Posts Tagged ‘cerebral palsy’

What are hippotherapy and therapeutic riding (THR)?

Wednesday, July 3rd, 2013

horse-1For children with special needs, horseback riding may be very therapeutic. It may help your child improve socially, cognitively, behaviorally, physically and emotionally. And, to top it off, it can be loads of fun!

Hippo is the Greek word for horse. Hippotherapy and therapeutic riding (THR) are terms that are commonly used interchangeably to describe therapy that is provided with the help of a horse. But, there are some differences between the two.

What is hippotherapy?

The motion of the horse as it walks provides sensory input to the child. The horse’s movement is rhythmic and repetitive and closely resembles the normal gait (walk pattern) of a person. This sensory input movement is thought to help your child feel and learn the motion that is needed to learn to walk. Usually a licensed professional therapist provides OT, PT or ST as the child is on the horse. A child may even do certain exercises while lying down on the horse. In essence, it is therapy given while on a horse. The horse handlers are responsible for controlling the horse. Your child is not learning how to independently ride a horse in hippotherapy.

What is therapeutic riding (THR)?

Therapeutic riding is different from hippotherapy because THR focuses on riding skills and therapeutic activities. For instance, special tasks are given to your child to work towards certain goals (such as learning how to steer the horse, learning right from left, communicating with the horse handlers or “side walkers,” etc.). Your child slowly learns specific riding skills. Your child may or may not be in primary control of the horse depending on his level of skill and expertise.

Whatever the differences, the similarities are clear in that the use of a horse is key in working towards achieving functional goals.

What is it like?

When my daughter was younger, I took her to therapeutic riding sessions once a week. She sat on the horse and needed to sit up straight, hold the reins and pull on them to make the horse go in a certain direction. She needed to give walking commands to the horse (“Walk on Toby”) and listen to the instructors by her side. At first I was nervous as my little one sat atop this huge horse – she was speech delayed and often needed more time to process what was said to her. Her muscle tone was relaxed so working on her posture was not an easy task. But, I sat on the sidelines and watched quietly.

In time, I saw my daughter become more confident in her speech and movements as she directed the horse to move ahead, slow down or stop. Her posture improved as the sessions became more complicated – such as reaching for hoops or picking up objects alongside the rink while she kept the horse moving forward. She had conversations with her horse “side walkers” and formed a special bond with the horse, Toby.

My niece, who has autism, absolutely loves her riding sessions. Her ability to understand verbal commands has improved considerably since starting her therapy. She shows a sense of confidence and excitement when she arrives at the stable that she does not show in other environments. It is hugely evident from the smile on her face that she is thoroughly enjoying herself. She also displays a level of patience and control while on the horse that is not seen in other circumstances.

Where can you find hippotherapy or THR?

To learn more about hippotherapy, contact the American Hippotherapy Association. Click on “find a facility” in their drop down menu to locate a stable near you. The AHA maintains hippotherapy standards for programs and professionals.

To learn more about therapeutic riding, contact the Professional Association of Therapeutic Horsemanship International (PATH Int’l). Click on “find a center” to locate a stable near you. PATH establishes the industry standards for program safety as well as instructor training and certification.

Usually, a program accepts children as young as 4 years of age but rules may vary from one organization to another. Likewise, the cost of a program varies widely, although many organizations offer financial assistance. Be prepared to encounter a waitlist as these programs are usually immensely popular.

Is hippotherapy or therapeutic riding medically beneficial?

There aren’t a lot of robust studies, but I took a look at some of the more recent research as it pertains to children with developmental delays, autism and cerebral palsy (CP).

One study found that therapeutic riding may lead to improvement in gross motor function in developmentally delayed children “and that these improvements remain once therapeutic riding ceases.” Another study found that children with autism had improved behaviors (such as social motivation and less inattention, distractibility and sedentary behaviors). A review of 8 studies found that “riding therapy is indicated to improve postural control and balance in children with CP,” while another review found that both hippotherapy and THR have positive effects on gross motor function on children with CP. But, there are also studies that did not show definite results. Some had sample sizes that were too small to draw conclusions, or simply did not find any benefits for kids with CP.

Bottom line

More studies are needed to back up the benefits to which many parents, clinicians and even the patients themselves attest. But, aside from the studies, it may be worth it to look into any therapy that might benefit your special needs child. What works well for one child may not help another, and vice versa. Often you have to try more than one therapy to see what helps your child. And, often it is a combination of therapies that helps a child take off and make progress.

Have you tried any kind of horseback riding therapy for your child? Please tell us about your experiences.

Have questions? Send them to AskUs@marchofdimes.org.

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started on January 16, 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

Twins & triplets have greater odds of needing a NICU

Thursday, August 12th, 2010

tripletsToday, more than 3 percent of babies in this country are born in sets of two, three or more; about 95 percent of these multiple births are twins. The high number of multiple pregnancies is a concern because women who are expecting more than one baby are at increased risk of certain pregnancy complications, including premature birth (before 37 completed weeks of pregnancy).

About 60 percent of twins, more than 90 percent of triplets, and virtually all quadruplets and higher-order multiples are born premature. The length of pregnancy decreases with each additional baby. On average, most singleton pregnancies last 39 weeks; for twins, 35 weeks; for triplets, 32 weeks; and for quadruplets, 29 weeks.

More than half of twins and almost all higher-order multiples are born with low birthweight (LBW), less than 5½ pounds or 2,500 grams.  LBW can result from premature birth and/or poor fetal growth. Both are common in multiple pregnancies.

LBW babies, especially those born before about 32 weeks gestation and/or weighing less than 3 1/3 pounds (1,500 grams), are at increased risk of health problems in the newborn period as well as lasting disabilities, such as mental retardation, cerebral palsy,  and vision and hearing loss.   While advances in caring for very small infants has brightened the outlook for these tiny babies, chances remain slim that all infants in a set of sextuplets or more will survive and thrive.

Preeclampsia and diabetes in the mother are two conditions that, for the safety of the mother and baby, can lead to an early delivery. Women expecting twins are more than twice as likely as women with a singleton pregnancy to develop preeclampsia. Gestational diabetes can cause the baby to grow especially large, increasing the risk of injuries to mother and baby during vaginal birth and making cesarean delivery more likely.  Babies born to women with gestational diabetes also may have breathing and other problems during the newborn period.

Have you or someone in your family had twins or triplets?  Were they in the NICU?

A compelling personal story about CMV

Tuesday, June 15th, 2010

Brendan and his momOur guest post today is from Tracy McGinnis, mom to Brendan and founder of the CMV Foundation.

THIS is one of the leading cause of cerebral palsy in children
THIS is the leading cause of non-hereditary deafness in children
THIS is the second leading cause of mental retardation in children
THIS is the most common infection present at birth
THIS permanently disables a child every single hour in America
THIS kills approximately 400 babies each year in America
THIS is congenital CMV, cytomegalovirus.
THIS….is the story of my precious son, Brendan and our lives with congenital CMV …

My son Brendan was born in 2004, the picture of perfect health. After having four miscarriages, holding this beautiful miracle in my arms was a dream come true! During the few days after his birth, they ran the newborn hearing screen on Brendan numerous times, continually getting a “fail” on his right ear. I was assured it must be water in his ear.  After a week of failed screens they completed an ABR, auditory brain response, hearing test. This was the beginning of life as I knew it being forever changed. The ABR showed his hearing loss was neurologically based. I was crushed thinking my son would be deaf in one ear. Little did I know that this was just the tip of the iceberg. At his two-week newborn check-up, the pediatrician noted that Brendan’s head size was very small and told me that combined with the hearing loss, we needed to test him for toxoplasmosis, rubella, and CMV. It was the longest 10 days of my life as I awaited the test results. Then the news came: it was CMV. The doctor spoke to me over the phone of cerebral palsy, seizures, deafness, blindness, mental retardation, and more.

What has occurred in the years since then are a number of tests, procedures, and surgeries. Brendan’s brain incurred severe injury from this devastating virus. He has calcifications, a portion of his left brain did not develop, microcephaly, and slightly widened ventricles. He now sees a number of specialists. Brendan is severely disabled both physically and intellectually. He cannot crawl, sit up, or walk. He is nonverbal, has seizures, is fed via a G-button, and has severe cerebral palsy. He has trouble sleeping, common with congenital CMV.  He receives physical, speech and occupational therapies 4 times a week.

Brendan’s diagnosis changed my world forever. However, it also gave me a new sense of purpose as I am determined to do all I can to eradicate CMV. I don’t want to see any other babies be born with this dreadful virus and have to suffer the hardships that my son goes through daily. So, in 2007 I established the first non-profit foundation dedicated to raising awareness of congenital CMV. Today, we remain the only non-profit foundation in the world that is also dedicated to financially supporting CMV vaccine research.  I named the foundation in honor of my son. The Brendan B. McGinnis Congenital CMV Foundation is a tribute to him, as he is my inspiration. Our mission is to raise awareness, to support CMV vaccine research, and to affect change in the medical community so that physicians will begin to test women for CMV prior to pregnancy. With a Board of Directors comprised of leading CMV experts and clinicians, we are doing all we can to reach our goal. Congenital CMV is more common than Down Syndrome, Spina Bifida, or Fetal Alcohol Syndrome. It is not rare: 1 in 150 babies are born with congenital CMV.

I don’t want to see this happen to any other babies. I don’t want any other moms to feel my heartache. I want women everywhere who are considering pregnancy to learn about CMV! Please go to our website  www.cmvfoundation.org  to learn about CMV and the measures you can take to help prevent congenital CMV. Until a vaccine is found, women must do all they can to protect their unborn babies from this common but life-altering virus by following the extra hygienic precautions recommended by the CDC. To contact us or to help us raise awareness of CMV, please write to us at: mcginnis@cmvfoundation.org

Welcome ambassador Katelyn Hall

Friday, January 23rd, 2009

2009 ambassador Katelyn HallBorn no larger than a ballpoint pen at birth, a premature baby girl who survived overwhelming odds has been named the 2009 National Ambassador for the March of Dimes. The National Ambassador Program is an annual campaign that puts a face on the March of Dimes mission…the face of a child who was saved by March of Dimes research, programs, or educational campaigns designed to improve infant health.

Katelyn Marie Hall, age 5, from Leesburg, Virginia, was born very early at 25 weeks, weighing less than one pound.  The family says Katelyn was given only a 5 percent chance of survival. During her five-month stay in the NICU, she endured many of the obstacles that are common to babies born prematurely.   She was treated for chronic lung disease, battled many infections, underwent heart surgery, and suffered from bleeding in the brain.

When Katelyn’s parents, Ashley and Michael Hall, finally got to take their little daughter home, Katelyn’s calendar quickly filled up with numerous visits every week to doctors, including a neonatologist, pediatric cardiologist, gastroenterologist, ophthalmologist, and more. Katelyn was also on supplementary oxygen and took ten medications every day.

Katelyn is one of the more than 540,000 babies born too soon every year in the United States.  “Premature birth is the most common, serious and costly infant health problem facing our nation, and it has reached a crisis,” said Dr. Jennifer L. Howse, president of the March of Dimes. “We are determined to find and implement solutions to prevent preterm birth, based on research, best clinical practices and improved education for moms.”

Today, Katelyn is the joy of her parents lives.  In many ways, she acts like a typical five-year-old – she loves to run, jump and play outside with her dog, Sequoia. But because of her premature birth, Katelyn has developmental delays and slight cerebral palsy that affects the left side of her body.  She began walking and talking late for her age, and continues to work with speech, occupational and physical therapists.  The March of Dimes says she was chosen as 2009 National Ambassador because she exemplifies the long-term problems faced by many children who survive an extremely early birth.

Follow Katelyn on her journey across the country.   If you are interested in becoming an ambassador family, contact your local chapter of the March of Dimes.

The last weeks of pregnancy really count: Here’s why

Thursday, December 11th, 2008

Scientists have known for a long time that premature birth can lead to problems with a baby’s brain development.

A research team, led by Dr. Joann Petrini of the March of Dimes, has learned that early birth increases the risk of cerebral palsy, developmental delays and mental retardation. The surprising finding is that this risk is true even for babies born as late as 34-36 weeks. The researchers published their study today in The Journal of Pediatrics.

A full-term pregnancy is 39 weeks. But more and more births are being scheduled early for non-medical reasons. Wouldn’t it be nice if the baby could be born when Grandma is in town? Or before the obstetrician goes on vacation?

But early births can cause problems for both mom and baby. If possible, it’s best to stay pregnant for at least 39 weeks.

There are lots of important things happening to your baby in the last few weeks of pregnancy. If you can, give your baby all the time he needs to grow before he’s born.

Those last weeks of pregnancy are hard. You’re tired, you’re not sleeping, you ache. It seems as if you’ve gained a million pounds. As my sister used to say with a long sigh, “I can’t see my feet any more.” But staying pregnant until 39 weeks matters: for you and for your baby.

The March of Dimes Web site has a helpful drawing, showing the difference between the brains of babies born at 35 and 39 weeks. Take a look. And tell us what you do to make those last hard weeks of pregnancy a little easier.