Special Needs, Special Horses: A Guide to the Benefits of

Therapeutic Riding (Practical Guide)

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 Special Needs, Special Horses
A Guide to the Benefits of Therapeutic Riding

By Naomi Scott

Number Four in the Practical Guide Series

University of North Texas Press

Denton, Texas

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 ©2005 Naomi Scott

Foreword by J. Warren Evans

@2005 University of North Texas Press

All photographs by Naomi Scott unless otherwise indicated

A portion of the proceeds from the sale of this book

will be donated to equine assisted activities.

All rights reserved.

Printed in the United States of America.

10 9 8 7 6 5 4 3 2 1

Permissions:
University of North Texas Press
P.O. Box 311336
Denton, TX 76203-1336

The paper used in this book meets the minimum requirements of the American
National Standard for Permanence of Paper for Printed Library Materials,
z39.48.1984. Binding materials have been chosen for durability.

Number Four in the Practical Guide Series

Library of Congress Cataloging-in-Publication Data

Scott, Naomi, 1935–

Special needs, special horses : a guide to the benefits of
therapeutic riding / by Naomi Scott.
p. cm. -- (Practical guide series ; no. 4)
Includes bibliographical references and index.
ISBN 1-57441-190-X (cloth : alk. paper) -- ISBN 1-57441-192-6
(pbk. : alk. paper)
1. Horsemanship—Therapeutic use. I. Title.
II. Practical guide series (Denton, Tex.) ; no. 4.
RM931.H6S36 2005
615.8’515--dc22
2004023088

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 Dedicated to the riders and everyone
involved in equine assisted activities

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 Contents

Foreword ...............................................................................ix
Preface ..................................................................................xi
Acknowledgments ...............................................................xiii

Part I: Therapeutic Riding and Activities

Chapter 1: Description ............................................................3
Chapter 2: Benefits ............................................................... 11
Chapter 3: Origin and History ............................................... 17
Chapter 4: Instructors and Therapists .................................... 25
Chapter 5: Owners, Community, and Volunteers ..................... 31
Chapter 6: Horses .................................................................39
Chapter 7: Procedures for Riding Sessions ..............................47
Chapter 8: Recreational Riding—with profile of Amy ............. 53
Chapter 9: Hippotherapy—with profile of Cory ...................... 61
Chapter 10: Alternative Activities—Vaulting and
Carriage Driving .......................................................... 69
Chapter 11: Competition ........................................................77
Chapter 12: Private Riding Program—with profile of Erika ......85
Chapter 13: Starting a New NARHA Center ............................ 91
Chapter 14: Helping Troubled Youth .......................................99

Part II: Profiles

Chapter 15: Leah—Intrauterine Stroke ................................. 107
Chapter 16: Brandon—Cerebral Palsy ....................................113
Chapter 17: Barbara—Transverse Myelitis............................ 121
Chapter 18: Larry—Parkinson’s Disease .............................. 127
Chapter 19: Kate—Paralysis, Auto Accident ......................... 133
Chapter 20: Alicia—Sensory Integration Dysfunction ........... 139
Chapter 21: Tracy—Multiple Sclerosis .................................. 145
Chapter 22: Stephen—Shaken Baby Syndrome...................... 151

vii

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 Chapter 23: Milan—Sensory Damage, Auto Accident............ 155
Chapter 24: Lynn—Paralysis, Skiing Accident ...................... 159
Chapter 25: Andrew—Infantile Strokes,
Possible DPT Reaction ................................................... 167
Chapter 26: Ben—Infantile Seizures ..................................... 173
Chapter 27: Nick—Down Syndrome .................................... 179
Chapter 28: Seth and Noah—Autism .................................... 183
Chapter 29: Miracles and Research....................................... 189

Appendix ........................................................................... 191

Notes ................................................................................ 194
Glossary ............................................................................. 207
Bibliography ....................................................................... 214
Index ................................................................................. 216

viii

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 Foreword

I highly recommend Special Needs, Special Horses for anyone wanting

to learn about equine assisted activities, or therapeutic riding. Written in
an easy to read format, the author fulfills an informational and educational
need that has existed for a long time in the industry. Before this text,
those who wanted to know more about equine assisted activities for the
emotionally and physically disadvantaged had to consult a number of
resources, often getting conflicting or outdated information. The people
who assisted the author in preparing the text reads like a who’s who in
the field of equine assisted activities.
Parents of participants or potential participants will enjoy the
descriptions of what happens during a typical riding session. The
reluctance of some participants to initially ride is described, as are the
technologies to alleviate the reluctance, and to get them comfortable on
the horse. Most important, the author describes the potential benefits for
a number of emotional and physical challenges that parents can expect,
and the time period to observe the results. It is explained that everyone
may not benefit from the therapy. The author describes the desire of
most participants to continue this form of therapy/recreation for a much
longer period of time than other treatment modalities. Participants in
other forms of therapy often lose interest in therapy after three to four
years. Some riders have the potential to become independent riders and
enjoy riding as a family activity.
For those who are considering a career in the field of equine assisted
activities, the text gives an excellent overview of its many facets. The
author describes the roles of riding instructors and therapists in typical
riding sessions, and presents examples. How physical, occupational,
speech, and psychological therapists utilize equine assisted activities
as one of their modalities of therapy, how participants respond, and the
expected results are also explained.
Current volunteers and those considering volunteer work at a
riding center will greatly benefit from Special Needs, Special Horses. The
importance of the role they have in a successful riding session and what

ix

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 FOREWORD

to expect when they are assisting a rider are also offered, and in fact, the
book will serve as a guide for the volunteer.
The advice about starting a program in a community is very helpful
for community leaders, riding centers, and motivated equestrians. This
information has been difficult to find in the past. The author discusses
the types of horses needed for various activities, special equipment
needs, establishing a volunteer base, and community involvement.
A strong component of this book is the profuse use of case histories
and interviews with a wide variety of participants. These carefully
chosen profiles illustrate the number of different mental and physical
challenges that benefit from therapeutic riding. In addition, the notes
section, organized by chapter, and the sample list of studies are a
valuable part of Special Needs, Special Horses. This provides sources
for detailed information on all the topics discussed. The sample list of
studies (research reports) is invaluable to those who must justify the
use of this therapy to medical personnel and others, and predict positive
results. The author has certainly accomplished her purpose and provides
a well-written account of equine assisted activities.

J. Warren Evans, Ph.D.

Professor of Animal Science and Coordinator,
Roy E. Dye Therapeutic Riding Program
Texas A&M University

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 Preface

“Walk on!” a soft voice commands from atop a thousand-pound

horse. The animal responds, one volunteer leading, and one on either
side holding the child’s knee to give security. An instructor follows,
closely directing a session of therapeutic horseback riding.
Equine assisted activities is the umbrella term preferred by the
North American Riding for the Handicapped Association (NARHA) for
interaction between special needs individuals and horses, the client
either mounted or on the ground. These remarkable relationships can
result in benefits to the physically, mentally, and emotionally challenged
greater than those of conventional therapy. In some cases, riding can
replace or supplement treatments that may be far less motivating. Even
surgery has been avoided in instances.
A particularly appealing aspect of equine assisted activities is the
incorporation of recreational, and social pleasures for those unable to
participate in other sports. The overall result is an improved quality of life.
Improvements resulting from these activities are documented,
although additional research is needed.
The primary purpose of this book is to provide information, in
layman’s terms, about procedures, techniques, and the many benefits
participants in EAA have experienced. The objective is to acquaint
prospective clients with the programs, particularly children who haven’t
ridden, or had contact with horses before, and may be apprehensive,
or downright scared. An explanation of what to expect, with pictures
of youngsters playing games on horseback, or a small child with a big
smile as he hugs his horse’s neck, will lessen the anxiety of the possibly
formidable first session.
People involved in equine assisted activities are introduced to
the reader. These are the capable, caring, and dedicated instructors,
therapists, owners, and staff of NARHA centers, and the volunteers who
comprise more than eighty percent of the workforce.1
A chapter is devoted to the wonderful horses that make these
activities possible.

xi

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 PREFACE

Amazing results achieved from riding are detailed in several case

studies, which illustrate how the challenged conquer obstacles the
able-bodied often believe hardly possible. These stories will reveal to
others with similar problems what they too might achieve, and will be
of interest to those who are drawn to human drama.
In studying about equine assisted activites, I found information in
several sources, including the publications of Barbara Engel.2 However,
most appeared to have a technical orientation, targeting instructors,
therapists and volunteers. I saw a need to provide information which
would also be of more benefit to prospective clients and their families.
The book is written from interviews with instructors, therapists, and
others involved in the programs, from research, primarily compiled by
NARHA, into the origin and history of using the horse’s motion as a
treatment tool, and from my observations as a volunteer for several years
in the Fort Worth/Dallas, Texas area. Procedures may vary at facilities
across the country, however, NARHA centers operate within association
guidelines so the differences should not be significant.
More than seven hundred centers are members of NARHA, repre-
senting all fifty states,3 and one hundred centers operate in Canada.4
However, the need is great for more. Most NARHA centers have per-
petual waiting lists, and could accommodate more riders with additional
workforce. In many areas there is no center at all. It is hoped this book
will encourage the development of new programs, and that it will entice
prospective instructors, therapists, and volunteers.
Inside the field of equine assisted activities engaged in for the
purpose of improving physical, mental, and emotional well-being, there
currently is much debate about the terminology used to describe each
activity, in particular, recreational riding vs. therapeutic riding. Those
who practice hippotherapy want to insure that only licensed therapists
do so. Instructors want it known that the good work they do is much
more than teaching horseback riding.5

xii

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 Acknowledgments

Many people contributed to this work, making it truly a team effort.

My heartfelt gratitude goes to all of you.
First, thanks to Holly Robinson, NARHA Registered Instructor, who
provided me with details of the technical side of riding, procedures, and
how various parts of the anatomy benefit. She was always available to
answer questions as I assembled the information, read the written copy,
and made changes to insure the integrity of the book.
Others with whom I worked and/or learned from, contributing
greatly to the book, include Gayle Ainsworth, Denise Avolio, Terri
Barnes, Deb Bond, Jake Bond, Margaret Dickens, Patricia Diness, Dr.
Ronald Faries, Charles Fletcher, Mary Gwinner, Lili Kellogg, Iris Melton,
Cynthia Moore, Sarah Muniz, Judy Nagy, Sanna Roling, Jonquil Solt,
Lisa Stajduhar, Sandy Webster Stolte, Jessica Whaylen, Anna Vlachos,
Helga Vogel, and George and Tracy Winkley.
Michael Kaufmann, NARHA Communications Director, provided
details about the Association’s function, statistics, and read chapters
directly pertaining to NARHA, to assure the technical information is
correct.
A valuable addition to the book are published works of others I
was permitted to excerpt including writings by Isabella (Boo) McDaniel,
Gisela Rhoads and Barbara Stender.
The public libraries of Fort Worth and Grapevine, Texas, furnished
important research material.
Doug and Vivian Newton, owners and operators of Rocky Top Ranch
and Therapy Center, Keller, Texas, availed me of their facilities where I
observed, learned, and gathered material for many of the case histories.
Staff and volunteers assisted me in innumerable ways, with information,
photographing equine assisted activities, and permitting me to use their
photos. Janet Venner, and Janice and Terry Richards, provided their
insights into the motivations and rewards of volunteering.
Much credit for helping to shape and polish the content, with
critique and suggestions, goes to members of Trinity Writers Workshop.
A special thanks to Warren Fulks who read and improved the entire

xiii

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 ACKNOWLEDGMENTS

manuscript, and to Paula Oates, University of North Texas Press, for her
editorial assistance to bring it all together.
The best, as usual, is saved for last. Most important to the book
are the riders and their families. My appreciation to all who participate
in equine assisted activities, and in particular those whose stories I
was permitted to include, in hopes the information will be of benefit to
others.
Brandon Barnette
Erika Bartelson
Leah Epich
Seth and Noah Gile
Nick Hogan
Barbara Lamb
Andrew Levy
Milan McCorquodale
Tracy Roberson
Benjamen Schwalls
Lynn Seidemann
Amy Stefanko
Kate Stuteville
Larry Walls
Alicia Wettig
Stephen White
Cory Winton

xiv

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 Part I

THERAPEUTIC RIDING AND ACTIVITIES

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 Christopher Carrier enjoys a hippotherapy session aboard Siesta. Left to right:
Sidewalkers Cecil Hill and Valerie Schlegel, leader Deanna Dede. Christopher
has progressed from a bareback pad to riding in a western saddle, and standing
in the stirrups. He holds a baton behind his back, an aid to stretching and better
posture.

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 Chapter One

Description

A fourteen-year-old with cerebral palsy, frail of limb but stout with

courage, grips the surcingle handle tightly. His body sways slightly with
each stride of his palomino mount as it is led around a large arena.
Another volunteer and I walk on either side, holding him firmly on the
bareback pad, supporting his thighs, offering smiles and praise.
An instructor follows, closely observing and encouraging, “You’re
doing great, Brandon. Try to relax. They won’t let you fall.”
Slowly his muscles, taut beneath my fingers, begin to soften. His
fear of the unknown turns to excitement and he grins, then laughs out
loud, again and again. He is riding a horse for the first time. To him it’s
just fun. He doesn’t know it is going to spare him the ordeal of surgery.
A five-year-old autistic boy, who does not speak, and barely com-
municates, gazes vacantly into space as I lead his horse away from the
mounting area. After a couple of laps, the child smiles, leans forward,
reaches out, and taps his horse on the neck, his way of saying, “Let’s
trot.” We pick up the pace, breeze flicks tousled curls from his forehead,
and he laughs, his hand in the air. His instructor has worked for weeks
to connect this gesture with trotting, which his smiles and body lan-
guage show he loves to do.
A breakthrough? Perhaps.
An ancient Greek sage’s observation, “The outside of a horse is the
best thing for the inside of a man,” is more profound than he could have
imagined. Equine assisted activities actually improve the quality of life for

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 THERAPEUTIC RIDING AND ACTIVITIES

many physically, mentally, and emotionally challenged. But perhaps the

sage did know this. Hippocrates spoke of “riding’s healing rhythm.”
We cannot know how much people’s lives may have been improved
from riding, down through the centuries, when a large percentage of
the world population made their living from the land with the aid of
horses. Many no doubt also rode these wonderful, all-purpose animals,
and reaped abundant rewards from it, without realizing the extent of the
benefits they were receiving.
The marvelous programs using the motion of a horse as a treatment
strategy have been reported to achieve improvements greater than con-
ventional methods of therapy, while providing recreational and social
pleasure to children and adults.
Dramatic results have been documented. The most fantastic one I
have seen personally is the case of Brandon Barnette, the fourteen-year-
old mentioned above, where impending surgery was deemed unneces-
sary after a few months of regular sessions on a horse.
“Riding aligns the hips, and promotes stability. That’s the same
thing surgery would do,” reports Brandon’s mother.1 Brandon’s story
appears in chapter sixteen.
Many equally amazing benefits are credited to equine assisted ac-
tivities, examples of which are related in the profiles presented in this
book.
Riding programs afford an opportunity to interact socially, and en-
ter into competition, for those unable to participate in other sports. As
contestants rein their horses around the show ring, then reach down to
accept a gleaming trophy, medal, or ribbon, the expressions of pride and
accomplishment on smiling faces are exactly the same as those you see
on your television when an athlete takes the Olympic Gold.
In addition, the recreational nature of riding removes the negative
connotation many have toward therapy, particularly for children, or the
mentally challenged, who might not understand why they must endure
monotonous, perhaps even painful, treatments.
Riding can also facilitate other types of therapy. An example of this
is a Parkinson’s patient whose rigidity and tightness limited the degree
of adjusting his doctor, Ronald Faries, D.C., could do. After a few hippo-

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 DESCRIPTION

therapy sessions, the tension relaxed, allowing for expanded treatment.

“At first I had to lift him off the table. Now he does push-ups on it,” Dr.
Faries said.2
A psychological plus is that when mounted on a big horse, a rider
can look down at his world, instead of up, as those who use a wheel-
chair must do.

TYPES OF ACTIVITIES
1. Hippotherapy
From the Greek word hippos, meaning horse, the term literally
means “treatment with the help of a horse,” and refers to the use of the
horse’s movement as a treatment tool to improve neuromuscular func-
tion. A true medical intervention, it is administered by licensed Physical
Therapists, Occupational Therapists, Speech-Language Pathologists, or
assistants, who have received training in the principles of hippothera-
py.
The therapeutic qualities of riding are recognized by many medical
professionals, including the American Physical Therapy Association and
the American Occupational Therapy Association.
The horse’s walk provides sensory input through motion, which
is variable, rhythmic, and repetitive. The resultant responses in the
patient are similar to human movement patterns of the pelvis while
walking. The variability of the horse’s gait enables the therapist to
grade the degree of sensory input to the patient, and then use this
movement in combination with other treatment strategies to achieve
desired results.
Patients engage in activities on the horse which are enjoyable, and
challenging, and they respond enthusiastically to this pleasant experi-
ence in a natural setting.
Hippotherapy is generally indicated for children and adults with
mild to severe neuromusculoskeletal dysfunction. Resulting conditions
which may be modified with hippotherapy are abnormal muscle tone,
impaired balance responses, impaired coordination, impaired commu-
nication, impaired sensorimotor function, postural asymmetry, poor
postural control, decreased mobility, and limbic system issues related

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 THERAPEUTIC RIDING AND ACTIVITIES

to arousal, motivation, and attention. Functional limitations relating to

gross motor skills such as sitting, standing, walking; speech and lan-
guage abilities; and behavioral and cognitive abilities, may be improved
with hippotherapy.
Primary medical conditions, which may manifest some or all of the
above problems and may be indications for hippotherapy, are cerebral palsy,
cerebral vascular accident (stroke), developmental delay, Down syndrome,
functional spinal curvature, learning or language disabilities, multiple scle-
rosis, sensory integrative dysfunction, and traumatic brain injury.3
However, hippotherapy is not for every patient. Specially trained
health professionals must evaluate each potential rider on an individual
basis.
A better quality of life has been attained, through hippotherapy or
recreational riding, by some with other conditions including amputa-
tions, cardiovascular accident, muscular dystrophy, Parkinson’s disease,
spina bifida, spinal cord injuries, and visual impairments.4

2. Equine Facilitated Psychotherapy (EFP)

EFP is a form of experiential psychotherapy that includes, but is not
limited to, equine activities such as handling, grooming, lunging, riding,
driving, and vaulting. The administering therapist must be an appropri-
ately credentialed mental health professional.
The unique relationship formed with a horse provides the client
with opportunities to enhance self-awareness, and re-pattern maladap-
tive behaviors, feelings, and attitudes.5
Isabella (Boo) McDaniel, M.Ed., co-founder of the Equine Facili-
tated Mental Health Association (EFMHA), wrote: “The definition of
therapeutic riding has been expanded and enhanced by including those
whose mental health, emotional well-being, and ability to learn have
been severely challenged.
“EFMHA members, parents, teachers, therapists, and hospital ad-
ministrators, are seeing first-hand that self-esteem grows by leaps and
bounds once riders experience their own competence on and around a
horse. This ‘can do’ attitude helps develop a sense of worth which is es-
sential to the whole process of rebuilding broken lives.”6

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 DESCRIPTION

EFP may be used for people with psychosocial issues and mental health
needs that result in any significant variation in cognition, mood, judgment,
insight, anxiety level, perception, social skills, communication, behavior,
or learning. Examples of this are anxiety, attention deficit hyperactivity
disorder, autism, behavioral difficulties, depression, language (receptive or
expressive) disorders, major life changes (such as environmental trauma,
divorce, grief and loss), mood disorders, personality disorders, post trau-
matic stress disorder, psychotic disorders, and schizophrenia.
EFP denotes an ongoing therapeutic relationship with clearly es-
tablished treatment goals and objectives developed by the therapist, in
conjunction with the client. It both promotes personal exploration of
feelings and behaviors, and allows for clinical interpretation.
Complementing EFP is Equine Facilitated Experiential Learning,
which promotes personal exploration of feelings and behaviors in an
educational format. It falls under the heading of equine assisted activi-
ties, and may be conducted by a NARHA instructor, an educator, or a
therapist. The term implies that persons learn about themselves through
interaction with their environment, including the people, animals, and
situations involved.
EFP, or EFEL, helps clients with specially designed interactive expe-
riences, which may promote psychosocial healing and growth through
the following: improving self-esteem and self-awareness, developing
trust in a safe environment, providing social skills training, encourag-
ing sensory stimulation and integration, combining body awareness
exercises with motor planning and verbal communication, developing
choice-making and goal-setting skills, developing sequencing and prob-
lem-solving skills, encouraging responsibility, and promoting pro-social
attitudes through care-giving experiences.7
The tools used to strive for these results include the simple hands-
on activities of working with a horse, in a natural outdoors environment.
Learning to care for the animal—grooming, saddling, riding, feeding—
requires following directions, working with a group, sequencing, com-
pleting tasks, building skills, having confidence, finishing a project, and
trusting adults. At the end of the session, the client can feel that he did
things right because the horse responded.

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 THERAPEUTIC RIDING AND ACTIVITIES

Information about precautions or contraindications to EFP can be

obtained from NARHA. Chapter fourteen contains examples of programs
for helping troubled youth.

3. Recreational Riding
Clients ride under the direction of a trained, certified therapeutic
riding instructor, privately or in a group. The objective is to enhance
quality of life through physical and emotional stimulation, while learn-
ing horsemanship skills.
Although each type of activity has specific procedures and objec-
tives, the fundamentals overlap. The human body and psyche being
interwoven, most participants in one category receive some benefits
which are generally associated with the others.
Riders with more serious disabilities often start with hippotherapy,
then when their strength and balance have improved sufficiently, they
progress to recreational riding.8

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