Sooner or later one of your special needs riders will be interested in volunteering in your program.  How can you accommodate them while minimizing liability concerns?  What are some successful ways programs have included special needs riders as volunteers?

Program can choose to integrate riders into their existing volunteer program or design a program especially for riders interested in volunteering.  Both strategies have their merits and limitations.  Having riders volunteer in your existing program means that your special needs riders must meet the same criteria for safety and skills as your average volunteer.  Many programs need volunteers to help with office work, special events, landscaping and other tasks.  These may provide a “just right” match for the volunteer with a disability.  However many riders want to volunteer with the horses and lessons.  Can that rider with a cognitive impairment understand the safety concerns when sidewalking?  Can the rider with a mild physical impairment complete an emergency dismount?  These are important factors to consider when including special needs riders into your existing program.  Your program must balance both the desire and opportunity for people with disabilities to volunteers with your program with the safety needs of the riders in the lesson.  If a rider were to sustain an injury with a volunteer with a disability as the sidewalker what liability would your program assume?

Creating opportunities for riders to volunteer can be a way to mitigate risks.  Your program may decide to create a buddy or mentoring program for independent riders to mentor each other and provide encouragement and support.  This is an excellent way of involving riders with riders!  Your buddy program can help riders who want to volunteer their time by having them assist with grooming and tacking and then providing encouragement and suggestions to riders during the lesson.  This type of program has been used successfully with several adaptive riding programs.  Other programs for riders to volunteer may include programs focusing on horse care and maintenance.   Program volunteers and rider volunteers can learn horse care skills and provide these during volunteer hours.  Skills can include bathing, clipping, mane pulling, braiding, hand walking and hand grazing, carrot stretches and TTouches.  These skills are first provided to everyone under supervision and as groups progress they are allowed to do more of the horse care with minimal supervision.

What programs have you seen that incorporate riders as volunteers?  Are you a rider that volunteers at a PATHI center?

Why take fieldwork students?

Taking fieldwork students is service to the OT field and the field of Equine Assisted Therapy.  It allows me to refine my clinical reasoning skills by explaining my treatments and interventions to the student.  It allows me to see my clients in a new light- a student will often try things that I may have already dismissed and may have a totally unexpected result.  Taking students keeps me in touch with changing OT trends.

How does our fieldwork program run?

Our facility accepts both Level I and Level II students.

Our Level I student fieldwork is guided largely by the school assignments and the schedule of the student.  Some Level I placements require students to complete one week of 40 hours and others have students complete one day per week over the course of the semester.  Students are hands on throughout their placement and design an intervention for one client during their fieldwork.

Our Level II program is significantly more involved.  It requires the student to have prior horse experience.  The student must attend our volunteer orientation and training prior to fieldwork.  They complete forty hours per week for 10-12 weeks (depending on their school).  During this time they treat the OT caseload, co-treat with PT and SLP clients, do a consultation with an adaptive riding instructor and riding student, present on an OT topic to volunteers/parents/the public and complete an fieldwork project that is of interest to the student and benefits the facility.  The student is also videotaped during intervention at three periods throughout their placement.  Students come out of the placement with a strong foundation in movement and using equine movement as the primary strategy in treating a pediatric caseload.

I am happy to have helped another great OT-to-be in her career and hope to see many of my students in the field some day.  Keep looking for a guest blog post from my most recent student!

• Structure your lesson to match the child’s attention span- PATHI suggests that children be four years or older before participating in adaptive riding lessons and many able-bodied riding facilities will only take children over six years old.  Younger children (4-6 years old) may need a shorter lesson time.  Similarly, children with developmental delays and ADD or ADHD may need lessons tailored to meet their ability levels.  Lessons that require attention beyond that of what children are capable invite behavior problems.
• Keep lessons positive and motivating- learn what the child would like to do and gear your teaching towards meeting the child’s goal.  If the child would like to jump- set up small “jumping” courses with ground poles and have them follow a jumping map or number the poles to jump in order.  Have the child practice jumping position as a warm-up prior to the main event.  If the child would like to trot or canter have them work on the safety skills to maintain control at higher speeds and focus on the development of a safe position for riding at trot and canter.  For children who are non-verbal or who are unable to express their goals be creative in incorporating things they like to motivate them to improve their riding skills- such as posting to music, choosing pictures of food with riding tasks on the back to make a recipe or “sandwich” of riding tasks or collecting Pokemon pictures to create an obstacle course.
• Challenge them within their skill level- allow the child increasing freedom within the abilities they are capable of.  Allow then to ride off lead or independently at the walk for the majority of the lesson and practice a little bit of trotting on lead.  Encourage the child to create challenges for themselves or each other in a group setting.  The instructor can have the role of teaching the children what is safe and within their ability level while encouraging development of riding skills.
• Practice, practice, practice- some children (especially those with cognitive delays) need lots of practice to learn a new skill.  Chances are the instructor and volunteers will be bored long before the student is proficient at the skill.  In some cases, the student may be just grasping a skill when the instructor begins to move on to another skills.  Focus lessons on one skill, steering or halting, but not both.  Have volunteers assist the student with the skills that are not the focus and find several ways to practice the skill to encourage learning.  To teaching and practice halting: use halting at a visual object, halting when the student hears a sound and after walking 10 steps.  A whole series of lessons can be planned around halting; from halting when told to halting when too close to another horse for safety reasons.

Teaching children to ride horses can be fun and rewarding, but can also have special challenges when compared to teaching adult riders.  Keeping some basic principles in mind when planning lessons can improve their performance and help them develop a lifelong hobby.

Pros

• Fresh air and nice weather seem to have a positive impact on affect
• Visual flow is improved when traveling through space (rather then around an arena)
• Patients’ may be more motivated to communicate to direct the horse to a particular location or area they are interested, sessions can be more client centered
• There is a variety of terrain and slope of surface to utilize
• Nature may have a calming effect on some children

Cons

• Multi sensory input can not be graded as easily
• Additional distractions in the outdoor environment can make it difficult for some patients to focus
• Therapists must exercise caution for patients with poor temperature regulation, photosensitivity and allergies- including those to insects
• The environment is less controlled, resulting in increased safety risks
• Weather may change suddenly

Both pros and cons must be carefully weighed for each patient, during each session.  Our partner, the horse, must also be factored into the equation because the change in weather before a thunder storm may have your favorite “steady eddie” all riled up and ready to go.  I do love nice weather and the opportunity to provide OT outside, but it is not without additional clinical reasoning on its’ impact on my treatment session and my team members.

Do you have any other pros or cons to add to the list?

Therapeutic riding is a term that was generated early on in the use of horses with people with disabilities.  Liz Hartel won an olympic medal after returning to riding and therapists came back to the US and Canada from Germany after learning about hippotherapy.  These early professionals worked together to develop a team model combining the therapists experience with that of the riding instructor to produce therapeutic riding.

As the industry has grown both riding instructors and therapists have become more specialized in their skills.  Riding instructors became certified and the programs they worked at became accredited.  People came to them to pursue riding for many reasons.

Therapists began taking courses in the use of equine movement.  They incorporate this treatment strategy into their practice and identity as an occupational, physical or speech therapist or therapy assistant.  Some people go further to become a Hippotherapy Clinical Specialist.

These once merged team roles have grown into different specialties.  Riding Instructors do not provide therapy and Therapists do not have the skills to teach horseback riding.  The original term “therapeutic riding” continues to confuse the issue as each professional has grown into his or her own area of expertise.

So, what is in a name?

Adaptive riding is derived from the terminology used to refer to adaptive sports and adaptive physical education.  Adaptive sports includes the para olympics competition for equestrians.  Adaptive sports are sports and activities that have been modified for persons with disabilities to participate in.  Many people with disabilities are familiar with adaptive skiiing and wheelchair sports such as rugby and basketball.  Adaptive physical education typically takes place within the school setting, but its’ meaning to parents of children with special needs reflects the inclusiveness and importance of physical activity, recreation and competition to their children.  Some of the benefits of aligning riding with other adaptive sports includes excellent references from organizations such as the National Consortium for Physical Education and Recreation for Individuals with Disabilities.  The World Health Organization recognizes the following:

“Adaptive Physical Activity is an umbrella term, which denotes theory and practice aimed at promoting physical activitity participation in education, sport, recreation and leisure for individuals of all ages with disabilities needs.”

Wouldn’t it be great to have a reference from the World Health Organization related to what NARHA Certified Riding Instructors do?  Wouldn’t it be great to draw from other established organizations regarding the benefits from physical activities and involvement in sports for people with special needs?  By using the term adaptive riding we are able to align ourselves with a much larger community of professionals serving those with disabilities.