When I think about all the therapies and interventions we’ve tried over the years to help my son, Leo, who has autism, I have to say that therapeutic riding ranks up there at the top of my list. It’s hard to believe that only five years ago, Leo was such a sick little boy. He had problems with eating, speech, gross and fine motor issues as well as social and developmental delays. He also had a host of co-morbid conditions that frequently accompany autism, including gastrointestinal problems, allergies and eczema. One morning I remember reading in our local paper about Walk On, a therapeutic riding center that was opening up in our hometown. I didn’t think twice about picking up the phone to get an appointment. I didn’t know anything about the program and had limited knowledge of or exposure to horses myself, but my gut told me that my son would love to be around the animals, and that this would be a perfect environment for him to learn to overcome some of his challenges.
I was so excited to get a call from therapeutic riding instructor, Mary Illing (who is the co-author of this article) a couple of months later telling me that they had an opening for Leo. I still felt a sense of trepidation while pulling into the parking lot. How would Leo do with the testing? Would he have a meltdown and cause the horse to spook? Would he get hurt?
The result of his evaluation showed that Leo had an attention span of two to three minutes for preferred activities, and that he was easily distracted by visual and auditory stimuli. He had difficulty with motor planning, tactile defensiveness, and low/decreased muscle tone; and he was reluctant to change position on the horse.
Mary’s goals for him included increasing vestibular processing, strength and sensory processing. To achieve this, he would ride sitting forward, sideways and backwards for one lap around the arena with assistance for balance and position. Soon Leo was to stand up in his stirrups for half the length of the arena with assistance for balance, and to follow a simple two-step direction with two repetitions. He would also need to complete a three-step obstacle course with visual assistance.
We continued to take Leo to his lessons weekly. He progressed, albeit slowly. I can’t effectively express the joy and excitement that followed each gain he achieved. Some of my favorite moments were when Leo finally was able to stand up in his stirrups for a full lap around the arena, when he trotted for the first time, and when he could finally sit up straight in the saddle.
Back to Basics
Therapeutic horseback riding, as defined by the North American Riding for the Handicapped Association (NARHA), “uses equine assisted activities for the purpose of contributing positively to cognitive, physical, emotional and social wellbeing of people with disabilities.” The human-animal bond has been researched extensively, and there’s abundant evidence that many riders develop significant bonds with the horses they ride. That’s certainly been the case with a couple of Mary’s students at Walk On Farm. Mary is a licensed occupational therapist and NARHA-certified Master Level Instructor.
Johnny, who is nine, came to Walk On for the first time in 2007, at which time he didn’t speak, use picture cards or sign language. He communicated his wants and needs through crying, which was a source of frustration to his family. This made Mary’s initial sessions a guessing game. Sam, another of Mary’s riders, was on the higher end of the spectrum and was on the point of transitioning from an average-size middle school to a very large high school of over 3,000 students. His parents were very concerned about his ability to tolerate the crowded halls, and the other stresses he would encounter. Both children were very different, with very different issues to address, and both benefited from therapeutic riding.
Why Is Therapeutic Riding Effective?
Physically, the way a horse moves closely resembles the normal gait of a human, and this means it can be used to produce specific changes in your child as he rides. A horse offers its rider a three-dimensional, rhythmic, repeatable and dynamic moving surface. This means that as he rides your child’s pelvis is moving three-dimensionally, which is very similar to walking. The pelvis moves back and forth, side-to-side and rotationally. As a result of these movements, many riders calm their bodies almost as soon as the horse starts to walk.
What happens during the first lesson?
` Initial assessment of social/learning skills, fine and gross motor skills, and sensory issues.
` The warm-up period may consist of stretching exercises, regulation of your child’s sensory system, and socializing.
` Riding skills, such as guiding, trotting, or using alternative positions such as sitting sideways on the horse, backwards sitting, kneeling, or even
quadruped positioning (riding on hands and knees), are evaluated.
` A game or a trail ride.
` Discussion of observations.
` Development of mutual goals.
` Identification of instructional supports, i.e. picture cards, schedule.
If your child has sensory-integration issues, a horse that moves at a consistent pace can help him to establish rhythm, while a horse with a bigger gait can help build body awareness. Riding can help develop trunk/core strength, coordination, balance and tone. Visual perception and spatial awareness is improved by simply guiding the horse through obstacles. Guiding also requires the rider to sit centered and continually adapt as the horse changes direction.
Grooming and tacking requires your child to sequence. (Sequencing is putting each task in the correct order.) Following the instructor’s directions helps your child’s ability to process verbal commands and complete tasks. Other cognitive benefits include regulation of your child’s alertness level, problem solving, life skills and attention span. For example, if a rider comes to class unfocused, after a few minutes on the horse he’s usually able to follow directions. Also, many riders experience an improvement in speech and communication skills. Therapeutic riding can bring about improvements in socialization, empathy and self-esteem. Many riders develop friendships with fellow riding classmates.
Selecting A Riding Center
NARHA sets standards for therapeutic horseback riding centers, so its website is the best place to explore while learning the basics of the therapy. The site is easy to navigate and provides many options to help narrow your search. Because therapeutic riding isn’t considered a treatment session, it’s more cost effective than other forms of therapy. Insurance companies don’t, however, typically cover it.
Once you’ve located several centers near you, call each of them for more details. Be sure to ask them about their cost for lessons and available riding times. Keep in mind that many centers have a waiting list. It is important to ask for credentials of the person who is likely to be teaching your child. NARHA sets standards for therapeutic horseback riding centers, and offers three levels of instructor certification: Registered, Advanced, and Master Level. A registered instructor isn’t going to have as much knowledge as an advanced or a master level instructor.
Find out if the center has the supports your child might need, such as picture cards or visual schedules. If it doesn’t, ask if the staff is willing to develop those supports. The next step is to visit the center and observe a lesson. Is the facility clean? Do the horses look clean and healthy? Are there things in the barn or arena that would be distracting or unsafe for your child, such as busy roads, a pond, or loose animals?
Is It For Everyone?
All riders are different and therefore, the overall therapeutic riding experiences vary widely among participants. Therapeutic riding is not a magic bullet. Some riders make great strides initially, some make slow but steady progress, and for some, while progress may not be apparent or measureable, riding is nonetheless a fun experience.
Therapeutic horseback riding may not be for everyone with autism. If a child or adult has significant seizure activity, riding can be unsafe. For some, there may be too much sensory input, which can lead to overstimulation and shut-down/meltdowns. Some riders are allergic to the horse or the barn environment. Others could have a significant fear of the horse.
Riders with significant behavior concerns will need to be evaluated for suitability for riding, and a full evaluation is typically performed at your child’s first lesson (see box). Many people with autism initially demonstrate inappropriate behavior but within a couple of lessons are eager to ride. The safety of the child, the horse and the spotters/instructors is absolutely vital. Should inappropriate behavior or unsafe conditions continue, riding should be discontinued as part of your child’s therapy.
Mary’s two young students, Johnny and Sam, benefited from their contact with the horses. Johnny loved it when the horse was walking and was very motivated to keep the animal continuing in this mode. Mary and her team used this motivation to teach a very simple “walk on” sign. The sign he used was to touch his fingers to the palm of a volunteer. Now he understood he could influence others around him to get what he wanted. This new understanding gave Johnny the ability to answer “yes” and “no” questions, so now we could communicate!
Sam was able to ride independently at the walk level and trot with a little support by the time he stopped riding. His parents attribute the sensory input from riding with his ability to tolerate busy hallways at school.
The Milik kids have made similar progress. It has been over four years now since Leo started riding at Walk On and his progress has been astounding. These years of riding have strengthened his core muscles, which has positively impacted other abilities such as swimming, running, and other gross and fine motor activities. He rides without assistance now, and he’s able to control the horse on his own. His language and speech have developed beautifully. He is in a regular education classroom in a blue-ribbon school, has many friends, and is thriving.
Leo’s little brother, Joseph (pictured in these pages wearing an orange shirt), was 28 months old when he developed signs of sensory processing disorder. Therapeutic riding was a natural choice for him also. He started in the program the week of his third birthday, and he and Leo ride at the same time each week. Mary is able to work with both children, even though they have very different issues to address. Having Leo and Joey ride together each week has brought with it many blessings and surprises. They have races at the end of their lesson, and learn how to take turns as well as help each other solve problems. Most of all, they are able to have family bonding time that is so important for siblings. Seeing the joy on both of their faces when they are together doing something they both love is priceless.