his hamstrings while doing a lacing activity. I held the shapes near his feet so he did pretty good reaching to grasp them. We did this first with the horse stationary and then walking.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, November 9, 2009

Home-made Hoops

The hoops at work keep disappearing and they are a bit too large for some kids to manage. So I made smaller rings by rolling up newspaper and shaping it into a circle. I wrapped strands of plastic around them (the strips that are used for trash bag knitting) and then connected rubber bands and wrapped these around. The result is a hoop that is slightly flimsy so that children need to grasp it with both hands but strong enough to work. They are round and fit inside the hand more comfortably than the flatter hoops (such as the orange one in the picture). My hoops are just large enough to require using both hands, but small enough to be easy. I like having toys that are all different to do trial and error and see which the kids prefer or use most easily. Most of my kids like placing hoops over tubes such as this one . This tube has a squeaky dog toy attached to the top. I use this tube in a variety of ways that all involve reaching and squeezing, although sometimes I squeak it just to get someone's attention.
I admit these ring took a good hour to make which is why I only made two, but they kept me from munching on potato chips during a movie.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Friday, November 6, 2009

ICYou Health Care Videos

I found this great site with health care related videos. Two of mine have been added:

Thursday, November 5, 2009

Melody Stands on Top of Horse while Wearing Prosthetic Legs

This amazing little girl is a double amputee but can still stand on top of a horse!

Monday, November 2, 2009

Improving body Awareness

I have been thinking a lot today about how to increase body awareness so that the children help move their legs while transitioning from facing forwards, sideways and backwards. Some of them don't understand what I want even after I have moved their shoulders and hips, shifted their center of gravity and all they need to do is finish swinging their leg over.
Today I had the opportunity to use the larger arena and tried having the horse make tight turns in ways that would get momentum and gravity to help them swing their leg over. I also had the horse do tight turns to help them readjust and center their bodies while leaning to the side- If the child's body is sliding toward her left side-turn the horse sharply to the left and the feeling that she is falling off will increase body awareness so that she readjusts to sit in the middle.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Saturday, October 31, 2009

Standing on top of Horse Video

I just realized that I have been blogging about hippotherapy for a full year!
This video of a child standing on top of a horse gives you a sense of the tremendous effort, strength, body awareness, balance and concentration that goes into standing on top of an animal even when the animal is just standing there. This activity can be gradually graded with challenges offered by having the horse walk straight lines and later on curves. I sometimes ask children to do the velcro bottle activity while standing stationary. It is very familiar and relatively easy to pull the toys off the bottle and insert them inside. They can do it pretty quickly so they know that they will be able to sit in a few minutes and children with attention disorders seem to get very nicely focused when doing a hand activity while standing on top of a horse.

Friday, October 30, 2009

Hippotherapy and Hemiplegia

A parent recommended this video on her blog and indeed it is an excellent video that explains restraint therapy to help a child with hemiplegia to use the affected arm because the other arm is restrained in a cast. Hippotherapy is a great tool for helping children to use the weaker arm. They weight bear on both hands while facing backwards and while facing sideways with the affected hand near the tail. It is easy to offer activities such as popping bubbles, reaching for rings or giving high five on the weaker side and since the child is sitting on a horse it is difficult for her to manipulate her body in order to use the stronger hand. Children also use both hands while putting weight on the mane, grasping reins, grasping large balls or hoops during activities and clapping, touching named body parts (head, shoulders, knees and toes) during songs. I often sing while the horse is moving, then stop to encourage the hand movements and move again as a reward. Many of the kids can't coordinate the hand movements while the horse is moving, but when they can it is awesome!

Tuesday, October 27, 2009

Quest for Rehab

Check out this new article in Advance for Occupational Therapists
Quest for Rehab


Jane--anne said...

Once again, a very good idea!!!! I look forward to opening your blog every morning. You are a great inspiration.

It's so nice to get feedback and know that people are reading my blogs! I just saw the movie Julie and Julia about a woman who got intensely into blogging about following Julia Child's recipes and she never knew at first if anyone was even reading them!!

Yesterday at work, another frustration couldn't find any large rings to toss over the cones. I am working on making my own rings out of newspaper, plastic bags and rubber bands- all free stuff around the house. So far I rather like them better because they are a bit smaller and a little bit wobbly so that one really needs to use both hands to control them. A photo is soon to follow.

Monday, October 26, 2009

Fun Vibrating Ball to Promote Bilateral Grasp

What I like about making my own materials is that I get to use exactly what I want and have it immediately. I wanted a vibrating ball that did not make weird noises and was large enough so that a 2 year old would have to grasp with both hands. I made this by filling a plastic bag with other plastic bags. There is a vibrating pen (point removed) jammed inside and the rubber bands hold it in place so that I can easily find it and move the lever to turn it on and off.
One little girl enjoyed holding this while facing sideways as we walked in circles. The curvy movement while facing outward quickly impacted her posture and she sat more erect. She typically neglects one hand, but grasping this ball gave some nice sensory input while balancing during movement.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Saturday, October 24, 2009

amy-bob blog

Check out these pictures at my new client's blog:

Friday, October 23, 2009

Trotting in the Indoor

I was looking around youtube for an interesting video to post and what a surprise!!! I found me!!! (I'm the one talking my head off)

Wednesday, October 21, 2009

Electronic Toys

I gave an almost 3 year old the plastic animal picture toy shown below. He asked why it didn't make music when he touched it!!I think that is toooo funny. Children are so used to electronic toys, they have come to expect it. It turned my session into a game of he touches my head or my side walker's head we are activated to make animal sound. This worked really well because I got him to do some fantastic reaching and trunk rotation while reaching for our heads. He even did this while in the cossack hang position- on his back over the horse's barrel- a wonderful way to stretch tight muscles.

Here, my little friend is removing small animals from a bottle. I raised the bottle so that it was positioned at a height to encourage upright posture and bilateral hand use. He is sitting on the horse facing backwards.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Tuesday, October 20, 2009

New Toys Keep the Kids Happy

While walking up the street I came across one of those large toys (in the trash)where you deposit the baby inside with stimulating objects surrounding her and hope that she will stay out of trouble for a few minutes. I removed this attached picture toy, threw it in the dishwasher and used it during hippotherapy to stimulate language. It's nice and sturdy and on the bottom is a mirror. I have been thinking of making a picture book of only B words (boat, baby, bed, book etc.) since so many common words start with B and although I am no speech therapist, it seems that the B sounds (like in Barbara) is pretty easy.

Aside from the B discovery, yesterday was a day filled with pediatric sniffles, coughs and my own headache possibly due to allergies.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Friday, October 16, 2009

Video with Great Activities

I love this video- some great eye hand coordination activities...

Wednesday, October 14, 2009

Swimming Noodle Sensory Trail

Check out this sensory trail!!! I would love to noodles hanging for my kids to reach up and touch.
Sensory Trail

Sit-ups to Strengthen Abdominals

Special thanks to Jane-Anne at MiraclesSudan for permission to use photos.

Sit-ups are a wonderful way to strengthen the abdominal and trunk muscles. These photos show what occupation therapy is all about- using activities to motivate the child to reach, visually attend, use hands bilaterally and strengthen all at the same time.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Tuesday, October 13, 2009

Horsebackriding for Beginners

Here is a helpful site I can appreciate since 3 years ago I thought the stirrups were what you kicked the horse with!!!
Horseback riding for beginners

Miracles at Sudan


Jane--anne said...

Very clever!!! I must try it out. I will let you know how I get on.
Looking forward to learn more good ideas from you.
Your site is very helpfull.
Well done.

I love your Miracles at Sudan site. Good job!

Monday, October 12, 2009

Magnetic Puzzle Pieces

Anyone who does hippotherapy knows that you need ten hands to work with the child and control the materials. I often use Velcro to keep my materials in order. Today I used a puzzle with small pieces of magnetic tape on the back of the pieces. I attached them to a cookie sheet.

An almost 3 year old child enjoyed reaching while standing on top of the horse for a puzzle piece. Then he squatted to place each piece in the board. This child is quite bright and was able to easily find the matching hole without frustration, so it worked well. I like teaching the concept of number one by asking the child to take only one when given several to pick from.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Wednesday, October 7, 2009

Horse Card Fun

I have been trying to get a 2 year old with cerebral palsy to tolerate being positioned over the horse's barrel prone and he always cries. Today he was so interested in a new toy that he forgot to be afraid. I gave him a picture card to hold that shows a moving horse when the card is opened and closed. He had much better head control in this position than I expected and he was able to hold the card with weight on his forearms while my side walker held onto his legs. We were even able to do this while the horse was walking.
The technique used to make the card is called scanimation and the book Gallop is filled with these moving animals.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Saturday, October 3, 2009

Turning Around on the Horse

This brief video nicely shows the many postural adjustments required for a child to turn from facing backwards to sideways. Its always great to see a child scoot herself back up.

Massachusetts Occupational Therapy Conference

The hippotherapy presentation I gave with Monica Wu (from REINBOW Therapy) went very well. The only glitch was that we had so much information, we went overtime. That's something my Toastmaster's friends would not approve of. However, we did our talk from 3:30 to 5:00 -expecting the audience to be sleepy or eager to leave and they weren't, lots of good questions.
I will be sure not to combine coffee and Sudafed (for allergies) during my next presentation- a toxic mix that made me almost manic!! I will be talking at the Education Resources, Inc. Occupational Therapy in the Schools Conference in Framingon on November 20 about Realistic Goals and Treatment Strategies for the Child with Moderate to Severe Impairments in a School Based Setting.
Karma Anais said...

Would you mind sharing your presentation?

barb said...

That is a good question! You may have noticed that I never mention where I work. I am not allowed to use any photos that enable my clients or where I work to be identified. My presentation is full of pictures from work and this was allowed because I was not paid to present at the conference and actually my presentation promoted my employer. My employer thinks there is a conflict when I earn money via my website/blog (an insignificant amount from the Ads) and their nonprofit status. So, unfortunately I am limited in what I am allowed to show on my website and blog. Very generous therapists from other facilities have given permission to use their photos and I have given them credit as due.
FYI, I greatly appreciate any photo contributions and will provide links back to promote these facilities with many thanks!!!

Wednesday, September 30, 2009

Pediastaff resource link

I found a great therapy resource recently called They print articles of interest to therapists. Here is the link to their current newsletters to check out.

More Fishing Activities

The fishing activity shown below was successful again today. Sorry that I don't have any new photos due to my very busy hands. An almost three year old guy who refuses to sit with legs crossed at home due to tight hips has been avoiding any long leg or crossing leg positions during hippotherapy (he also cries when the EI. PT touches his legs but is fine with his parents). However, I convinced him to cross one leg, with other hip abducted while reaching for fish with the magnet and putting the fish in the basket. Kids like this who are really good and love fine-motor activities don't really need to work on hand skills, but I use the activities to get them to tolerate positions they don't like. Another child did squat stand repetitions while on top of the horse- reaching for the fish and squatting to put them in a container on the mane. Sequencing and motor planning to do this was big progress for him and his mother filmed the whole thing.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Saturday, September 26, 2009

Finger play songs and hippotherapy

This video demonstrates how finger play songs make kids happy while riding but also work on language and motor planning. I use singing a great deal. My favorite song is "If you're happy and you know it clap your hands, give a kiss, touch the mane, touch the tail, kick your feet etc. because I can easily move their body parts to perform the movements. If the child doesn't do the movement by himself along with the song, I stop the horse and then help him do it. Moving again is a reinforcement. Of course, doing these movements on a moving horse also works on postural control and following directions. So much learning from one little song.....

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Thursday, September 24, 2009

Trash Bag Knitting for Hippotherapy

This video related to both recycling and hippotherapy so I am putting it on both blogs.

Tuesday, September 22, 2009

Inmate Rehabilitation and Horse Training

What a great idea- having inmates train wild horses. They benefit from the human/horse therapeutic relationship as part of the rehabilitation process.

Creating a Sensory Trail

Its almost time for the OT conference in Massachusetts MAOT on October 2. I will be presenting with OTR/L Monica Wu . Monica owns Reinbow Therapy in Acton and also works at Windrush Equitation Center in Boxford.

She created an awesome sensory trail that has lots of objects for the children to find while riding such as the bears shown in the tree. This works on figure ground discrimination, language and object identification.

She also has the children check off the items seen on the trail. This is a great way to work on scanning, pencil grasp and visual matcing during a hippotherapy session.

Barbara Smith, M.S., OTR/L is author of, The Recycling Occupational Therapist


Karma Anais said...

Barbara- I had a similar reaction with a little girl with a strong startle reflex. She was frightened by the horse sneezing. I told her father that she would not be able to continue HPOT if we were not able to manage her fear. We did two things that were very successful. We positioned her backwards to remove the visual stimuli of the head and neck (in my case where the sneeze came from). We also placed a towel over the horse (neck and rump) for a few sessions to decrease the visual response from the patient. I hope my experience may be helpful to you and your patient.

Thanks Karma,
I saw this little guy yesterday and used a different horse and all went fine. The child grew scared very briefly after a small horse sneeze but then I was able to quickly redirect him. I do believe that other horse shook a lot to see if he could get a reaction. I like your idea of facing backwards to take the focus off and create some distance from the horse's sneezing head. i am not sure how the towel helped- did it serve mainly to distract or actually block the view of the horse's head . I have to admit a photo is worth a thousand words- which is why I keep taking them!!!
Thanks for the thoughts.....

Monday, September 21, 2009

Focus on Ball Play

I bought a ball recently that changes color when tossed thinking it would be a great motivator. I realized that many of my almost three year olds can throw a ball into the basket at close range (from on top of the horse but have problems motor planning to throw to me and position the hands to catch. so I worked on this a lot with my squeaky dog toy and plan to bring in the bag that I sometimes use for catch. A bag is often easier to toss and catch, especially catch than a ball. Just fill a market plastic bag with lots of other bags and tie a knot. It also has nice sensory qualities.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist
Here is the ball that changes color. I will try it out soon with some older higher functioning kids .

Animated Horse Pictures Promote Movement

I know that this video is a bit long, but I love how it shows a child combining reading with movement. The child loves animals so much he is motivated to read and make animal movements- thus developing bilateral coordination, motor planning and language skills. I just saw this book over the weekend while visiting the Institute of Contemporary Art in Boston and bought one of the animated horse greeting cards to incorporate in some of the activities my kids do while on the horse.

Wednesday, September 16, 2009

Modified Position Facing Backwards

This child is a lot of fun to work with-not only does he sing with me, and smile a lot but he tolerates me as I try out different positions. He has cerebral palsy and I started out today's session with a facing sideways position. Then as I was about to transition him to weight bear facing backwards-decided to try this position with his left hip externally rotated and right hip abducted. It broke up the spasticity and his arms were a bit more relaxed than usual. Then I reversed the leg position. I only spent the last 5 minutes or so facing forwards, because he tends to go into a posterior pelvic tilt and slide. I thought his head control was better while doing sit-ups probably because I put this pillow under his head, shortening the time he spent transitioning from sit to supine. I would love any PT feedback on working with kids with CP since my expertise is working with kids on the autism spectrum. But I have to say I love working with this particular little boy.
Oh, at the end of the session-he was able to reach for balls bilaterally (in front of him) and shoot into the basket at his side. The body suit is a big help in increasing postural control and hand skills.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, September 14, 2009

Horse and Child Relationship

A two-year old became afraid of a very experienced and sweet hippotherapy horse because the horse was shaking his head to ward off flies a month ago. The little guy grew so afraid that I had to take him off toward the end of the session. The next two sessions he was given a different horse and now a couple of weeks later was given the original shaking horse today. The child remembered his fear and the horse seemed to be shaking his mane more during this child's session (as compared to the kids I saw earlier in the morning) . I am wondering if the horse was shaking to see if he could induce a reaction much like a little kid would who is testing others. It almost seems like a personality conflict and I am going to request a different horse for next time.
On a more positive note, an almost 3 year old child with Down's Syndrome spontaneously pulled the reins to stop- a first and he was highly motivated to drop hoops rings over a cone. He was first sitting facing sideways and then I turned him around to sit facing forwards and he wanted to keep doing it. This was wonderful because he usually throws toys onto the ground instead of using them functionally. I put the toy pony shown in the picture at the left, inside the top of the cone so that I could hold the toy pony very close to him, almost guaranteeing success. This photo shows the hoop and pony toy that I used but today I positioned the pony stick in the opening at the top of the cone and so that when the child put the hoop over the pony toy it fell down the cone.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Wednesday, September 9, 2009

Desensitizing Heidi for Hippotherapy

My riding instructor Maria Hurley demonstrates how to desensitize a horse for hippotherapy
I used letter form boards today having the child pull each letter out of the bag attached to the horse. One almost 3 year old did a very nice job pushing the letters into the corresponding shape boards that I put on the horse's croup. This promoted weight bearing which he tends to avoid.
Another child with cerebral palsy did 2-3 sit ups and then refused to do more until I put a squeaky ball on the mane. Then each time he pulled up, he reached to press on the ball to make the noise. He loved this so much he asked to do more and ended up doing more than 10 sit ups ( with assist as he grasped our thumbs).

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Tuesday, September 8, 2009

I found this short video on youtube of a child kneeling. I am impressed that she is so cooperative given that she needs to work really hard to control her trunk.
I can get several of my kids into a quadruped position while grasping the handle. Its very exciting when they will grasp my hand (and the sidewalker's hand) to hold a kneeling position. It looks like the facility in this video has the same problem I have- a small arena with a lot of walking around curves. I wish I had an indoor with long straight lines to practice challenging positions such as kneeling before doing them on curves.

Hippotherapy Ideas

I am always thrilled to hear when others are benefiting from this blog!!! I will be presenting on hippotherapy at the Massachusetts OT conference in October as well as for the OT class at Salem State college and the OT dept. at Hogan Regional Center last Friday in October. These last 2 events are not open to the public. However if you are an OT in th greater Boston area you may call the OT dept. at Hogan to get info and attend their monthly support meeting (last friday of the month) for OT's interested in developmental disabilities.
My presentation schedule is at:
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist


lshelley said...

Hi Barbara-

What a great line "The best thing about hippotherapy and the kids with autism is that I have all these great sensory reinforcers at my fingertips and they can't run away from me."

I volunteer at a farm, and I love seeing your props and creative ideas put to such good work, and you are right, they can't run away!


Thursday, September 3, 2009

Wednesday, September 2, 2009

Weight bearing and posture

This little guy who has cerebral palsy did great today. I'd like to think it was due to all the weight bearing activities. Shown here- he is bearing weight on a vibrating pillow (he is facing backwards). But I think part of this picture of erect posture is that he is wearing a body suit.
He also had better control while performing a ring stack type activity.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Saving Ben: A Father's Story of Autism

Check out the article I wrote about a Father's quest to help his son overcome autism.
Saving Ben: A Father's Story of Autism

Thursday, August 27, 2009

Here Comes the Sailing Bride

Here Comes the Sailing Bride
My sister-in-law started her marriage off with a vestibular sensation. check it out!

Monday, August 24, 2009

Horse at Olcott Amusement Park

This is the only horse in my life this week. We went to my sister-in-law's wedding in this little town called Olcott, on Lake Ontario. Its in New York.
Tomorrow we climb a mountain in New Hampshire and will stay at the Mitsvah hut. This is my first time climbing and then staying in a hut on the mountain.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Wednesday, August 19, 2009


A big part of hippotherapy is helping children who have gravitational insecurity or fear of being off the ground. By positioning the basket off to the side and downward this little girl has to Reach Out Of her Base Of Support or ROOBOS. She has made huge gains since riding and can now turn from forwards to sideways to backwards and around forwards again with just some verbal prompts.
Connecting these pop-it-beads is always an interesting motor planning activity since so many kids attempt to connect the bead while stabilizing from the bottom of the chain rather than grasping the bead that is being connected. Some kids can attach them after having their hands repositioned, but others do not yet have the hand strength. I think this is overall a great activity to work on strenght, motor planning, sequencing, bilateral hand use and balance.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, August 17, 2009

Saving Ben: A Father's Story of Autism

I wrote a bit in the previous entry about the book I was reading called Saving Ben: A Father's Story of Autism. Dan Burns the author sent this photo of Ben doing some type of equine therapy (not sure exactly what type) but this is a child (actually now an adult) who enjoys sensory stimulation whether riding a horse, hiking or cycling.

Occupational therapists will find the description of the home based sensory integration he had when 3 years old pretty interesting. Rather than talk more here- please visit my Amazon book review at:
Amazon Book Review
I will also be having a review on the same book written with a focus on occupational therapy issues in the Advance for Occupational Therapists magazine. Obviously, I loved this book. It was well written and has a lot of important information for those of us in the field and with family members affected by autism.
Oh, here is Dan Burns' web site: Saving Ben Book
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Friday, August 14, 2009

Saving Ben: A Father's Story of Autism

Dan E. Burns, the author of Saving Ben: A Father's Story of Autism sent me a copy of his new book so that I could write a review. I am so glad because even though there are plenty of memoirs on the autism parenting experience, he is a really talented writer and I always find that each memoir has a different perspective to offer.
I am only halfway through the book, but in this case the boy has severe developmental delays and at five years of age the parents suffer through- screaming, lack of toilet training, stripping and an overall unwillingness to cooperate doing anything for himself. Now the father has discovered that behavior modification can make a big difference in his search for a "cure". I don't believe that autism can be cured but I do believe that the person can be helped to lead a happy and productive life. Even Temple Grandin who is obviously successful, is not "cured".
However, a few thoughts- I come across parents during my hippotherapy work who have syrupy sweet voices even while saying "no" as the child throws a toy and wonders why the child has these behaviors. I try to role model being firm. My voice gets angry when the child tries to pull my glasses off or throws my activity on the ground and then I make them do the activity (hand over hand) one more time. After that I try to find something they really enjoy, (like popping bubbles while we walk), can do successfully and follow up with a rewarding trot.
I always want the kids to get a lot of sensory stimulation with trotting, weaving and going up and down hills no matter what, so I often start out the session with these and toward the end of the session do something less desirable (such as lacing a board or closing buttons) and give an additional trot afterwards. I also like to have the horse walk, stop for the child to do a brief step in an activity (such as put a ring on a stack) and then walk again (movement reinforcement again). All that stop and go provides its own wonderful sensory input.
These are just a few thoughts spurred on by this book and I will write more when I finish reading it. The best thing about hippotherapy and the kids with autism is that I have all these great sensory reinforcers at my fingertips and they can't run away from me.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist


In reference to the video about the study at Washington University

Karma Anais said...

Too bad they called it horse therapy and not occuaptional or physical therapy using equine movement or OT or PT using hippotherapy as a treatment strategy. The continue to confuse riding for people with disabilities with medical treatment that incorporates equine movement.

Certainly Tim's work is phenomenal and he's an OT! Go OT!

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Yes, by calling it "horse therapy" it makes it sound like they are treating the horse rather than providing OT. PT or SL therapy. They used the term "hippotherapy" at the beginning and at the end of the piece and "equine therapy" a few times during it, as well as using the term "horse therapy" several times. They probably thought that they were making it easier to follow by using these terms but unfortunately, I think that made it more confusing for people unfamiliar with equine assisted therapies to understand the differences.

Wednesday, August 12, 2009

Working on Snaps

I missed work on Monday due to an eye swollen from a sty. On the bright side, I wore my glasses instead of contacts today and needed to use these clip- on sun glasses. I asked the children to open and close the snap. Usually I have them open and close a zippered glasses case when I need my sunglasses. A few children successfully opened and closed the snap and I think some will be able to learn this with practice.
One boy with autism thought that my ring stack with vibrating toy inside was hilarious and laughed throughout the activity. He needed less cuing than usual to continue the task by picking up rings that I placed in front of him (while facing backwards). I put the rings inside the cat bed shown below and we were able to manage this while the horse was walking. This was rewarding since the child I saw before him fell asleep one minute after being positioned on the horse and she ended up leaving after a ten minute trail walk.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Thursday, August 6, 2009

Wednesday, August 5, 2009

Using Cat bed for adaptations

I passed this luxurious cat bed for sale at a drug store for six dollars and thought that it would somehow be useful for hippotherapy. My cat prefers to be on my bed anyway.

This child is on the horse facing backwards. I dumped the puzzle pieces into the bed so they wouldn't get lost and used the bed to support the puzzle. I also used the bed as a work surface (over the horse croup) while a child connected button squares.

But trying to use the bed to hold tactile balls was a disaster, since the balls easily fell out. I am going to sew some type of bag inside to hold objects in place. The kids love the soft material. When I fold the round bed it works well simply as a pillow to bear weight on while the child faces backwards or forwards.
On another note, a child who is tactile defensive was willing to put all the tactile balls back inside a bag (shown below). Another child with gravitational security was willing to reach high up the mane to pull off pins.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Monday, August 3, 2009

Using Tactile Balls for insertion Task

I knit this small bag and clipped it to the tack today. I was able to design the bag so that the opening was just big enough for children to insert balls, but small enough to keep them from easily falling out.
Then I collected the many squeeze/stress/tactile balls bought over the years.

It seems that children either love or hate these balls. They definitely are fun to use in placement activities when the child is not tactile defensive. Some kids actually cried when I put them in their hands.
Other children enjoyed inserting them into the bag as part of a squat and stand sequence or rotating to reach the bag while facing backwards.

On another note, a little guy who is usually very happy and cooperative was frightened to the point where I took him off the horse, because the flies were making the horse shake so much. I just hope that he doesn't have a bad association now when he comes to the farm.

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Thursday, July 23, 2009

Promoting Language with Movement

Parents will sometimes tell me that their child only talks during the hippotherapy session. A frustrated mother was stunned when I told her that her two year old spontaneoulsy pointed to the sky and said "airplane" and repeated many words including some of the vegetables (paper ones) that she fed to the toy bunny.

I suggested that she put her child in a bicycle seat and try to combine movement with language prompts. Movement can also be offered while in a child carrier or pulled in a baby/toddler sled. Encourage language by:

  • Stopping periodically to point to and name objects such as cars houses and flowers. Encourage imitation.
  • Babbling while walking and waiting for imitation.
  • Say "look!" and point. See if the child names what she sees. Offer choices- "Is that a dog or an elephant?"
  • Bring small items that can be named (i.e. doll, spoon, book) and pull one out now and then and say "what's this?" If the child doesn't verbalize the word, help her to sign it before handing it over.
  • Sing songs leaving off the last word or sound for the child to repeat- "Old McDonald had a farm, e i e i ________

I am not a speech therapist (I'm an occupational therapist) but I see how much benefit movement brings to speech production. Why work on this once a week during hippotherapy when you can encourage speech with movement every day? In addition, after the hippotherapy session ends- encourage some functional movement so that your child can benefit from all that stimulation. Check out these ideas:

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist

Friday, July 17, 2009

Purchase Hippotherapy Games

I recently came across this site that sells games and activity centers designed to use during hippotherapy. They use lots of velcro and magnets and weigh the materials so that they stay in place.

Check them out at:

Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist