ADHD and Hippotherapy
Earlier this month one of our members had asked about hippotherapy and so I thought I would write a post to describe this type of therapy in detail. If you are like me, you might be wondering if "hippotherapy" has anything to do with hippos. It does not. In this case "hippo" comes from the Greek word for horse. The American Hippotherapy Association defines hippotherapy as "...a physical, occupational, and speech-language therapy treatment strategy that utilizes equine movement as part of an integrated intervention program to achieve functional outcomes." This is not to be confused with therapeutic riding which does not involve any occupational, speech, or physical therapies but only focuses upon teaching the child to ride a horse.
Max has gotten a chance to experience both hippotherapy and therapeutic riding so I can tell you a little about both. But before I do, let me explain some of the purpose behind these equine activities. The rationale for using hippotherapy is that the movement of the horse provides sensory input to the child's central nervous system and organizes their attention so that teaching is more productive. The rhythm of the horse's movements can be soothing to many children. The theory is that children who engage in hippotherapy or therapeutic riding can learn to have better balance, postural control, and coordination. With hippotherapy you are adding a teaching component where the child can learn speech and language skills, motor planning (how to sequence and put together a series of physical movements), and/or social skills.
The children who are said to benefit from hippotherapy include kids who have: Cerebral palsy, brain injury, sensory integration disorder, developmental delays, autism spectrum disorders and ADHD.
I bet you are wondering if there are any studies to show that hippotherapy has any therapeutic benefits. The answer is yes but it is very sparse. At this time there are more testimonials than actual research about this type of therapy as it has not officially been around that long. Hippotherapy began in the late 80's and it was only in 1992 that The American Hippotherapy Association was created. Right now there is a government clinical trial underway to evaluate the efficacy of hippotherapy for children with developmental disorders and they are using children who have autism or ADHD as their subjects.
In addition, there is a recent study in the October 2009 issue of the Journal of Autism and Developmental Disorders where they looked at whether there were any beneficial effects of therapeutic horseback riding on the social functioning of children on the autism spectrum. The researchers found that these children did have improved sensory functioning as well as more social motivation and less distractibility. It will be interesting to see the results of further research on this type of therapy.
So what is therapeutic riding or hippotherapy actually like?
When Max was about six or seven we took him to a farm where they offered therapeutic riding for children having special needs. Since it was offered for free to children with any sort of disability we jumped at the chance. I have to tell you that I am not much of a horse lover. They do scare me a bit. And I wasn't sure if Max would also be anxious but it was worth a try. I quickly found out that Max had absolutely no fear of the horses and got right on. They had a small course going through some woods near the farm. There were trained volunteers there; one to lead the horse and one to stay at my child's side. And of course parents were permitted to walk along too. All I can say is that Max loved the experience and smiled up there and was happy and engaged (more alert and paying attention.) It makes sense because when you are riding a horse you do have to pay attention as the horse is moving and you have to constantly adjust your balance. Max also seemed more at ease and calm after his rides. The owner sensed my discomfort with horses and so he enticed me to go for a ride as well. I must say that it was an easy going gentle ride and it helped me to overcome one of my fears. So in our case it was both therapeutic for mom and child!
Hippotherapy is different from therapeutic riding as I have described. Depending upon your child's needs and how much you can afford, there might be a speech and language therapist, an occupational therapist, and/or a physical therapist involved. When we tried this, Max had a speech therapist and an occupational therapist to help him.
Hippotherapy is usually done in a covered arena so that weather is not an issue. This type of therapy can be expensive and you can try to get insurance to cover it but quite frankly I personally have not heard of anyone who has gotten it covered by their insurance. I think we paid around $75 dollars for a 45 minute session but this was years ago. The rates seem to vary depending on where you go.
What sorts of activities might the therapists do during a typical session?
I really think it varies depending upon the age of the child and their unique needs. Some children will work on more motor skills and some children will work on more attentional and social skills. When Max was doing this I remember they would have large cones on the ground along a circular path and Max would reach for hoops to place over the cones. They might have baskets on the path to throw certain colored bean bags into. He learned how to pull on the reigns and communicate to the horse to slow down or stop. Likewise he learned how to make the horse go and to pick up speed to a trot. Max learned to groom the horse and basically how to show affection for an animal.
As the result of our good experiences, I would recommend either therapeutic riding or hippotherapy to other parents. As I see it, using a horse is just like using any other therapy aide or tool, except a horse may even be better because your child can develop a relationship and bond with the animal. Will it cure anyone? No I don't think so. But I think it is a fun and motivating way for your child to receive therapy.
Where to find more information:
- Equine Assisted Therapy Programs by State
M.M. Bass, C.A. Duchowny, and M.M. Llabre. The Effect of Therapeutic Horseback Riding on Social Functioning in Children with Autism. Journal of Developmental Disorders, 2009: Oct.