Wednesday, May 15, 2013

Vibrating Cone Stack

Here is a pile of today's toys!

 I mostly used the vibrating cone stack, but I decided to turn this into a 2 part activity. First the children needed to remove the rings that I cut from the top of detergent bottles. They are pretty  flexible and sometimes break but if they do break, that's OK, its easy to get more.

I asked the children to place the rings in a basket attached to the tack behind them.

The child in the photo and video is facing backwards on the horse.

 After removing the rings she reaches for a cone to stack on top of the cone that is attached to the tan door snake (these are sold to place under doors to keep out cold air).

 There is a green massager hidden inside the cone attached to the snake, so when they press downward it vibrates. This seemed like a good way to not only motivate but to build strength because they really needed to push.

I wish that I had a photo of the client  who stood on top of the horse to reach for the cones and then squatted to stack them up. She did this about 20 times which amazed me because she often refuses to stand on the horse at all. The secret is in providing exciting activities :-)

video

Wednesday, May 8, 2013

Rolling Ball to make squeaks while Kneeling and more.....


I love bringing in different activities to try out. I set up a pole with a bottle attached on the trail. I filled it with a variety of textured balls and asked each child to reach for them while facing backwards on the horse. They needed to insert the balls into the pink bag hooked onto the tack behind them. The video shows my client opening and closing the pin bag's zipper as I set up the activity.

This was a fairly easy activity which all of my 2-4 year old clients could do with very little help. I designed the ring stack made out the blue swimming noodle to provide a bit more challenge than the usual ring stack - since they have to make the rings fit over the noodle's curves in order for it to go down. You can see the client working on this, although the computer won't let me rotate the photo. She loved the feel of the vibrator that I pushed into the noodle opening. Its the motor from the Squiggly Wiggly pen.  I also attached some fabric through the handle with a blue noodle doughnut shape tied to each end.  I asked them to help me tie a knot to get it out of the way- which they all did very nicely.. ..

video videoThe last activity was rolling the ball in the hands to make it squeak. I counted as the children rolled. The girl in the video is kneeling while doing this and I just turned the camera on as she reached 23 or 24. She really enjoyed doing this !!!






























Wednesday, April 24, 2013

Cone and Stringing Activities to Develop Postural Control

video
 I hung the cone holder that a nice man at Trader Joe's store allowed me to have. It is used for holding flowers but is also perfect for hanging cones in the tree. So while riding down the trail, the children stopped next to the cones. Then I attached the holder inside one of the stirrups while the child faced sideways (facing me).

The first little guy in the video seemed to really enjoy reaching from his left side , rotating his trunk and placing the cone behind his right shoulder. The little girl is facing backwards while doing this. You can see how nicely this challenges their balance, motor planning and postural control and its a lot of fun, too !


















The other activity came out a bit blurry but I want to share it anyway, because it provided a nice challenge for a little girl who has pretty good motor skills.

She loved it and asked to repeat the activity, so she did this while kneeling after stringing the shapes while standing on top of the horse.

I attached the end of the cord to a sensory ring- made by filling socks with plastic bags and sewing the ends.

She first brought this over her head with a little help and down to her waist. Then she stood up on the horse and did the stringing activity. She was able to remove the sensory ring independently after sitting down.

All of these clients are almost 3 years old and I am so proud of them !




Wednesday, March 27, 2013

Strengthen those Hands!

We spent the beautiful spring day outside and the kids were all in great happy moods.  This little guy is facing sideways while we walk up a hill. I am encouraging him to put weight on his right hand. I gave him some joint compression input to the elbow when not holding the camera, too. He has very low muscle tone and avoids touching let alone grasping objects.  We played the game called "you grasp the chick with both hands and don't let go even when I pull". He is starting to understand that he has to really use some muscle to play this game! 
The video demonstrates very briefly how my client pulled links apart and placed in a container (highly edited to remove her face) and a client who just loved the whooppee cushion to no end. I discovered that if I tell the riders to stay in the 1/2 seat (leaning forward with bum off horse all the way to the top of the hill (about the time it takes to sing the ABC song) I can reward at the top of the hill by playing with the whooppee cushion since they can finally sit down. WHOOPEE!   

video

Wednesday, March 6, 2013

When your Hippotherapy Client Cries......


I work with very young hippotherapy clients. My youngest was 11 months old and she cried so much , I told the parents to come back later when older. She did return 6 months later and did very well.

Not every  facility offers hippotherapy services with such young children but I have found that the 18 months to 3 year old early intervention clients are my favorite. They often start out crying, perhaps for a few weeks and then realize how much they love the experience. There was only one child who cried intensely for about 3 weeks and the mom and I agreed that he should stop.

So what to do with the crying hippotherapy client?  Lets take a look at the reasons for crying.....
  • the child is not used to and does not want to separate from the caregiver
  • the horse is big and scary
  • all new experiences are scary
  • the child finds the sensory experience (i.e. movement) threatening and scary
  • the environment is over-stimulating

Strategies:
1. Its not always possible to work in the ideal environment, but if possible decrease the number of people and horses, sound and action taking place around the sensory sensitive, young child.  I have learned to lower my naturally loud voice as needed.
2. I explain to parents that most young children cry during the first few weeks. It may be beneficial to at first have the parent side walk or walk within view of the child. Sometimes the child does better when the parent is out of view. Some of my parents want to be the side walker all the time (and that's OK) and others enjoy the break. The parents and situations vary, but its good to explore the options that decrease crying during the first 2-3 weeks.
3. Spend time introducing the horse while holding the child, patting, brushing and talking to the horse. Sometimes I spend time playing with the child before even going near the horse so that the child is more comfortable with me before separating from the caregiver.
4.  Once the child is on the horse, get moving, stay moving, sing and talk about what you are both looking at. I hang pictures of animals on the arena walls and if we are outside there is of course, lots to talk about. I also find the song "If you're happy and you know it pat the pony, clap your hands, blow a kiss....." familiar and calming.
5. I encourage the child to bond with me the therapist, by telling the volunteers to minimally  interact  and after 1-2 weeks I encourage the parent in the waiting area to not interact. I turn the child to face sideways so that we can look into each others face, as soon as the child is able to tolerate this because we can bond even better in this position.
6. If I do something that the child really hates (i.e. kneeling, bearing weight on hands) and he or she cries, I do it briefly and count to 5 or 10 or sing the ABC song so that the child knows it will be ending soon. I then switch to a preferred activity or no demands riding.
7. If the child is super upset  and you feel uncomfortable keeping him on the horse, play with the child in the waiting area with the parent nearby or perhaps while the child sits on the parent's lap. Try not to send them home early- that gives the wrong message.
8. Sometimes kids are just feeling sick and the session needs to end early. This is especially apparent when working with a child who usually loves hippotherapy.
9. Discuss with the parent how they feel about the situation. Do they have suggestions? Some parents bring in a favorite toy from home.
10. .......and most importantly, involve the child in choice making with words, pointing or pictures so that they feel in control and have fun!



Thursday, February 14, 2013

Using Apps during Hippotherapy

video
I occasionally use my Iphone during hippotherapy to have fun and motivate my very young clients. They love touching pictures that make things happen-such as an animal that makes a sound. This involves nice finger isolation and motor control. I have to remind some of them to use the index finger and not the middle finger.

In the video you will see how the app motivates him to make sounds. I can also ask the children to find and press the animals I name so that they need to scan and follow directions. That would be a bit more challenging but I will work up to it with this 2 year old.

I have worked with 3-4 year old children doing this same activity while they kneel, stand on top of and are prone on their belly (extending arms like superman)  while the horse stands stationary.

Usually riding is so exciting children don't need much more to motivate engagement but there are a couple of clients who are particularly cooperative when they know they will get to use my phone app either during or at the end of my session. One almost 4 year old who has down syndrome ends her session walking up 3 steps to put her helmet away on a pole. Sometimes I ask her to remain balancing on the top step while pressing some animal pictures. This takes her mind off her fear of falling (while I hold her belt)  while doing something she loves.