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