What is Hippotherapy and how can it help children with Autism and ADHD
The reason I decided to interview Beverly Saddler was because I was interested in learning about Hippotherapy as a means of therapeutic services for Autism related therapy. I wanted to learn about the differences between Hippotherapy and equestrian therapy and it all seemed very confusing to me. So, I decided to go the horse’s mouth (sorry for the Pun) and went straight to a therapy centre here in Connecticut where I live to find out more.
Leslie: I am here with Bev Saddler in Ellington, Connecticut on March 30th, 2013. And Bev runs the Ellington Therapy Center.
Beverly Sadler: Ellington Therapy Riding Center
Leslie: Would you mind telling us, how you came to start the center?
Beverly Sadler: Yes, my sister in-law who is the owner and manager of the barn about four years ago and called me and said “Bev, I have couple of girls who want to come ride. They have ADHD. What’s that?” and I explained to her what it was and so she and I worked together with this kids and we found some pretty amazing things for them and so I drove out here saying to myself, this is what I want to do. So I did the research. I found out what I had to do to become certified in what’s called hippotherapy, hippo is Greek for horse and hippotherapy is often used as one of the tools used by occupational therapists, physical therapists or speech language pathologists and that’s one of their tools and its part of their plan of care and that is what I do. As an occupational therapist, I do occupational therapy and it just so happens that the horse is one of my main modes of intervention for the children. I also have a small clinic here and sometimes we start there. We work on anything from strengthening, range of motion, to expressive language that comes just naturally. I am not a language pathologist but I have worked enough with them where I know how to prompt the children. If they want the horse to go they have to say that little word of “GO” and then we start expanding from that.
I think one of the major differences to point out is that therapeutic riding is different and that people who go into that are “horse people” and they have to learn how to work with people and kids with special needs. So, it could be anyone as long as they can walk, trot and canter and teach the kid how to ride, they can be certified as a therapeutic riding instructor. They often do multiple children or adults in a group so it can be anywhere from three to eight people in their sessions whereas most of us [hippo-] therapists do one on one.
Leslie: With hippotherapy?
Beverly Sadler: Yes. And I would just like to point out that most of us [hippo] therapists would say we’re doing occupational or physical or speech therapy and were using hippotherapy as our intervention because insurance companies do not cover the whole therapy. They cover OT, PT and speech, so the delineation between therapeutic riding instruction and a therapist doing a therapy is the number of kids, (group versus one on one), and our perspective.
When I have a child stand up on stirrups, I am looking at their balance, their coordination and their endurance to be able to sustain that position whereas a therapeutic riding instructor would say, “Maybe they are ready for posting because they are thinking what can I teach this kid on a horse to be a more independent rider, [whereas a hippotherapist is focusing on the child gaining balance, coordination, endurance, etc. to achieve the highest level of independence and functioning].
Click here to find out more
Leslie: And how do you become certified in hippotherapy? Do you have to be a certified occupational therapist, first?
Beverly Sadler: Yes
Leslie: And then, do you have a program to go through for hippotherapy?
Beverly Sadler: It was quite a great experience, I went to Rahobeth, Massachusetts to Greenlock Therapeutic Riding Center (http://www.greenlock.org/#!) and so I got to work with OT’s and PT’s and SLP’s (speech language pathologists) and they tried to group us with one of each discipline in each group and they taught us how to work with the horse. Quite a few of us already had experience with horses but I tell you some of them there didn’t have a clue how to put on a halter or pick up a hoof. But they were there to do those things and the purpose of it is how to learn to use that horse in various diagnosis and they brought in half a dozen children with different diagnosis so that was great. It was a little pre-testing you know, can the child jump over that stick and pretty much a hundred percent of the time after doing your magic on the horse the kid came back was able to jump over the stick. Whatever that child needed that is what we evaluated and that’s what we worked on with the horse. So that’s a long weekend, Friday, Saturday and Sunday but it was a great experience
Leslie: And so the Ellington Therapy Riding Center has wheelchair accessible bathrooms, handicapped parking and even have wheelchair ramp to mount the horse.
Beverly Sadler: Yes
Leslie: You were telling me earlier that a lot of it donated, some of it donated?
Beverly Sadler: Some of the services were donated like I needed the ramp and a teacher who was willing to help and then there was a group of girl scouts who needed to get their silver badge so they went to his home and he delegated them. You are going to sand this, you’re going to paint that and you’re going to measure that. So he got them involved. On the website there’s a lot of pictures of them working together, so that was a nice experience.
I guess the other important thing to point out is that I’m not a non-profit, most the therapeutic riding centers are and we all struggle, we all struggle. The reason being is that I had a very bad experience with a non-profit experience with toxic board members and so i can say it in 60 seconds, I resigned from my own board of directors and we asked them to leave and the owner of the horse took her back because it was donated to me. They wanted me to be working with the horse, they went to another barn and they closed in 9 months. The lawyer I consulted with said, “Well, why do that again?” It’s pretty common for those kinds of things to happen. I didn’t know that but when I did approach other workshops in therapeutic centers and other therapists happens more often than you think and so I stayed as a small business an LLC
Leslie: I can completely relate having previously owned a business.
Beverly Sadler: People don’t realize, I mean non-profit sounds wonderful but small business and a non-profit run the same way. Different paperwork and also technically I can’t be a fundraiser but fundraising is terrible, I mean it’s tiring. You have to come up with ideas. I have a lovely young woman who is a majoring in Early Education and she wants to do something for me. Well, I am not a non-profit but her and her mother just love doing this. Having a cocktail party to raise money, the money raised and the people just came and donate money to it and I assure them that it’s not going to pay me and it’s not going toward boarding of the horse and it’s going to the clients, to the children. I have one boy that comes, when I have money and I have a cancellation and I call him up and I say come, come on over and he loves it. I sponsor whoever I can, whenever I can.
Leslie: That’s great! The website that you did mention is EllingtontherapyCenter.com and there’s a lot of information and there’s a lot of therapy that is offered here
Beverly Sadler: I am not sure what you mean by that, we offer occupational therapy but what you mean by other therapies?
Leslie: It stated on the website – animal assisted therapy, occupational therapy, physical therapy, hippotherapy?
Beverly Sadler: Oh, okay. Animal assisted therapy just goes with everything because there are some children that have depression or from post-traumatic stress, high anxiety especially in children on the spectrum of autism or Asperger’s. Oftentimes just getting them involved with just brushing a horse and a lot of people refer to that as animal assisted therapy and there’s actually a group called EAGALA and that is actually psychology of the horse and the kids never get on the horse. They learn to communicate with the horse and they may brush the horse. It’s all about verbal and physical, you know our body language so there are all different approaches I guess, and so equine assisted therapy, animal assisted therapy. It all kind of gets rolled into what you’re doing even if it’s therapy, I mean I am doing occupational therapy. You have to let the people get a rapport with the horse
Leslie: Right. You have to build that relationship.
Beverly Sadler: There is no way around that.
Leslie: Also, on the website there was a mention of “brain gym” can you elaborate?
Beverly Sadler: “Brain gym” is a very wonderful program and if you ever want to look it up, just go on You Tube. They have great videos on You Tube of adults and children doing it. It has to do with activating the left and right side of the brain, as well as, the left and right side of the body. I like to give the example, if people don’t understand of someone having a stroke. It affects the left side of the brain. Then physically it impairs the right side of the body and they have learned that when you activate the brain, you get more neuroactivity going on and it’s called neuroplasticity. Way back when I went to school they would say oh you know in 6 months the person is all done recuperating. Not anymore I mean now they’re saying 2-3 years now depending on how active this person is, just look at what they say and see on TV. Now they have come up with games for people with Alzheimers to activate their brains. So, I have a few physical activities just crossing the body midline, touching your feet like this, you’ll be surprised on how many people can’t do this [taps right hand on left knee and left hand on right knee], or the alpha sign (makes a sideways figure eight). So crossing body midline activates the brain and the body so sometimes I can get better results when they are trying to use the reins. A lot of the children they use the reins like a steering wheel. So, I have to get them to separate left from right.
Leslie: So it’s exercise for the brain that helps with neuroplasticity?
Beverly Sadler: Yes, it’s an exercise program therapy.
Leslie: Okay. Is your staff trained or do you do almost all of the hippotherapy?
Beverly Sadler: What I did was, besides getting certified which they talked about during certification of how to train your volunteers. I also, went to High Hopes which is big. They have been in business for 32 years, they do mostly therapeutic riding and I think they have 1 or 2 physical therapists down there. So, I joined their volunteer program and I went through the training and I volunteered a couple of times so I could really get the feel of it. So I really understood what I needed to do here [at Ellington Therapy Riding Center]. I also, did some volunteer time at a couple of barns so I could see what they do, so I kind of try to get opinions and approaches from a few different barns so I could optimize my training. So I put together a training manual because as they say “if it’s not written down it didn’t happen.” Yes, they are all required to go through training with me first.
Leslie: Have you found that there is a certain type of autism that hippotherapy is more effective on? For children with high functioning or low functioning does that come into play? Or is it helpful for everyone?
Beverly Sadler: Pretty much! The whole purpose of having a therapist I think we’re a little bit better at evaluating the child. We determine the weaknesses and the strengths. We also interview the parents of course or whoever knows them best (sometimes, adoptive or guardians.) Then from there you determine where you need to go. We always go for up, we always go for the highest level of independence and the highest level of functioning whatever that might be. For example today, a young woman has cerebral palsy however she is totally, cognitively intact. In fact she is above average. So she is stuck in this body and non-verbal, she can only say one word at a time. So we were working on eating skills today and she is so motivated that we got her to use a weighted cup to bring it to her mouth and drink and put it down and then after seeing what she could do and we go get her on the horse and we do weight bearing and that is very important for upper extremities and she uses the reins, she does change of position using her body to you know and its challenging for her and then you come back into the clinic space and do that same activity. So, it’s a pre-imposed type of test and I’d say a 100% of the time you see in them an improvement in my experience, in their function, I can go on and on and on.(laughing)
Leslie: I’m going to let you…
Beverly: I mean I have a girl who has tight abductors in her legs, so whenever she walks on the ramp her feet scissor. Well after the horse they don’t do that. So I asked the parents how long does it last? Unfortunately, just until tonight. Long term? Well, if she could be here every day – that would be another story.
Leslie: So if a parent wanted to get their child involved in this, how did they go about that? Do they contact the insurance company? Do they pay for it out-of-pocket or can they do a combination?
Beverly Sadler: I followed another person’s example. Unfortunately dealing with insurance companies can be an exhausting job, if not a full time job a part-time job so I am out of network. I have invoices with all the codes that the insurance companies need with me and the diagnosis codes and intervention codes and I can provide that to the parents to submit themselves. If there’s something the insurance needs, the evaluation done or the progress notes, I can provide all of that. The thing is that if I were to try to do it, it would be too time consuming for me to be in network. I actually have a parent who said “No, I don’t want to try ‘cause I am too tired. I said, “Oh my God! It broke my heart and I said you’re too tired ‘cause it took them two years to put their child in a special school and they are just tired of fighting.
Leslie: They are just too tired of fighting. Yes I completely understand. I actually had to get help from someone at my daughter’s pediatrician to fight with my daughter’s insurance company on a weekly basis. So I understand their frustrations.
Beverly Sadler: I am out of network so I provided a guide to make sure you call not on Mondays and Tuesdays ‘cause it’s a high volume, try Wednesdays, Thursdays and Fridays cause I learned it myself. I always get the name of the person you’re talking to, make sure you know your ID number, you’re asking for OT, PT and speech out of network benefits. Do I get them? No? Then how do I get them? So how could I change my insurance plan cause there are so many plans. How do I change that for my child? I hope that could be so helpful for some, we have to admit that some people are not that assertive as others and that’s a natural thing for all people.
Leslie: As parents we are exhausted being caregivers we are already tired and stressed. We don’t need the additional frustration. Fantastic! Thank you for your time.
Resources and Websites to check out relating to this interview:
Ellington Therapy Riding Center
This article is featured in Issue 5 of Autism Parenting Magazine on Hippotherapy