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

Monday, July 13, 2009

V seat and leg lift activities

I used a squeaky ball to motivate several children today to stretch and move body parts in challenging ways. Pictured here is my instructor's daughter (from Divinity Farm) demonstrating long leg sitting position facing backwards. She is lifting each leg to touch the ball and I squeak it after each touch. She can lift both legs at the same time to perform the vaulting move called V seat. This is very good for developing core strength, balance and bilateral coordination. Moving in and out of vaulting positions develops motor planning skills.

A major success today involved a a little boy who always begins his sessions crying. He stood on top of the horse to touch this ball. I didn't expect him to do it so willingly since he seems to be gravitationally insecure and he always wants the horse to be moving. The horse stayed still as he stood up tall for a good ten seconds.

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

Thursday, July 2, 2009

Bearing Weight to Decrease Muscle Tone

Hippotherapy provides great opportunities for weight bearing on hands to help decrease muscle tone and strengthen shoulders. (sorry, I did a lot of smudging with photoshop to protect the identity of my little friend and where I work). In the top photo, he is facing backwards and you can see that he does not have much weight on his hands. But in the photo below while he is facing forwards using the pillow- a lot of weight is on his hands. His fingers are open and his chest is also more open with shoulders less rounded. Use of the stirrups helped him to maintain this position for several minutes. I am working toward holding this position with some flexion in elbows and knees, so that they aren't locked. I typically hold his feet back to get knee flexion, but I am busy with the camera here.

Sitting side facing with forearm bearing weight on pillow is also excellent to decrease spasticity. I love this position so that I can look right into the child's face while encouraging speech and singing. It's one of the best positions for this type of emotional bonding, but also very insecure for the child because he can't grasp the handle. So you may need to build trust first with some kids before doing this.

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

Crossing Legs for External Hip Rotation

I just love when a child's physical therapist, or ANY physical therapist gives me suggestions. As you can tell, my greatest joy lies in creating hand activities. After all I am an OT!

But this little guy's mom told me that his PT is concerned that he is unable to maintain sitting on the floor with legs crossed. I started out with crossing only one leg and having the other leg (his left leg in this photo) hang down. After a couple of minutes I switched legs and then was able to cross both legs. As we continued, I could feel his hip tightness loosen. Best of all he didn't complain one bit. If a child has a lot of spasticity I often begin the sessions facing sideways until they loosen up enough to abduct the hips.

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