Posts Tagged ‘therapy’

Helping babies with FASD

Wednesday, April 8th, 2015

baby in distress

Drinking alcohol during pregnancy can cause your baby to have serious health conditions, called fetal alcohol spectrum disorders (FASD). Alcohol can also cause your baby to:

• Be born too soon (prematurely)
• Have birth defects (heart, brain and other organs)
• Have vision or hearing problems
• Be born at low birthweight
• Have intellectual disabilities
• Have learning disabilities
• Have sleeping and sucking problems
• Have speech and language delays
• Have behavioral problems

What can you do?

The earlier a child is diagnosed with FASD, the sooner interventions can begin, and the child can start making progress. Special services that can help a child with FASD include early intervention, special education, speech therapy, occupational therapy, physical therapy and other services. This blog series can help you learn how to access services for babies and toddlers or children ages 3 and older.

Not all babies born with FASD will experience alcohol withdrawal symptoms. According to Mother-to-Baby, “There are reports of withdrawal symptoms in infants whose mothers consumed alcohol near delivery. Symptoms included tremors, increased muscle tone, restlessness and excessive crying…Once your baby is born, it is also recommended you tell your pediatrician about your alcohol use during pregnancy. Your baby can be evaluated for effects of alcohol exposure. Services and support are available for children with alcohol related problems.”

Additional resources

The FASD Center for Excellence has information, including screening, diagnosing, intervention programs and resources.

The National Organization on Fetal Alcohol Syndrome (NOFAS) has a resource list and several fact sheets that may be very helpful to parents of children with FASD, such as FASD Identification.

March of Dimes’ role

In 1973, March of Dimes grantees were the first to link drinking alcohol in pregnancy with a specific pattern of birth defects and intellectual disabilities they called Fetal Alcohol Syndrome. Since then grantees have continued to study how alcohol harms the developing brain, and to discover better ways to prevent and treat FASDs in alcohol-exposed babies.

Here is more information, including resources on how to quit drinking alcohol. The good news is that FASD is entirely preventable by avoiding alcohol during pregnancy.

If you have questions, please send them to AskUs@marchofdimes.org. View other posts in the Delays and Disabilities: How to get help for your child series, here.

 

From NICU to EI services

Wednesday, February 18th, 2015

preemie hand in adult handIf your baby was born prematurely or at a low birth weight, chances are he or she may benefit from Early Intervention (EI) services. EI services are designed to help your baby catch up developmentally. They can include speech, physical or occupational therapy, as well as other kinds of treatment.

Usually, the hospital NICU staff will give you the information to have your baby screened or evaluated so that services may begin soon after your baby gets home (if they are needed). But, parents – you should know that a doctor or hospital referral is not needed to start the process of requesting early intervention services. You can contact your state’s agency yourself. Although it is very helpful for hospitals to give parents all of the information they need to get services started early, a hospital referral is not a requirement for a screening.

Read this post on Early intervention for babies and toddlers to learn how to request a screening. In many cases, a phone call to your state’s early intervention program is all you need to initiate an evaluation (which is free of charge to you). EI services are available in every state and territory of the United States.

Don’t delay with delays. The sooner your baby gets help, the sooner he can start catching up. If you are concerned about your baby’s development, make the call, get the free screening, and put your mind at rest.

See other topics in the Delays and Disabilities series here.

Parenting your child with a heart defect

Wednesday, February 11th, 2015

When your baby has a heart defect, it is overwhelming, exhausting, emotionally draining, and beyond scary. Have I left any adjectives out?

Congenital (present at birth) heart defects (CHDs) affect 1 in 100 babies every year. These heart defects can affect the heart’s structure, how it works, or both. Did you know that congenital heart defects are the most common types of birth defects? Each year, about 40,000 babies are born with a heart defect in the U.S. The good news is that more and more children born with CHDs are living longer, healthier lives, due to medical advances.

Heart defects develop in the early weeks of pregnancy when the heart is forming. Severe congenital heart defects are usually diagnosed during pregnancy or soon after birth. Less severe heart defects often aren’t diagnosed until children are older. Depending on the heart defect, your child may or may not need active treatment. For example, some defects resolve on their own. However, there are heart defects that require more intensive treatment and care.

What is CCHD?

Critical congenital heart disease (CCHD) is a group of the seven most severe congenital heart defects:  Hypoplastic left heart syndrome (HLHS); Pulmonary atresia (PA); Tetralogy of Fallot (TOF); Total anomalous pulmonary venous return (TAPV, or TAPVR); Transposition of the great arteries (TGA); Tricuspid atresia (TA); Truncus arteriosus.

About 1 in 4 babies born with a heart defect has CCHD, or about 4,800 babies in the U.S. every year. Babies with CCHD need treatment soon after birth – often within hours, days or months, depending on the severity of the condition. A baby with CCHD will need ongoing treatment from a pediatric cardiologist, a medical doctor with advanced training.

Your child with CCHD

Some babies with CCHD will receive surgery soon after birth, and others require subsequent surgeries as they get older. The treatment your child receives will depend on the type and severity of the defect. If your child has been diagnosed with CCHD, it is important to understand his disease and the treatment that is required. Ask your child’s pediatric cardiologist and pediatrician all of your questions. The doctor can tell you if your child’s activity should be encouraged or restricted, if your child needs antibiotic treatment before certain procedures, if your child requires extra calories (from food) to help maintain his health, if he needs physical therapy or other kinds of therapies.

Children with heart defects may be delayed in reaching their developmental milestones. Early intervention may help enable your child to make strides and catch up. Other children may develop a disability over time. The early intervention program is designed to be family centered – moms and dads receive help in parenting their child, and the child receives therapy to keep progressing. Early intervention, together with medical advances, are helping children with CCHD live richer, fuller lives.

You may need support

Parenting a child with a congenital heart defect involves a blend of vigilance, medical interventions, health advocacy and lots of love and patience. The March of Dimes’ online community, Share Your Story, is a place where parents of babies with heart defects as well as other birth defects or disabilities, can go to find support, comfort and information. There is nothing like the camaraderie of another parent who has walked in your shoes to help you through your journey.  Just log on and post a comment and you will be welcomed and supported.

Where can you learn more?

Visit our website to learn more about CCHD. We discuss the most common heart defects, how they are diagnosed and treated, as well as possible causes. You will also learn about screening tests your baby can have to determine if he has CCHD. Additional guidance on parenting a child with a heart defect is available on the CDC website.

What is dyscalculia?

Wednesday, March 19th, 2014

math bead boardPrior blog posts have focused on the different kinds of learning disabilities (LDs) that often affect preemies (as well as children born full term). Today’s post focuses on a learning disability in math, also known as dyscalculia. Although it is not noticeable in babies or toddlers, your preemie may still be affected by this kind of LD, so it is good to know about it and keep an eye out for warning signs.

Every child has strengths and weaknesses when it comes to learning. But some have more intense problems (learning disabilities) in a particular area such as reading (dyslexia), writing (dysgraphia) or math. For my daughter, her most difficult struggle was in math. “I hate math! Why do I have to do this?!”  I can’t tell you how many times I heard these words from my daughter. I can’t say I ever loved math, but I just didn’t understand the intensity of her dislike. But once she was diagnosed (through testing) with a math LD, it all became clear to me.

What is a math disability?

The experts at NCLD (National Center for Learning Disabilities) explain it best: “Individuals with dyscalculia have significant problems with numbers: learning about them and understanding how they work. Like other types of LD, the term dyscalculia does not capture the specific kinds of struggle experienced in such areas as math calculations, telling time, left/right orientation, understanding rules in games and much more.”

Dyscalculia is not a one-size-fits-all disability. There are varying degrees (mild to severe) and various kinds of math difficulties that may be present. No two kids with dyscalculia are exactly alike.

Similar to the other kinds of LDs, dyscalculia does not go away. Your child will not “outgrow it.” It is a lifelong disability; however, it CAN be managed. With the right kind of teaching methods, supports and/or accommodations, your child with dyscalculia CAN learn math.

Early warning signs of a math learning disability include difficulty…

• recognizing numbers or symbols

• remembering your phone number

• counting

• sorting items

• recognizing patterns of numbers

Later warning signs include difficulty…

• telling time

• knowing left from right

• estimating

• visualizing a number line

• counting by 2’s, 3’s, etc.

• reading a map

• memorizing multiplication facts

• counting change

• keeping score in a game

• experiencing intense anxiety when doing any kind of math work in school or at home

• retaining information (learning a concept one day but not recalling it the next)

• understanding word problems

• understanding formulas

See NCLD’s warning signs by age (from young children through adults).

Is a math LD common?

Although you may never have heard of dyscalculia, the NCLD reports that it is the next most common form of learning disability after dyslexia. As many as one in every seven kids may have a math learning disability.  That’s a lot of kids!

What can help your child?

Knowing what kind of learner your child is can make a huge difference. For instance, if your child learns best through visual and kinesthetic teaching, then seeing and touching/feeling or manipulating math items will be the best way for her to learn a concept. If a child learns best through auditory modes, then be sure that the teaching method includes verbal instructions. Many kids with LD (like mine) learn best through a combination approach – visual, kinesthetic and auditory. Attack the senses from all angles to help her understand and internalize the information presented.  The good news is that once she learns the concept the way her particular brain learns, she is unlikely to forget the information. (Yay!) Here are other strategies that may help:

• Getting extra time on tests or eliminating timed tests

• Using manipulatives (such as a bead counting board, magnets in the shape of numbers, or any other kind of object that your child can touch, hold, feel and work with.)

• Drawing pictures of word problems

• Using assistive technology (such as a calculator or a specialized math computer program)

As with other LDs, getting a clear diagnosis is key in knowing how to help your child. You can either ask the school district to test your child, or have her see a specialist for private testing. Once you have the results you will know where to focus treatment. NCLD has a full page of resources that may help.

Keep in mind that a child with a math learning disability may also have dyslexia or dysgraphia or other disorders that complicate learning. When this occurs, it becomes even more challenging for your child to learn. For instance, how can a child do a math word problem when she struggles with reading and understanding language? For this reason, getting help as early as possible and monitoring progress is very important.

Bottom line

Usually, a learning disability in math can be managed successfully. It takes getting the proper diagnosis as early as possible, getting the right program in place, continually advocating for your child, and providing plenty of positive reinforcement.

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 in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). As always, we welcome your comments and input.

What is dyspraxia?

Wednesday, February 26th, 2014

child using forkDyspraxia is a complex motor skill disorder that interferes with the activities of daily life. It can be mild or severe and affects every child differently. It is also called developmental dyspraxia and developmental coordination disorder.  It affects boys more than twice as often as girls. Dyspraxia is a lifelong disorder that can be managed but not cured.

What are some warning signs?

In babies and toddlers, signs of dyspraxia include delays in reaching developmental milestones, such as not rolling over or crawling, and later having trouble learning to walk. In young children, some of the signs of dyspraxia include being clumsy, having trouble using utensils to eat, being unable to tie shoe laces, ride a bike or catch a ball, having difficulty with speech and not completing tasks.

As you can see, dyspraxia does not have one specific sign or symptom. Having trouble talking is very different from not being able to catch a ball. But, all of these symptoms share the common basis of planning and carrying out a motor task. But, just to muddy the waters a bit, some children with dyspraxia still achieve major developmental milestones. (Are you confused yet? Wait, there’s more.) Yet, other children may have some of the signs or symptoms of dyspraxia but they are due to another diagnosis entirely. (Think of a runny nose…it could be due to a cold, the flu or allergies. The symptom is the same for each diagnosis.)  So…

How can you tell if it is dyspraxia or not, and what should you do?

In order to know if your child’s symptoms are due to dyspraxia, a developmental delay, a vision problem, or a different diagnosis entirely, it is important that a professional evaluate her. First, discuss your concerns with your child’s pediatrician at an office visit. He may recommend an additional evaluation by another expert. In addition, you can have your child evaluated through the early intervention program in your state for babies and toddlers, or through the special education system for children age 3 and older.

How is dyspraxia treated?

The kind of treatment a child receives depends on the type of symptoms and severity she is experiencing. Treatment  should be individualized. For example, if a child has trouble speaking (can’t form words properly, has trouble with the volume of her voice, etc.), then speech therapy would probably be appropriate. If a child has trouble with buttons, zippers, using a fork or knife, brushing teeth, is extra sensitive about hair brushing, or tags on clothing drives her to distraction, then occupational therapy may be helpful. If a child has trouble with moving around (she bumps into things, seems uncoordinated or clumsy, has trouble riding a bike, and generally has a tough time negotiating her space), then physical therapy may be in order.

In many cases, a child needs more than one kind of therapy in order to overcome obstacles. And, as a child grows and develops, the therapy needs to be adjusted to address her current issues and age.

It is worth noting that children with dyspraxia are often challenged by having other disorders at the same time, such as a learning disability, a speech and language disorder and/or attention problems. This is why it is important for a child to be diagnosed accurately and to receive appropriate treatment as early as possible.

Good company

shoelaces undoneDaniel Radclliffe, the actor who plays Harry Potter in the film series, has openly discussed his dyspraxia. He has trouble with handwriting and tying shoes, and admits he struggled in school.  Evidently, he has been able to focus on his gifts and talents to become a world famous actor. (Or perhaps there was just a little bit of magic thrown in?) But seriously, hard work and perseverance are always factors in learning to be successful despite a disability.

Where can you get more info?

You can learn more about dyspraxia and other learning disabilities at the National Center for Learning Disabilities (NCLD).  They have a short video that is helpful in understanding the different facets of dyspraxia. The NIH also has information on dyspraxia.

Bottom line

Although dyspraxia is a lifelong disorder, it can be managed through appropriate treatment. If you are concerned about your child’s development, be sure to speak with her health care provider or ask that your child be evaluated. Intervention at any time, is valuable.

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 in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

What is peer-reviewed research?

Wednesday, November 6th, 2013

teacher-and-childYou may have heard that your child’s program should be based on “peer reviewed research.”  But, what does that mean?

Peer-reviewed research is when research is reviewed by respected colleagues in a specific field (their “peers”), before it is considered acceptable to publish. If the method or research has been peer-reviewed and was published, then it is much more likely to be of high quality and reliable. The process of going through peer-review lends validation to published work – it makes it more believable and credible. It is considered solid and effective.

How can peer-reviewed research help your child?

If you use a therapy that has already been tried, tested, and proven successful, it is more likely to help your child. By using peer-reviewed research as the basis for your child’s therapy or intervention, it increases the chances that your child will improve. For example, if your child has a specific diagnosis of dyslexia, using a reading program proven to help children with dyslexia would be appropriate for your child. Why use another program if one exists that is validated through peer-reviewed research? In other words, why spend time using an untested instructional method when a tried and true method is available? It just makes sense. It also is the law.

Do peer-reviewed methods always HAVE to be used? What does the law say?

If you have a baby, toddler or child with a delay or disability, IDEA (the law that governs early intervention and special education services) says that the services your child receives should be based on peer-reviewed research whenever possible. In fact, the language used in the law is “to the extent practicable.” This will ensure that your child receives a method of service or therapy that is appropriate for her. Of course, there will be times when it is not practicable to use a particular method, for various reasons, but if it is possible, it should be used. Here is what the law actually says…

• For infants up to age 3, IDEA says: “The individualized family service plan (IFSP) shall be in writing and contain a statement of specific early intervention services based on peer-reviewed research, to the extent practicable, necessary to meet the unique needs of the infant or toddler and the family, including the frequency, intensity, and method of delivering services.”

• For children ages 3 – 21, IDEA says: “A statement of the special education and related services and supplementary aids and services, based on peer-reviewed research to the extent practicable, to be provided to the child, or on behalf of the child, and a statement of the program modifications or supports for school personnel that will be provided to enable the child.”

Peer-reviewed research is a win-win for the child, parents and schools

Wrightslaw has a discussion on why peer-reviewed research is a win-win for both child and school system. They say that in 2004, when IDEA was re-authorized, “Congress clarified that IEPs must include research-based methodology. Including methodology in the child’s IEP will benefit the child’s parents and teachers. As participants in developing their child’s IEP, parents will benefit by having input into the instructional methods used to teach their children. The teachers who implement the IEP will benefit by having guidance from a team of professionals who are familiar with the child and who have reviewed the research to determine the interventions and instructional methods that are most likely to provide the child with educational benefit…This is a win, win situation for all – especially for children who will benefit when they receive effective instruction from teachers who are trained in research-based instructional methods.”

Bottom line

Before you and your IFSP or IEP team decide on the services that your child will receive, (parents are equal partners of the team), see if it is possible to use an instructional method based on peer-reviewed research. Hopefully, the method will be appropriate and meet your child’s unique needs.

 

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

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

What is a Developmental Behavioral Pediatrician?

Wednesday, September 11th, 2013

doctor-and-child2Is there a difference between a Pediatrician and a Developmental Behavioral Pediatrician? In a simple word – yes.

A Pediatrician is a medical doctor (MD) who is specifically trained to care for children (from birth through teen years). If you have a baby, child, or a teenager, you have probably had her seen by a Pediatrician for her healthcare needs. This would include well-care visits as well as sick visits.

But if your child has any kind of need beyond the “typical” health issues common for her age, you might wish for her to see a pediatric specialist. A Developmental Behavioral Pediatrician (DBP) is a Pediatrician with advanced specialty training in the physical, emotional, behavioral and social development of children.

The American Academy of Pediatrics (AAP) says “Developmental-behavioral pediatricians are medical doctors who have completed
• Four years of medical school
• Three years of residency training in pediatrics
• Board certification in pediatrics
• Additional subspecialty training in developmental-behavioral pediatrics
In 2002, the American Board of Pediatrics began certifying developmental-behavioral pediatricians via a comprehensive examination process.”

When should your child see a Developmental Behavioral Pediatrician?

If you have concerns about your child’s development in any area – social, emotional, behavioral or developmental – you should ask your child’s health care provider about consulting with a DBP. Often a Developmental Behavioral Pediatrician works with a team of pediatricians or pediatric health care providers. This team approach can provide a more in-depth perspective for a parent, which will ultimately help your child be the best that she can be.

You may benefit from having your child see a DBP if your child has (or you think she may have):

• Delayed speech and/or trouble understanding language
• Delayed motor skills (crawling, walking, eating, riding a bicycle)
• Poor social skills
• Trouble sleeping (including bedwetting)
• Trouble feeding or eating
• Sensory sensitivities
• Trouble at school (paying attention; learning to read, write or do math)
• Cerebral Palsy
• Attention Deficit Hyperactivity Disorder (ADHD) or ADD (without hyperactivity)
• Learning disabilities
• Anxiety disorder
• Depression
• Tics or Tourette Syndrome
• Spina Bifida
• Autism Spectrum Disorder
• Intellectual disability
• Other chronic conditions, serious illnesses, or complications due to prematurity

A Developmental Behavioral Pediatrician may suggest additional testing or input from other pediatric specialists or therapists. Then, she will review the results and take all the different pieces of the puzzle and put them together to make a plan of action. The result is a comprehensive evaluation with treatment recommendations which will give your child the best chance at making progress.

The AAP has a great one-page sheet that describes all of the ways that a DBP can help you and your child.

How do you find a DBP?

To find a Developmental Behavioral Pediatrician near you, visit AAP’s physician locator or ask your child’s health care provider for a referral.

Bottom Line

Often a visit with a Developmental Behavioral Pediatrician will help to clarify complex issues. If your child is having difficulty in an area, it may be very beneficial to gain the insight from another pediatric specialist.

Note:

This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 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.

Do siblings of children with disabilities need help?

Wednesday, August 14th, 2013

unhappy-little-boyBrothers and sisters of a child with special needs are often negatively affected according to a July 2013 study in Pediatrics.

If you have a child with special needs, you know all too well the enormous time, energy and resources you expend to take care of her. You do it lovingly and willingly, and often to the exclusion of everything else. But what happens when you have more than one child? As much as you try to divide yourself among all of your children, it may be impossible to give attention to your other children when your child with a disability is in need of support or attention at that same moment. You can’t read a bedtime story to Johnny if Susie needs her therapy. It would be like going out for coffee instead of putting out a fire. It just doesn’t work. You try to divide yourself as equally as possible, but the responsibilities of caring for a child with a disability often make it impossible to be equitable. But, will there be long term effects on the “typical” siblings?

The results of this study

Although there have been other studies that have looked at the effects on brothers and sisters, this study was much larger. More importantly, it looked at families with children who live with a sibling with a disability and compared them to families with children who live with siblings who are typically developing.

This study examined how the parents’ care of a child with special needs impacts the other children in the family. The study found that children who have a sibling with a disability are more likely to experience difficulty functioning at school, in sports or activities, and with friends. They tended to get sick more frequently and experience more relationship problems, especially with their mother. They also experienced more psychological or emotional difficulties than children who did not have a sibling with a disability. But, children who had another typically developing sibling (in addition to a disabled sibling) tended to do better than a child with only one sibling who is disabled.

I don’t find these results surprising, do you? When you parent a child with special needs, your world centers around your child with a disability – it is only natural. Often, this is such a time-consuming task that your other children may feel that they do not get enough time to bond with Mom or Dad. You do your best, but your typically developing children definitely get a different kind of upbringing. The study authors commented “It is not that parents overlook their other children who are typically developing. Parents worry that they can’t provide enough for all their children.” Sound familiar?

This study emphasized the financial, physical and emotional toll of caring for a child with a disability. All of these stressors can lead to not noticing or having the time to deal with early signs of trouble in your “typical” children. If left untreated, these problems can lead to mental illness (such as depression and anxiety) and behavioral problems that negatively impact a child’s life. (Not to mention that all of this stress can affect you and your spouse or partner, too!) But don’t beat yourselves up parents – you are not super-human. Instead, let’s look at possible solutions.

So, what is the upshot?

First of all, not all siblings wind up having problems. But if they do, the study authors suggest “a family-based health care approach for all family members.”  Interventions aimed at helping parents learn better ways of juggling and managing stress, as well as providing strategies to help the brothers and sisters cope, can be very helpful.

• Check to see if your town has any support groups for parents of children with special needs. You may learn time management skills and other tips to help you balance the parenting load, and spend more time with your “typical” children. The extra coping and parenting skills for Mom and Dad will have a trickle down effect and help everyone in the family.

If you see any of your children acting out or turning inward and withdrawing, explore getting him help as soon as possible. You can do this in a several ways:

• take your child to his pediatrician for a check-up and discuss your concerns;
• have your child join a siblings support group;
• have your child speak with the counselor, social worker or psychologist at his school. Often, in a private setting with a non-family member, a child will open up about his feelings. This relief may go a long way in modifying his behavior and lifting his mood.

Try to get the ball rolling on getting your typical children help as early as possible. Early assessment and interventions can make a huge and lasting difference.

Bottom line

There is no doubt about it – life with a child with a disability affects all family members. You are not alone in your journey. Reach out for assistance and you will see that every little bit of help…helps.

What has worked for your family? We’d love to hear from you.

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.

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

Delays and disabilities series – a recap

Wednesday, August 7th, 2013

babiesHere is a list of all blog posts to date with links, grouped by topic. You can go back and see what pertains to you and get caught up. This post should help you to make sense of this series which started in January 2013 and appears on News Moms Need every Wednesday.

Intro – Why this series? How it will help you

A new blog series is here 

First things first – Is your child’s development on track?

Developmental milestones and delays 

Getting help for free  – the evaluation

Early intervention for babies and toddlers 

Early intervention for children ages 3 and older 

Figuring out the language of special needs

Learning the lingo

Words and terms – a whole new world 

Delays, disabilities and the law 

Navigating the early intervention and special education systems

What is an IFSP? (for kids from birth to age 3)

What is an IEP? (for kids ages 3 and up)

IEP or 504 – that is the question 

April is IEP month 

IEPs and LREs – the nitty gritty 

What is Prior Written Notice or “PWN”?

Keeping track of your child’s records –useful tips

An easy way to find resources for kids with special needs

Different diagnoses (there will be more diagnoses added to this part of the blog in the coming weeks)

Did you hear me?  The child with auditory processing problems

Different kinds of therapies

What are Related Services? 

What is Speech Therapy?

What is Physical Therapy or PT?

What is Occupational Therapy or OT? 

What are Recreation Services?

What are Hippotherapy and Therapeutic Riding (THR)?

Summers, vacations and transitions

Vacationing with a child with special needs 

Re-entry: life after vacation 

A transition tip – how to help your child go from activity to activity, or place to place

Parenting suggestions and caring for YOU

Caring for the caretaker – put on your oxygen mask  

Emergencies – Preparing for disasters when you have a child with special needs 

Delays and disabilities worldwide

International focus on children with disabilities 

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 suggestions for future topics.

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

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.

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.