An Amazing Young Man

A young  man with blindness due to Septic Optic Dysplagia SOD -named Anton Sviridenko, not only enjoys  therapeutic horseback riding, he dances the Tango, skis and is an incredible musician.
  

I never heard of SOD before but here is the info page on Anton's web site.
http://sites.google.com/site/santonmusic/home/septo-optic-dysplasia-sod

Supine using boppy pillow

I like looking through the youtube videos and getting ideas. I have had clients supine with knees flexed and feet flat on the withers, but I like the idea of using the boppy pilloow to help maintain that position.

The difference between therapeutic riding and hippotherapy

The woman in this video does a nice job explaining the difference between therapeutic riding and hippotherapy.

Vacation Time

I am on vacation for 2 weeks. No horses to work with but we are going back to Myakka state park  in florida where I made this video last year. It was sooooooo cold there last January.

Candy Cane Ring Stack

I hope that you can make out what this photo shows. (I cropped to hide her face and ID the facility). Attaching the rings to a candy cane shaped ring stack adds a nice motor planning challenge. I also attached a massager to the bottom  so that the activity vibrates making her more aware that she needs to stabilize with one hand while working. A couple of kids did this today while standing on top of the horse.

We had a bit of a warm spell today so worked with no heat and were allowed to go on the trails, opening the indoor doors without costing a fortune in heat.It was exciting after being indoors for the past 2 weeks.

Reaching to Place Ornaments

I like the activity on this OT's blog. She has the client reaching (working on balance) to place the ornaments. Very seasonal!
Hippotherapy with a christmas tree

Pediatric Seminar

Check out my upcoming pediatric seminars in Aprilin Syracuse and Buffalo New York.

http://www.iedseminars.org/bro.cfm?seid=XOS1S1-SYR

http://www.iedseminars.org/bro.cfm?seid=XOS1S1-BUF

End of Year bonus

An interesting observation-
My husband works for a business and I work for a nonprofit.
He gets an end of year bonus. I get a letter asking for a donation!!

Suspended toys

This looks like a creative setting. I like the butterfly lady (or is she a fairy?) and love the suspended toys.

Bells Season

I guess it's the season for bells which is great because I am always trying to get my little clients to make that B sound- bubbles, ball, Barbara and now bells.
The little boys are very motivated to pull the reins and stop in front of one of my vehicle pictures. (I have an airplane, motorcycle, train, fire truck, back hoe, pick up truck, train and airplane). Most kids are not eager to pull the reins and stop, but stopping to see one of the pictures is a big motivator and then I can working on having them say go. My higher functioning kids can follow directions such as "do around the world and stop in front of the train picture".

Dog and Dolphin Buddies

check out this awesome dog-dolophin relationships!

Retts Sydrome

I think that girls with retts can benefit from all the sensory input provided during hippotherapy.....
http://www.brighthub.com/mental-health/autism-pdd/articles/98098.aspx

Horse Coloring Pictures

I came across these horse themed coloring pictures to print out. enjoy :)

http://www.angelfire.com/tx4/horselovers/coloringpages.html

Basket ball posting

I found this small basketball game at a yard sale. I find the sounds rather annoying but the kids like it. It gave us something fun to do while on the trail and some kids were motivated to pull the reins to stop as we approached the toy. This little guy did great posting to insert the ball.

Another little guy with mild hemiplegia demosntrated good postural control to string large shapes while standing on top of the horse.

Here's an interesting article about using horses as life coaches
http://www.newburyportnews.com/lifestyle/x970729172/Listening-to-the-relationship-experts

Two new clients (a 5 year and 6 year old) had initial sessions today. The parents decided that they liked hippotherapy and plan on coming back in the spring. I will stop for the winter at Stone Ridge farm in Haverhill, Mass since it is not heated and I will continue one day a week at another farm that is heated.  The 6 year old who has autism followed directions really well and loved all the movement (as expected). When he got off the horse, the first thing he said to his dad was "piggyback" and up he went again on a different mammal.

Activities for Student's with Rett's Syndrome

Stringing while standing on top of horse

Two kids did fantastic today standing on top of the horse while stinging donut shapes (flat plastic pieces with holes in the center) on a cord attached to the tack handle. A 2 year old who has downs syndrome actually did a better job sequencing the steps to insert the cord through the donut shape and grasp the cord tip so that the shape falls down- than she has done while sitting on the horse. I think that she realized that I was too busy keeping my hands on her ankle and gait belt to help her use her hands, so she did it all herself. I was very impressed.

   

Ring Stack Pole

I like the pole with three dowels for rings. Maybe my son will make one for me......

Standing on horse for first time

This little girl does something new and daring each week. This video shows the first time she stood on top of a horse. Today, she demonstrated good postural control to go up and down steep hills while facing sideways and touching named body parts with one hand. Another postural challenge I like to do is having them give the side walker high fives as they face sideways (facing me) as we walk in circles. Then they have to rotate to reach behind to give the high 5 and this tends to improve their sitting posture. Its also amazing how movement and motivation help this little girl's speech volume and articulation improve during the 30 minute sessions.  

comments:


kjo0521 said...

I really enjoyed reading the blogs discussing the application and use of hippo therapy. I am a OT student in upstate NY and have been involved with horses most of my life. I have participated and volunteered at several programs, and one thing I would like to see changed or improved is the activities included in these programs, to increase the amount at which therapists challenge or push the individual. Many programs allow the individual to walk around on the horse, but I would love to someday run a program which challenges horse and rider. I believe the application of hippo therapy and the activites come with experience, while at first I may also be worried about someone falling off, however I think to get a true therapeutic experience, new challenging activities must be included

Thank you Michele for some very good questions. The activities I choose to do are based on how receptive and able I feel the child is. Many of my children are very young (between 18 months and 3 years) and a big part of therapy is having them separate from their parents. Some are afraid of the horse and others take to it right away. The older kids (over 3 years of age) are usually more willing to try more challenging activities such as standing on top of the horse more quickly, but it all depends. One almost 3 year old is terrified of lying supine on the horse but will stand on top and play with my toys.
Parents have told me that various activities have improved sitting and standing balance and gait. I often see improved speech and visual attention than they might have otherwise and I have been told that this is the only time they speak.
I have also been more daring over the years.When I started I was terrified of a child falling off and barely let them move and now I push and push. So it comes with time and experience.As far as carryover goes- I sometimes recommend that the parents do specific fine motor activitiesat home and practice holding some positions such as kneeling and quadruped on land to make them more familiar and receptive to holding these positions while on the horse. 
I can't say how much carryover there is but it is certainly good for the child and the paretn to know that they have these abilities while on the horse and that they can strive toward carryover at home.

Michelelynne15  has left a new comment on your post "Pushing Kids to Develop Skills":




Thank you for all of the great hippotherapy ideas! I am an occupational therapy graduate student and know very little about hippotherapy- I guess I have been pretty close-minded about it until now after reading your blog. Before reading your blog I pictured the children riding the horses in circles to develop self-esteem/confidence and postural stability. I never knew all of the benefits and activities involved! I am astounded from the fact that you can get the children to stand on the horses; what a fear to overcome!

We recently just finished a case about autism and just reading your posts about all of the sensory stimulation that is involved is very interesting! How long did it take you to encourage the 2 year old with gravitational insecurity to stand on the horse? Did you use any preparatory methods prior to having the child stand on the horse? How do you ensure carryover of these activities at home?-- I know horses are normally not a part of a child’s natural environment so I was wondering if the children are able to generalize the activities and continue their overcoming of gravitational insecurity into their daily lives. Thank you for any insights you can give me!



-Michele, OTS

Pushing Kids to Develop Skills

Its quite an art to push a child just enough to move out of her comfort zone and develop skills but not upset her too much. I have been having a great time with a little 2 year old with Downs syndrome who enjoys working with me and being on the horse. She tolerates positions she does not like-ones that take a great deal of postural control. She can maintain the half seat position on a hill and quadruped grasping the tack handle with total assist while I quickly sing or count to 10. She enjoys standing on top of the horse but today she squatted to place a magnet into a can opening. My goal is to have her use both hands to remove one magnet from several and then squat to insert it into the can. But for now I just hand them to her one at a time.

Another older client did this for the first time today- beautifully with very little assistance. I also helped a 2 year old stand on top of the horse today for his first time and he didn't mind at all. In fact, I was able to let go of his legs and he was fine. Next time I will give him the Velcro bottle activity to do while standing on top of the horse like this little girl is.    She is a pro! 

Tossing rings while prone over horse's Barrel

We all had lots of fun today, another beautiful day even though it is November.

This 5 year old was very focused while reaching for and dropping the rings over pails and is getting very comfortable (gravitationally secure) moving in this position as we weave around the pails for him to drop rings over.

He and another 4 year old did a fantastic job steering around the pails- first with physical assist to maintain a bilateral grasp on the reins,but then with only verbal cues or independently.

Walking quickly up and down a short steep hill while facing sideways was also a great trunk strengthening  and balance activity.

Hippotherapy and autism

I like how this mom explains that her son who has autism is more focused and social due to hippotherapy

Up and Down Hills

Going up and down hills is great sensory stimulation and I love the hill at the Stone Ridge Farm in Haverhill because we have a nice wide area to repeatedly go up and down. This gives my clients practice going into the half seat position going up and leaning back while going down. This is great for postural control, strengthenging and teaching them to follow and remember directions.  I don't know if you can hear this little girl say "uphill" and "downhill" but she was repeating my words.Maria Hurley owner of   Divinity Farm in Groveland and coordinator of this hippotherapy program is the side walker.

Cute video

I would have loved to compare his gait after the treatment with the gait before riding. But I like how this video shows a variety if activities that he seems to be enoying.

Weighted ball exercises

                                                                                            

We did some strengthening work today with a weighted ball. I love the sensory feedback and how the children must use both hands to hold it. This little girl did some exercises with the horse stationary. Another client was able to move the ball up and down with the horse walking and holding the ball seemed to improve his body awareness.

Unmounted Equine Activities

I like the many activities in the article "Unmounted Activities for Rainy days: in the NARHA Strides magazine:
http://www.omagdigital.com/publication/?i=47188
Activities include:

• Making collages from old horse magazines
• Drawing of horse themed activities to color
• Equine themed decorations
• Equine board games
• Cooked and uncooked horse treats
• Play "horse and rider" with the rider leader around the blind folded child who is the  "horse"
• Play "Mother May I " but instead of using those words say "Walk on" and whoa".

There's lots more activities in the magazine.

Quadruped

Two more therapists shadowed me today, actually one led the horse and the other side walked as part of their training. I was amazed that my 2 year old with athetosis is getting so strong - he can sit grasping the handle with enough control for me to briefly take my hands off his shoulders and trunk and just press down on his thigh. Two months ago I had to wrap my arms around his shoulders to stop his arms and trunk  from flailing.Maybe he just likes it more and is cooperating, hard to tell.   His mom told me that the PT is working on maintaining a quadruped position (on  the floor and since I had a PT side walker-decided to give it a try. He cried but did hold a quadruped position with horse stationary . The PT held his hands on the anticast handle, some support under his chest while I held his legs in position-for about 10 seconds. It was awesome!

Shadowing therapist

It was fun having a new therapist shadow today and it turned out that she had previously worked with my new almost 2 year old client. He did very well as long as we kept moving and he also tolerated being stationary while popping bubbles.
The highlight of the day was having a two year old stand on top of the horse as she manipulating the velcro bottle. This involves grasping the bottle handle with one hand, pulling toys off with the other and inserting them inside. She has done this before while sitting but it was a first having her do it while standing. I love seeing kids do this while standing on top because the fine motor activity takes their attention off the fact that they are standing on a horse and they seem to realize that I am so busy keeping my hands on them that they are more willing to do the activity without any help from me. 

http://www.brighthub.com/mental-health/autism-pdd/articles/89954.aspx

Sitting on a Whoopee Cushion

Happiness is strengthening the legs in order to post and then sit down to make the whoopee cushion sound !

After the Hippotherapy Session

A parent reports first time she saw her child bend her knees when preparing to jump......

Kneeling during Walk

A beautfiul day spent in the arena trotting and kneeling and walking up and down hills. My 4 year old client has to work very hard to keep her knees together, tummy in and bottom up while in the kneeling position during a walk and also while stationary as she removed toys attached to a bottle with velcro and inserted them inside. This is a great positon to work on her core strength. She also tolerated prone extension position which she held to the count of ten before dismounting.

A Young woman's Story....

A young woman with a non-verbal learning disability (on the spectrum) explains how she perceives the world. She is so articulate, I think that she can be the next Temple Grandin- a spokeswoman who helps neurotypicals understand social challenges. No surprise- she loves horses!

Tourette's Syndrome

I think that this article about tourette's syndrome is fascinating. I would love to read about research studies of hippotherapy helping these children.
Helping Children with Tourette's Syndrome 

My 4 year old client is tolerating more and more movement that challenges her balance and postural control. Here she is shown pulling pins off the reins but she was also able to reach forward to remove pins high up on the mane. She is learning how to  bear weight on her hands over the withers while going uphill and leaning back while going downhill. She was a bit leery but more tolerant of faceing sideways while the pony made numerous sharp turns and circles around the outdoor arena's jumps and was very brave while trotting facing backwards.  I love doing therapy at Stone Ridge Farm in Haverhill. Everything there is so pretty and Charmer is such a good therapy pony.

The Temple Grandin Movie

I loved the Temple Grandin HBO movie starring Claire Danes. The acting was incredible and Claire Danes had the voice and body movements down perfectly. The plot was based on the book "Emergence: Labeled Autistic" so focuses on the childhood challenges including confrontations with school bullies, a doctor who wanted to institutionalize her and sexist ranchers who didn't want a woman around taking data for graduate school. The movie ends with her realization that the public is eager to learn about autism from the perspective of a person who can articulate the experience. I think that Temple Grandin's success can be summed up with one word- Persistence.

Is this horse real or fake?

I loved the visual perception/illusion exhibit at the Peabody Museum in Salem, Massachsuetts. This was one of several images viewers had to guess as to whether it was a real or fake. Nice paint job on this pony!

Its quite flattering when a 2 year old who has a limited vocabulary (in my presence) of "more", "go", "dog", "bye" and "mom" can also say "Barbara".

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

I really enjoyed this book:
The Best Kind of Different

Quadruped while facing backwards

I seldom position children in quadruped while they face backwards because so many kids find it difficult enough to maintain this position while facing forwards.(which feels more natural)  with the assistancet of the handle to grasp. The child in this video is doing a pretty good job maintaining balance even though she has to work hard  against gravity to hold her head up.

Motor Planning ring Stack

My client did a fantastic job using this new motor planning ring stack that my son just made for me. He attached the pcv pipe into a coffee can with cement and then glued the shown pieces of pipe so that the client has to orient the ring to fit over 3 pipe pieces before it falls down to the bottom of the pole. What I really like about this is that the child can't do an incomplete job because its obvious that the task is not complete until the ring falls all the way down.








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

I like how this little guys parents are sharing his progress with the world. Good job!
http://gas-food-lodging.blogspot.com/2010/08/recent-hippotherapy-triumphs.html#comments

Action Picture Book

It was nice to see my newest kids settle down and stop crying. One little girl enjoyed having her familiar toys attached to the handle and become much more engaged with me  as we popped bubbles. Her mother snuck away after the first 5 minutes and it worked out surprisingly well considering how much difficulty she has had with separation. I think she will be a big success story.
I made this action photo album to stimulate conversation and one 4 year old girl with down's syndrome enjoyed it so much I  used it repeatedly throughout the session between activity transitons. She is doing so well- I am going to discharge her so that she can sign up for a riding group with typically developing kids.

Stone Ridge Farm Outdoor Arena

I love the outdoor arena at Stone Ridge Farm in Haverhill, MA. Its fairly small and quiet with lots of poles to walk around and over. Today, I did some weaving and maneuvering around the poles to challenge a 4 year old's postural control. She loved trotting and was motivated to say "I want more fast please". Her mom reported that she usually has to be prompted to string a series of words, but she did it several times today. Her singing is more fluid and autmatic than speech and she was able to sing along and follow directions to "if you're happy and you know it....give a kiss, make a noise, say achoo. Mom suggested adding "stick out your tongue" to her repertoire. A very good idea.......

Links Toys on Tack

This two year old has difficulty separating from her mom even when the mom side walks or walks in front of us in plain view. We tried having the mom remain unseen but the child cried even more. Tday her mom brought in a favorite toy which was perfect because I could easily clip the links onto the tack handle. With constant movement, her toy, a pacifier and my singing we had some nice quiet moments even when mom was not next to her. I think we will bond a bit more each week so that she can start having fun- with or without mom present. She also seemed to like popping bubbles even though the horse was not moving.

Sequencing: 1, 2 3 - GO

I had a wonderful session with a new 4 year old client yesterday at Stone Ridge Farm in Haverhill, Mass. I thought she would be afraid but her older sister convinced her that it would be great. I am working on improving balance, motor planning and coordination but like many OT's who do hippotherapy- I also work on improving her speech production. She quickly learned to say "go" but sequencing the four syllables to - one-two-three-go is a bit more challenging. However, she did do it one time- horses really bring out the best in people.     

Walking after Hippotherapy

I wish I had time to work on walking, talking and other motor tasks after the hippotherapy session. I encourage parents to take advantage of all the sensory stimulation by engaging in activities afterwards. Possible activities include a bit of ball play, walking, climbing or completing a ring stack. Even skills to point to and name objects seen from the car and singing may improve after therapy- so try to put off the car nap for ten minutes.   
Parent Carryover Activities

The Best Kind of Different

I really enjoyed reading Shonda Schilling's new book about being a mother of four, discovering that child number three- Grant has asperger's syndrome and finally getting a diagnosis (at age ten) that explains his difficult behaviors. Finally the door opened so that she could receive school services, counseling and support from the local autism organization. As an occupational therapist all I can say is- why did it take so long for the medical and educational professionals to step in? This story is an inspiration.....
   

Survived another heat wave day on the farm.I have a new 2 year old boy who is cute and sweet but physically exhausting. He is athetoid and flailing so much I have to hold his shoulders in place so that he doesn't inadvertently whack me while I am also trying to keep his hands down on the handle or mane. I also did this while he faced backwards. He actually tolerated facing BW and side ways pretty well but still it is physically tough for me to maintain him in a stable position. It was better with the volunteer stabilizing one shoulder and hand over the croup while I held onto his  leg and gait belt as he alternated between putting weight on his hands and lying down- which seems like pretty good exercise in itself. He also briefly tolerated prone over the horse's barrel. This child did not seem happy during any of this touch - so tactile defensive but his parents said that he yells and cries throughout his other therapies. He didn't cry with me -so I guess the hippotherapy is the least aversive. Hopefully, it will become fun. I am so into having fun......

Check out my new article in The American Hippotherapy Association Magazine:
Therapy Share: Lacing Shapes Activity

Tall basketball hoop for trunk rotation

I like how the child is facing  backwards and using a tall basketball hoop that promotes trunk rotation.

One of my favorite little guys turned three this week and finished hippotherapy paid for by the early intervention program. His grandmother baked treats for all the staff-which shows just how much families appreciate what we do.
A little girl who was never able to do sit-ups without some physical assist- today lied supine reaching above her head with a magnetic bingo wand to catch plastic fish and then sitting up with just verbal cues. I have used this activity before- attaching paper clips to the fish, but today I hid them on the trail, so she could find them and then made her do sit-ups to catch each one as I held  them above her head. Motivating with activities is what occupational therapy is all about...... 

Props used during hippotherapy

I like the use of shakers (or whatever they are called) to work on following directions, body awareness,  balance (riding without holding on) and bilateral hand use.

Misty of Chincoteague

I have been thinking for several years that I would love to visit the wild ponies that live on the island of Assateague--a 33 mile long island off the eastern shore of Virginia. I recently came across the book  "Misty of Chincoteague" by Marguerite Henry--the story of a wild pony named Phantom and her baby Misty, descendents of the ponies who landed on the island during a Spanish voyage to Peru. The ponies won the hearts of a young brother and sister. It turns out that this is a children's book with exquisite illustrations that remind me of Robert McCloskey's "Make Way for Ducklings" as it transports the reader back to a simpler time and place. Now I am more inspired than ever to travel south, camp and see the island's wild ponies.

Finding Horseshoes

Finally a cool, drizzly day, my favorite weather for working outdoors.

I cut some horse shoe shapes out of plastic orange juice and laundry bottles and placed them along the edges of the trail. These were perfect because I don't care if they get lost-they are so easy to replace. One little girl immediately got excited when she saw them, pulled the reins to stop and I handed them to her to place in the folding basket attached to the tack. She posted to reach for them on the mane and tolerated lying down supine while grasping the toy and doing a sit-up before placing them in the basket. This was great because she ordinarily does not like to do sit-ups and will use her elbows to make it easier, but couldn't "cheat" with the elbow trick while grasping the toy. This gave me the idea of incorporating sit-ups into the "pull the clothespins off the mane" game. A different girl lied supine, sat up , then reached for the pins on the mane, inserting them into the basket, repeating the entire sequence about 8 times. We both found this a lot more fun than doing plain old sit-ups.
Barbara
HorseOT.com

Great essay!

I especially like the essay at the end of the video!

Heat Wave

It's so hot- I considered calling in sick knowing that I might get heat stroke. But I survived. This little girl spoke for the first time during her 3rd session. She said "TAIL". Usually the first word is "go" or "more", so I was quite impressed and took a picture. She loved my  game called "touch the ball and it will squeak" and she does a great job reaching for it. 

Another little girl requested that we play "what is mommmy doing?" This game involves my asking silly questions such as "Is mommy fishing"? or "Is mommy climbing a tree?" "Is mommy mowing the grass?" and eventually I ask "Is mommy waiting for you?" This seems to reduce separation anxiety and entertains all of us at the same time.  

Brain Gym Articles

I try to incorporate crossing midline during hippotherapy activities. Part of the warm up exercise routine is to touch the right hand to left shoe and left hand to right shoe. I sometimes addg touching body parts such as "touch your right hand to my head (I am on the child's left)" and "touch your left hand to the sidewalkers head". Then I may add different body parts in the directions such as touching our ears, shoulders, etc.I like the Brain gym activities that focus on crossing midline-as I wrote in these articles.....
Brain Gym Lessons 

Brain Gym Exercises

A perfect day-weather wise. Both an almost 3 year old who has gravitational insecurity and a 4 year old with Down's syndrome surprised me in that they were willing to be positioned prone over the horse's barrel (like supergirl) while putting large rings on the cones. Then they both tolerated holding onto me while in this position as we walked around the arena.
Although I am an OT, I work on lot on increasing speech output and started to use hand over hand clapping to encourage use two words consecutively - such as- "more trot". A little boy who is highly distractible can repeat each single word after me and I think he is starting to connect clapping his hands two times with my expectation that he accompany each clap with a word.  

Toy animals on trail

Another staff person put toy animals out on the trail. the pony shown in this photo is on the tractor. I have been wanting to do this for years but was told that the toys would disturb the horses. I don't know how she got permission to do this but it was fantastic. The children loved looking for the animals. I asked them to pull the reins to stop when they saw a toy. One little girl was able to stop and then show the toy animal her "tricks" including: sit ups, push ups, posting, around the world arm circles and touching right hand to left foot and right hand to left foot. 

Its scary to think of what can happen when horses are following each other so closely and one is leg by such a small child. But some of the children seem to really benefit from copying the others, although some of the time they are all doing different things. I loved seeing the child at the the very end walk over the poles in the center of the arena to use some of that great sensory stimulation to functional use!

Decreased Head and Postural Control

This video demonstrates how simply walking works on head and trunk control. That helmet looks really heavy for a child working so hard to keep his head up. Maybe one of the lighter foam or cloth helmets would be better. When I took my AHA courses-the PT even suggested no helmet, which sounded like heresy to me.   

All my kids did great today and were enjoying the sunny weather. My star client who has many sensory issues including gravitational insecurity stood on top of the horse while pulling pop it beads off a chain, one by one. She squatted to place each inside the basket attached to the tack. Then she did around the world while standing on top of the horse.

Hypotonia

Here's an article about baby and toddler hypotonia. Hippotherapy is great for increasing muscle tone, especially if the horse has jerky movements. The therapist can do lots of stop and go sequences (half halts),  change speeds and walk over poles to create different movement experiences that might increase tone.
http://www.brighthub.com/education/special/articles/73970.aspx

Cones on poles while weaving

This is such a simple but wonderful activity that makes the child aware of her body's position and need to reach in either left or right directions as the poles change from being on her left to right to left side. This is also a great way to encourage transitions to sitting backwards or sideways as needed to reach the cones. I wish I worked at a place that allowed this type of activity set up.

I can see his  body awareness improving over the session!! One trick I learned is to walk the horse in tight circles so that the child is even more aware that he is falling off to one side and needs to get centered.

Carrying the Saddle

I love how this photo shows this little rider carrying his heavy saddle as part of the tacking up process.Not only is he all involved, working on sequencing steps,  motor planning and following directions but he gets all that great proprioceptive sensory input.

Photo: courtesy of his mom Stacie at: http://smithscooptexas.blogspot.com/2010/05/smith-boys-saddle-up.html

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Gross Motor Activities that Help Children with Autism Improve Visual and Visual Perceptual Skills

Fine-Motor Activities that Help Children with Autism Develop Visual and Visual Perceptual Skills

Around the world while standing on the horse

I had a good time working with an almost three year old today despirt the rain and cold. She is now able to stand on top of the horse and step to change directions in order to see the animal pictures hanging on the walls while we provided support to her trunk. She is quite gravitationally insecure so it was great that she was willing to do "around the world" while standing and sitting on the horse. She was also able to take the toys off the "vekro bottle" independently while standing on the horse which mostly contact guard.
Barbara Smith, M.S.,OTR/L
HorseOT.com

Adhd & Vision | LIVESTRONG.COM

"There are lots of ways to work on visual skills during hippotherapy"

Adhd & Vision. Children with attention deficit disorder, or ADD, may have visual problems that are structural, functional or related to how the brain interprets or perceives visual information. H...

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Great Peg Pole Activity Set-up

I love this set up of pegs on a pole so that the child can reach different heights working on reaching out of his base of support (ROOBOS). I work with some clients who could probably do this while kneeling or possible while on their belly over the horse's barrel reaching out like Superman. A great activity such as this is versatile and used in many different ways-including teaching cognitive skills such as counting and color matching.

Photo is used with permission from mom and photographer Melanie on the BaetenFamily.blogspot.com  - blog.

   

Barbara Smith OTR/L
HorseOT.com

The Top Two alternative Treatments

Check out Dr. OZ and a pony!
http://www.doctoroz.com/videos/top-2-alternative-treatments

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I didn't do any hippotherapy this week because I was presenting at the Massachusetts Alzheimer's Association instead (nothing to do with hippotherapy). So here is an interesting video instead where a mother explains how hippotherapy has helped her son. I am sooooooo jealous of the mailboxes lined up along the arena. I wish we could have those but the indoor is too small and crowded.

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Ignore this video

This youtube video is titled: Ignore: Hippotherapy- but I think that she did a really good job. I always find snippets of new ideas from watching what others do. I had never thought of asking the child to do an exaggerated arm swing while on the horse to prepare them for walking, but from now on I will add that to my list of exercises.

1 comments:
gina taylor, OT said...
Since this is in South America they have different safety standards and access to safety equipment. However, there are still some serious safety issues with backriding and being mounted without a helmet! I too, found the little girl standing interesting, but for different reasons- the horse was standing still!
Gina


I agree with Gina that backriding is quite risky. I never do it and the American Hippotherapy Association recommends NOT to do it. The therapist is most at risk of getting injured and the redistribution of weight can cause back problems for the horse. There are other ways to compensate for low muscle tone and weakness.

I often have my small children stand on the horse while the horse is standing stationary but still shifting around in place.. The horses where I work are so laid back they can stand in one spot for quite a while. Sometimes I have the child do fine-motor activities while standing on the stationary horse and the more advanced children may stand on top while the horse walks (with the therapist and sidewalker providing stability at the ankles and gait belt. I find it fascinating to see how hippotherapy is performed around the world.
Barbara

I totally enjoyed the scenery, music and activities in this video even though most of them are not wearing helmets. I love seeing the little girl standing on top of the horse reaching for something (not sure what) in the tree. Where I work the trees are too high and we are not allowed to hang suspended activities, but it would be awesome!

I recently came across a web site and blog that provides hippotherapy information and activities. This is awesome sinc I couldn't find this when I started out 4 years ago and we therapists love resources. check out:
Horses can Help
and the following picture game used during a therapeutic riding lesson.
http://www.horsescanhelp.com/2010/03/09/therapeutic-riding-game/comment-page-1/#comment-31

The kids were all happy today despite the hayfever that is driving me crazy and the cold, wet weather. One little 4 year old was not feeling well, so I didn't push her do to a lot. We spent some time letting her talk into my recorder (that I use for notes) and she was totally fascinated with listening to it. Maybe I will be able to use this as a reinforcement down the road in exchange for doing some challenging work with me. Another little girl with balance problems and gravitational insecurity was willing to stand on top of the stationary horse while we played a game of -she gives me high five/ I make an animal sound/she names the animal. I also do a similar game where the child faces sideways facing me, rotates to give the sidwalker a high 5 who then makes animal sounds. Doing this game while walking in circles (child facing outside the circle) is great for building trunk and abdominal strength.
Barbara Smith, M.S., OTR/L
HorseOT.com

I haven't been working at the farm this week because I travelled to PA to give a presentation at Austill's Rehabilitation Services. But I still have horses in my life. Last weekend I met this horse (not to close because he bites!) while walking through Boston.

....and this week I came across this pony working in Philadelphia.

Barbara Smith, M.S., OTR/L

HorseOT.com

Research on Effects of Equine-Assisted Therapies

Parents observe how hippotherapy and other equine assisted therapies help children with autism. But here is a report of some results using evaluation tools that examined sensory processing and social skills before and after treatment. The results are encouraging.
http://www.horsesandhumans.org/HHRF_Final_Report.pdf

Also check out the site that supports this research:http://www.horsesandhumans.org/

Barbara Smith, M.S., OTR/L
HorseOT.com

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Here's a fun slide show-but I recommend wearing a helmet and do NOT lie down in front of a horse!!


Barbara Smith, M.S., OTR/L
HorseOT.com

The Recycling Occupational Therapist is now on Facebook

Come join my Facebook page. I am not sure how that differs from a blog but it seems to be the social trend.......The Recycling OT on Facebook.

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mhorselover said...
The tree faces are a wonderful idea! I actually have one of those on a tree at my house... that just might go missing ; ) What other kinds of things do you think I could suspend from those arches? Would a pole set in the ground with a box on top to hold sand or bird seed be ok? To hide toys in? Then when they birds eat it we can just refill it...

Megan,
I would love to have a mail box to either open and see what's inside or have the kids deliver toy mail. If you have a box with bird seed or sand for a tactile activity-that's cool. You must know pretty well what your horses will tolerate. Where I work they have horses on the trails (not the hippo horses) that don't like new objects- so they don't allow activities like the ones you are looking for. I would look at suspending containers that the kids can insert objects into- maybe objects that they can bat at and make noise, or bat at to make leaves fall, depends on what your horses can tolerate. Suspend a groan stick and they can flip it over. Will think of more....

mhorselover said...
Hi! My name is Megan Manning, I have spent the last couple of days reading through your blog and thought I'd post a little comment here, on completely catching up! I am a registered Therapeutic horseback riding instructor in Texas, about an hour from the big city of Dallas. I am currently studying to get my Occupational Therapy degree. As I was reading through your blog I can across some surprises... Your blog from August 17th, 2009 is a picture from our center! The horse pictured is named Sultan, and he has since been retired, but is still living with us there. The center's name is All Star Equestrian Center you can look us up at allstarfoundation.org. Another neat surprise was from your post on February 18th of this year. I personally know Michael Richerdson. He helps to just a horseshow called Chisholm Challenge for Special Riders that is held every year in Ft. Worth that our center participates in, a long with many other centers. It was neat to see him up there! He judges the trail sections of our horse show for us. At All Star my summer project is to get out sensory trail up and running... so far I have about 6 big arches placed out on a trail. They are about 8 feet off the ground I think... I was wondering if you have any ideas that I could use for the trail? I was thinking about a pool noodle 'car wash' as well as wind chimes in trees, with possibly a tree that has different door bell chimes up in the branches, so you can push the door bell button down on one of the arches and listen for the chime in the trees. Any suggestions you could give me would be marvelous! I will continue reading and look forward to any more new ideas you come up with! : )

Megan,
I'm glad that you are enjoying the blog and that you like the picture of Ben-that his father sent to me. I had written several book reviews on Saving Ben. I love doing hippotherapy with the kids on the spectrum. You may have noticed that most of my pictures are from outside of where I work-that's because I am not allowed to take pictures that show my clients or the farm. But I do photograph my activities without showing the kids. I have lots of ideas about setting up a sensory trail-but another source of frustration is that I can't do this at my job. But I am in the process of starting a new business with 2 riding instructor friends and their ponies.
As far as the sensory trail goes-here are my fantasies-I would place lots of toy animals and take photos of them . Then I would show a photo to the client and ask her to ride and pull the reins when she finds the toy- . You can bring rings along with you on the trail ride and place them over poles or gather rings on the ride and bring them back to the arena to do a ring stack activity. I would love suspended banners or balls to whack. Chimes and noodles-love that idea. I've seen eyes, nose, ears and mouth sets that can be pushed into the tree. Then you can touch a feature and have the child touch her own. Have numbers posted along the trail. Then when you stop there ask the child to do that number of motor acts-sit ups, push ups, post etc. My ideas go on and on, so frustrated.....

One more thought- if I had permission to post photos of your sensory trail on my blog that would be great and then we can all benefit from your creative ideas. I love the photo on your site of the girl reaching for the animals (lizards or something like that).
http://allstarfoundation.org/PICTURES/pictures.html

Barbara

Stabilizing the Hands

I made this for a little boy with CP who needed two handles to grasp to help stabilize and put his arms in some elbow flexion, breaking up the spasticity. This worked very well but the handles are too wide for his little hands. I bought some detergent bottles with smaller handles so I can try it again.

Barbara Smith, M.S., OTR/L

HorseOT.com

Check out this dancing cow boy!

A 45 minute Session

Sessions are typically 30 minutes where I work. But I asked to have a 45 minutes session with one little boy who has CP. He started out with such high tone, I was unable to abduct his hips to even sit on the withers. Here is why the longer session was so important: 10 minutes facing sidways, 10 minutes facing sideways the other direction, 5 minutes facing backwards with hips partially abducted, 5 minutes with a beautiful straddle facing backwards, 10 minutes facing forwards with feet in stirrups and grasping the handle, 5 minutes with a hand activity. He was able to grasp the handle to a bottle while I helped him (hand over hand) to pull off toys attached with velcro and insert them inside. I realize that the bottle was too high for him and if I had a bottle with two handles resting on the anticast handle- his posture would have been almost ---perfect! Now to create........
Barbara Smith, M.S., OTR/L
HorseOT.com

I have mailed out 50 letters to local special education depts., clinics and early intervention programs hoping to generate referrals to my new hippotherapy program at Divinity Farm at Stone Ridge.
Meanwhile, I adapted the anticast I bought with a thick soft piece that attaches with velcro under the handle. The anticast I bought was too large and this makes it fit the cute small ponies we will be using. It was a time-consuming project but kept me out of the potatoe chip bag while watching a movie.

Hippotherapy at Divinity Farm at Stone Ridge

It took 2 hours to drive in today given that one lane was closed for repairs. But the weather got nice and the kids did well even though I was a bit off kilter. I decided to ignore a little girl with Downs syndrome when she threw a toy and this worked well- she seemed disappointed when I ignored her after she said "I'm sorry". After weeks of being uncooperative about position changes- she not only sat sideways but sang ABC by herself while doing so and did a stringing activity while facing backwards.
Barbara Smith, M.S., OTR/L
HorseOT.com

My toy Corner

Here is an example of my day's toy corner items placed on top of my toy box. The cardboard box has a puzzle attached to the bottom section and the box cover has the puzzle pieces attached with velcro. A client stood on top of the horse today as I held up the box cover for her to pull puzzle pieces off. Next I put the box back down on the withers so that she could squat while placing the shape into the puzzle board.
I positioned a child on the withers facing backwards with the blue hippity hop ball in front of her. She was able to grasp the handle as I pushed the ball toward her trunk. After she relaxed a bit her muscle tone decreased and she was able to abduct to sit on the horse's back. Then I was able to position her legs into long leg and cross leg sit. She is an excellent worker and loves hippotherapy.
Another child stood on top of the horse and pulled all the toys off the red Velcro bottle (shown in the photo) and insert them inside. Then she did around the world while still standing on top of the horse and also maintained good posture while the horse walked (we gave a lot of support at the belt).

Barbara Smith, M.S., OTR/L
HorseOT.com

Meeting Lady and Dreamer

I spent the morning meeting Maria Hurley's ponies Dreamer and Lady. Maria is a riding instructor who owns DivinityFarm.com. We will be starting a hippotherapy program with Judy Lawless-owner of Stoneridge Farm in Haverhill, Mass.

Dreamer and Lady seemed like perfect hippotherapy horses, a good size to make reaching easy, smart, obedient and eager to please.

We introduced a few of my many weird toys. One shown here is a ring stack made out of a tube with a squeaky ball attached. Dreamer didn't mind having either the cloth or plastic rings on his body, having them fall to the ground next to him, nor the squeaky sound. Next week I will be meeting Charmer-Judy's horse at Stoneridge farm.

Stoneridge Farm-

I like the indoor arena and if you squint you might make out the view of the riding trails through that back door.
Please call Maria for information at: (781) 771-1565

Peaceful grazing horses surrounded by riding rings and trails.
If you are interested in hippotherapy in the Haverhill, Massachusetts area-please email me at: Bsmithotr@msn.com

Barbara Smith, M.S., OTR/L

HorseOT.com

Kids Refusing to do Activities

I have been working with a 4 year old with DX Downs Syndrome for about a year and a half and she has been refusing to do activities that she used to do willingly. For example, she used to like standing on top of the horse while we played games and turn around to face sideways and backwards. Now these activities scare her. Maybe she is just taller and the issue is her center of gravity has changed or she is becoming more aware of what is being expected of her.
In any case, today she cooperated and she did both of these activities without crying.We suspect it is because dad now waits until after the session to eat lunch. Maybe all the carbs made her tired or grouchy. Are others finding a similar situation with kids refusing to do activities that theyused to do willingly? Oh- she talks about riding the horse a lot while at home and even does half seat on her rocking horse- so I think she basically likes hippotherapy.
Barbara Smith, M.S., OTR/L
HorseOT.com

Weaving Around the Cones Video

This is a nice demonstration of the extra challenge to postural control weaving around the cones provides. I also like doing half-halts, but some horses don't like to move once they stop, so weaving as shown is sometimes the best for postural challenge and also some sensory stimulation for the kids who aren't ready to trot.


Barbara Smith, M.S., OTR/LHorseOT.com

I have used this ring stack in many ways to promote balance, reaching and coordination. The red ball inside a mesh bag attached to the tube with duct tape squeaks helping me to get the child's attention or reward him or her after placement. I attached the orange cone on the bottom. This one is sort of flat on top with an opening large enough for the tube to fit. The cone prevents the rings from falling off. I made the cloth rings by stuffing plastic super market bags inside little girl headbands ( I bought 3 for a dollar). The headbands are tubular and I snipped an opening to insert the bags, then sewed them closed. You can make the same thing with an old sock and sew the ends together. These are great for promoting using both hands to push the ring down since it is pretty hard to do with one hand. I had one girl today stand on top of the horse while using both hands to push the rings down. This was quite impressive because she has increased muscle tone and walks very slowly. Another girl was able to do this while on her belly over the horse's barrel.
Barbara Smith, M.S., OTR/L
HorseOT.com

I love seeing the emotional bond between children and horses in photos such as this one on the Miracles Sudan blog. Read about the charity Jane-Anne established at Miracles-Sudan and learn about the hippotherapy program.

Barbara Smith, M.S., OTR/L
HorseOT.com

A Pleasant Surprise

I live in an area north of Boston where there are many horse farms. I have begun contacting them to talk about starting a hippotherapy program and have been pleasantly surprised at the interest. One farm is owned by a woman who has a son with disabilities -so she has a special interest. Now the trick is to combine- a suitable horse, warm and friendly farm/owner and staff and a nice riding environment-preferably with an indoor arena and trails. It will be a challenge but well worth the time and effort to operate my own business and work closer to home. It seems that hippotherapy is growing in popularity and more and more horse farms have at least heard about it.
Barbara
HorseOT.com

Rotation while Reaching behind for toys

This little guy is reaching for the lacing shapes I put on the horse's croup. I think you can see how nicely he is rotating his trunk, strengthening his abdominal muscles and balancing at the same time. He was able to lace on the cord he is grasping in his left hand independently. A mom with a 16 month old with Down's syndrome told me that the physical therapist has noticed improved sitting balance since she started hippotherapy about 8 weeks ago. I love hearing that!

Barbara Smith, M.S., OTR/L
HorseOT.com