Hippotherapy

Marcy Uecker shares her son's experience with equine assisted therapy

Interview by Shanti Kurada

Hippotherapy, which is derived from the Greek word "hippo" for horse, is a therapy that is provided under the supervision of a speech/language, physical or occupational therapist. The American Hippotherapy Association defines it as"a purposeful manipulation of equine movement as a therapy tool to engage sensory, neuro-motor and cognitive systems to promote functional outcomes". Equine Assisted Therapy or Therapeutic Riding has many of the same benefits, but it is more of a recreational riding program that promotes social and emotional well being for individuals with special needs. Both hippotherapy and Equine Assisted Therapy use the horse's multidimensional rhythmic movement to assist positive developmental and well being outcomes. Therapists help individuals ride the horse in different positions, including sitting, laying forward, backward or sideways, standing up in the stirrups, and riding on the horse without holding on.

In the following interview, Mary Uecker, parent to a child with autism, shares their family's experience with equine assisted therapy.

SK: What made you want to try equine assisted therapy? How long have you been doing it?

MU: My son was in some form of therapy all day. He was getting ABA, Speech, OT. I wanted to get him out of the house. I wanted him to enjoy nature, the outdoors. Last year, when he was almost turning 10, I felt it was time for him to do more real world activities.

We then heard about NCEFRT from some of the other families at my son's school. We realized it was right here in Woodside, so we gave it a try. We've been doing this therapy for over a year now.

SK: What were some of your son's strengths and challenges at the time you started equine assisted therapy? Which of his challenges did you hope would be addressed by this therapy?

MU: Although my son did not start talking until 4, over the years he became more and more verbal. His speech went from being rote in the beginning to more spontaneous. Now, at 11, he is very verbal, fairly spontaneous, but not always socially appropriate. He doesn't make much eye contact with strangers or new people. But he can have quite a conversation with familiar people. He has a pleasant, mellow nature.

One of his biggest challenges is his difficulty with gross motor skills. He always had challenges in this area. He sat up late, walked late.

I was hoping that hippotherapy would help with his balance, coordination, strength building, and overall gross motor development. I also hoped that if he bonded with an animal, it would help with his social/emotional development.

SK: What happens during a session? Do they work on specific goals? How is progress measured?

MU: An occupational therapist works with the child. She first talks to the parent to get as much input as possible. She also observes the child before and during sessions. Based on this, she identifies key areas to work on and develops goals and activities that address these areas.

Progress is measured by observing increasing levels of skill and eventual mastery of specific tasks. For example, my son was required to reach for a ring while riding. As he progressed with this task, the level of complexity was increased.

SK: Is it always the same instructor? The same horse? How do you find the staff to be?

MU: It is usually the same OT or PT that works with my son. We went through a few horses. One of them was very calm and docile. One was very responsive. One horse was very strong - that was the one that worked eventually for my son. He needed a lot of input for his body. The people are very caring and supportive. And the horses are wonderful.

SK: How much does it cost? How did you pay for it?

MU: It is approximately $150 per session (depending on the child's needs) for hippotherapy. Each session is 30 minutes. Therapeutic Riding is $50 for a 30 minute session. We have Blue Shield Insurance and used codes for occupational therapy. They paid 60% and we paid the rest out of pocket. It is not easy to get insurance to pay for this. We had to go through a lot of hoops.

SK: What was your son's initial reaction? Has his attitude changed over time, and if so, in what way?

MU: At first, he was very hesitant. I told him we would go to this farm and check out some horses. He kept insisting he didn't want to ride any horses. He loves nature and hiking, but he was never very responsive to animals. I wasn't really sure if he would be willing to get on a horse. So, in the beginning, we simply looked at the horses, as they were eating or riding.

He did not take very long to get on a horse. I think the watching with no pressure helped make him comfortable. The therapist would take him on a 'sensory trail'. He would need to reach out to a mailbox and retrieve mail while riding. She would ask him to hold his hands out or cross them against his chest. He was required to ride sideways or facing the back. All of these exercises helped build his core muscles and improved his balance and coordination.

Sometimes he would start out eager and cooperative, but become more stubborn toward the end. He would get more tired and the demands would be too much for him.

SK: Have his therapy areas and routines stayed fairly the same over the year? Or have they changed?

MU: Although he started off reluctantly, he took to the "horsey farm" and began looking forward to it. During this initial phase, we focused a lot on his upper body strength and coordination. After a few months, some of the novelty wore off for him. Then we switched to therapeutic riding. They simply taught him how to ride and enjoy the activity of riding. He enjoyed that for a few sessions, but I noticed he wasn't really bonding with the animals. So, we've been encouraging him to take care of the horses. He likes brushing them and watches them eat. This is a new phase for us. We would like to get back to therapeutic riding eventually.

SK: What advice would you give to parents considering hippotherapy or equine assisted therapy?

MU: I'd say, it's well worth the time and effort to try something like this. Regardless of your child's challenges, riding a horse requires balance and coordination, so those areas get worked on. Also bonding with an animal can help with emotional development. Being outdoors is great for all kids, and especially for kids on the spectrum. For some kids, riding or taking care of horses may develop into a real interest.

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Marcy Uecker has been a member of the Executive Committee for Autism Speaks in the Bay Area. She is a mom to three amazing boys. Marcy works with families who have recently had a child diagnosed with autism and assist them in their journey. For her son August, she continues to focus on his strengths, independence, and interests. She can be contacted at marcy@theueckers.com