Wednesday, April 29, 2009

Sitting on Withers

You may not be able to tell, but this little boy is sitting on the horse's withers facing backwards. The handle is between the red belt and his forearms and he is putting weight on the stuffed animal. This child has increased tone and decreased hip abduction, so sitting on the more narrow withers is more comfortable. He always sits more erect when facing backwards because as the horse walks forwards his trunk extensors are stimulated. He tends to slump into a kyphotic position when facing forwards and I save that position for the end of the session after he has had some good stimulation in these other positions. Bearing weight on open hands helps to decrease tone.

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

Natural horsemanship

My instructor Maria Hurley is demonstrating what is called "natural horsemanship" . She uses the pole as an extension of her hand and body and as the pony progresses, she will use only her hands and body to give directions. This enables greater trust and communication between horse and human. The instructor can give directions to the horse in this way during her lessons, such as when wanting to speed up into a trot.

I am becoming more aware about how important it is to bond with the horse as I ride or work during hippotherapy. I get so focused on the child and my work that I ignore the horse (which is normal) but when there is no client on the horse, I am spending more time stroking and talking to them.

I have seen misinformation on other hippotherapy websites that I will try to clarify a bit here- hippotherapy is performed by registered/licensed occupational, physical and language therapists. If the facility is NARHA (where I work it is not) certified the therapist must be certified via the American Hippotherapy Association ( I did this on my own). Therefore, some therapists are not AHA certified.

If I were to work at a NAHRA facility, I would be required to have a certified NARAHA instructor leading or working nearby as I worked. If I were to manage to get certified as a therapeutic riding instrucotr (on top of all my other certifications!!), I would be able to work independently at any facility. My riding lessons might help me achieve this as a long term goal. But there is a lot to learn to become a NARHA riding instructor, especially if you are like me, a New York City girl relatively new to riding (its only been 2 1/2 years).

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

Monday, April 27, 2009

Hippotherapy promotes language

A mother of a 3 year old boy on the autism spectrum told me today that he talks all afternoon until dinner after hippotherapy (at 3:00 pm). It is great to hear about the positives.

Another 3 year old finally stopped crying after 5 sessions of nonstop crying. I usually tell parents that the child will get over separation after a couple of weeks, but this child seemed terrified. Finally, the beautiful weather seemed to impact his emotional state and he didn't even scream when the horse sneezed.

My main fine motor activity today was to take blocks out of the basket attached to the tack to insert inside a yoghurt container with a square hole in the center. Some of the kids were able to stabilize the container independently or with very little help. The kids seem to enjoy folding the basket when finished. We did this activity while facing backwards so that there was a bit more rotation involved and a wider work surface on the horse croup.

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

Wednesday, April 22, 2009

Vibrating pillow activities and games

My vibrating pillow has been a lot of fun today. Kids use it to exercise and while bearing weight on withers while in half seat, facing sideways and backwards.

The combination of a fast walk, feeling the vibration and my singing seem to be enough to motivate a nonverbal little girl to sign "more" after I stopped all three of these. She seldom signs without hand over hand assist, but did sign to get these going again with just a verbal cue.

This girl is very coordinated but has leg weakness. She was able to and motivated to stand on top of the horse, squat to squeeze a squeaky ball that I held in front of the handle and then stand again. My side walker and I held onto the belt loops and she did this sequence 10 times.
Other fun games with smart kids who get bored with the same old is taking turns naming animals, places and famous people while holding positions such as kneeling, quadruped or even half flag if they are really high functioning. I usually try to get them to hold less favorite positions such as long leg sitting while we count to ten or sing the alphabet song. By counting or singing this familiar song they know that the activity will end soon.

I realized today that the toy pony on a stick (the kind kids pretend to be riding) fits inside the opening on top of this large cone. One girl held super girl position (head, arms and legs extended) while prone over horse barrel and placed all the rings over the pony/cone.

In addition, I managed to get several kids to make "ice cream cones with their reins. That's very challenging to achieve.

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

Tuesday, April 21, 2009

Riding Lessons at Divinity Farms

I have been riding Bianca at Divinity Farm in Groveland, Mass. The training and knowledge about horses that I am learning from my instructor Maria Hurley is fantastic. I actually have time to get to know Bianca and bond, unlike with the many horses at my job who see dozens of staff and children each day.
Maria is able to control Bianca using only her voice, hands and body, an amazing feat (to me!) which I will try to videotape and post. Although I have had lessons before and trotted, I am finally starting to do it correctly and feel confident. This is all so elementary for horse people, but for me growing up in NYC and relatively new to horses (as of only 3 years ago), its amazing to learn all of this. This will really help me be a better therapist when doing hippotherapy with the higher functioning kids who can understand concepts such as inside or outside legs and do vaulting almost independently.
Maria is an amazing trainer and very patient teacher and has generously suggested that I have a future goal of riding Bianca in dressage events. I never would have dreamed that possible!!!!!
Maria is training her pony Heidi to do hippotherapy work with me in the future, so I will provide info on my web site when that is happening.

Monday, April 20, 2009

My Thoughts about The Horse Boy

A travel writer with a penchant for political advocacy and a tolerant, soul searching wife venture to the untamed landscape of Outer Mongolia with their five year old son whose behaviors would sap the loving intentions of any parent. The objective was to find the Shamans who can heal their son, an exploit that entailed meeting the chairman of the Shaman’s Association of Mongolia, ceremonies where they were spat on with vodka, lashed with rawhide followed by jumping as the ground beneath their feet was whipped, consuming half-cooked, bloody animal organs and traveling to the far north by horse to find the Shaman living amongst the reindeer people.

Descriptions of exotic cultures and Rupert Isaacson’s humor (i.e. “Code Brown” for poopy pants) make this an enjoyable book to read. In addition, the meaning behind an odyssey with filmmaker friends, translator Tulga and numerous guides and horses to carry equipment, supplies and Rowan’s dietary staple of Bacon beckons profound questions. Can the shamans heal Rowan of tantrums, incontinence and social isolation; to stride one leg into the world of friends, play, asking questions and self- control?

Was this a trip to cure autism? A simple yes or no will not suffice. All of the sensory stimulation that Rowan experienced both on the neighbor’s horse, Betsy and their Asian journey contributed to normalizing a nervous system set on high alert. The up and down, forward and sudden halt, side to side movements organize the brain, making a child more available for learning. The heavy pushing on arms, hands and neck while bouncing and jostling stimulate the joints and muscles and the touch and smells of horses and all the other animals in Rowan’s life again work to make an engine like nervous system run at a more normal speed.

But what about the Mongolian culture that accepts those with social differences in sharp contrast to the tourist who took the liberty to tell Rowan’s parents to control their kid in public. We also must not neglect the fact that the mother and father who provided the genetic material that gave Rowan the disposition to connect with animals, spiritual awareness and innate cognitive abilities (reading sentences by age six!) enabled him to blossom given the perfect storm of emotional, sensory and cognitive stimulation.

A story about healing a child with autism is destined to be controversial and strike a different cord in each reader. As an occupational therapist who has eschewed the dictates of school therapies to put joyful children on horses as I work to improve their sensory processing, language and motor skills I wholeheartedly believe in the power of the horse, as a living therapeutic tool. I combine the principles of sensory integration (providing the stimulation that helps the brain get organized to learn) with behavioral modification- saying “fast” will bring a reward of trotting movement and tantrumming will result in the horse stopping. Children who hate to touch objects learn that grasping and pulling reins makes the horse stop so that they can be rewarded with a high five from dad.

I highly recommend reading this book so that readers can experience the intensity of parenting a child with autism, to empathize with its impact on a marriage and admire the force of love that propelled such a journey, book and soon to be movie. May that tourist who so readily criticized Rowan’s parents for not controlling his volume turn red with shame and may the rest of us become a bit more open to those who are different, but all hold the same rights to social inclusion.

One last thought- the author questions whether such children should even be “cured” but instead better accepted in our culture of limited acceptance. Should those with atypical brains (atypical because they are the minority, but quickly gaining in numbers) be considered deviant in the first place? There is a whole “Aspie World” (the term Aspie was coined by Liane Holliday Willy) out there and brilliant minds- such as Temple Grandin’s who think outside the box. As my math majoring 20 year old Aspie said when I asked if he wanted to be part of a research project looking at how students with Asperger’s syndrome are managing in college- “don’t those neurotypical researchers have anything better to do than gawk at us geniuses?” HA!
My Amazon Book Reviews

Friday, April 17, 2009

The Horse Boy

I am still reading The Horse Boy so can't comment much yet. But this book offers an inside view into the lives of parents with a child on the autism spectrum and the horse/child bond that helps to heal him, as the reader experiences an exotic Mongolian locale and culture. Much food for thought.

Thursday, April 16, 2009

Making Water Bottles to Shake

Here is a video that shows how to make the small water bottles that my kids like to shake. they are small enough to fit inside little hands but heavy enough to provide the sensory feedback that helps them to motor plan and increase body awareness. Shaking them requires letting go of the tack handle and working more on postural control to maintain balance.

Wednesday, April 15, 2009

Travel bag on horse

Finally a beautiful day to do therapy on the trails. I attached this bag I made with a clip to the tack. It is so strong it held a ball, two small water bottles that kids like to shake, another bag shown below that I used to encourage weight bearing, a small bottle filled with clothespins and a folding basket.

Reaching into the bag with both hands to take out the activities was great for bilateral hand use, strengthening and balance. I use the two small water bottles (they fit inside the hands) to give proprioceptive feedback while they imitate arm extension airplane position and arm circles. They are really good for stopping new kids from crying.

This child is facing backwards. I knit this bag into a long stocking type shape, filled it with squeaky toys and more plastic bags. At first it was fluffy and worked great in getting the kids to bear weight on it to make it squeak. Then the bags started to flatten out. I need to find some foam and try again.

It also works really well when placed under the child's rear end while they are posting. Each time they sit down it squeaks.

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

Friday, April 10, 2009

Helping Hands

Helping Hands
Fine-motor activities to do during hippotherapy. This article is in the spring 2009 on-line edition of Strides, the NARHA newsletter.

Friday, April 3, 2009

Plastic Bag for Activities

I forgot to mention that the plastic bag shown below is extremely STRONG and seems to be holding up carrying the weight of balls and other objects while clipped at the top to the horse tack.

Divinity Farm

I just started riding lessons with Maria Hurley at Divinity Farm in Groveland, Massachusetts. This worked well for me since it is closer to home and I won't be as tired since the lesson is not on a work day.

It will be wonderful to get to build a relationship with her horse, Bianca rather than riding lots of different horses, although it is also good to get used to the varied personalities. Maria demonstrated her technique of "natural horsemanship" which involves communication using only her body language. She made her horse walk, trot, halt and turn around as she stood in the center of the ring. I wish I could connect a wire to download all that skill and knowledge. But for now I will learn all I can about riding and horsemanship via lessons.

Its incredible that 2 1/2 years ago I knew NOTHING about horses!!!!

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

Reaching into Bag Activities

The scanning activity board that I wrote about last time was very successful this week. It showed me just how bright some of my nonverbal children are as they followed directions to remove ONLY the named yellow fish. I will be doing the same activity asking them to remove only hearts or only stars.

I finally finished making the bag pictured below that I knit out of grocery plastic bags. I think there will be many uses for this but so far I have used it in the following two ways.

I clipped the bag to the basketball stand and stored 4-5 balls in it. Then when I wanted to do a ball activity- I clipped it to the horse tack. The children then needed to reach far to their sides to reach into the bag for a ball, rotate their trunks and toss the ball into the hoop placed on the other side of the horse.
I also used the bag to carry activities on the trail. Now the horses can do the carrying for me. My favorite activities to use on the trail rides are:
  • Pulling clothespins off the mane to insert into a small basket
  • Stretch toys
  • Small bottles filled with water and little plastic pieces to shake
  • bubbles
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist