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EQUINE FACILITATED THERAPY G U I D E L I N E S Prepared by: Ben H. Nolt, Jr. Coordinator, 4-H Animal Science Programs Department of Agricultural and Extension Education College of Agricultural Sciences The Pennsylvania State University 1995 |
GUIDELINES FOR THERAPEUTIC HORSEBACK RIDING PROGRAMS
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Why riding for people with disabilities?
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Since recorded time, we know that the horse has served humanity. In his relationship with mankind his use has included a food source, transportation, work, worship and war. His entrance into the rehabilitation field is deeply rooted in history. Early mythology tells of the horse being used as a healing agent and medical writers comment favorably on riding in the treatment of disease as early as 325 AD. World-wide attention was directed to the value of riding for rehabilitation when in 1952 Liz Hartel, a victim of the polio epidemic, won a silver medal in dressage at the Helsinki Olympic Games. In 1953, Pony Riding for the Disabled Trust was founded in England. From this beginning the movement began to spread. In North America, Joseph Bauer and Dr. Renaud started a program in Toronto, Canada, about 1965-1966. In 1968 the Community Association for Riding for the Disabled (C.A.R.D.) was formed. In the United States Maudie Hunter-Warfield established Happy Horsemanship for the Handicapped in 1967, and Lida McCowan was instrumental in the birth of the North American Riding for the Handicapped Association in 1969. Also in 1969 the Cheff Center for the Handicapped was established. The Cheff Center, located in Augusta, Michigan, is the largest facility in the world built expressly for therapeutic riding. Why all of this interest? What does riding do for the people with disabilities that cannot be similarly achieved in the treatment room or in other activities such as swimming? Little empirical research has been completed on the results, however, the use of accurate progress notes, reports from physicians, teachers, therapists, parents, etc., gives testimony to the fact that riding accomplishes the following: Psychological:
Physical:
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OBJECTIVES OF THE 4-H THERAPEUTIC RIDING PROGRAM:
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I. Determining Program Interest (Education)
To determine program interest, presentations to the following may be
necessary:
Your presentations will arouse interest, and once interest is established: |
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II. Form a Committee (Excitement)
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The committee should consist of ten or so people who will be seriously committed to organizing and raising funds for the program. It is suggested that you include representatives familiar with the following:
A chairperson, secretary, and treasurer should be chosen. The committee must make decisions regarding the scope of the program. For example: What populations will you serve? Who will be the instructor(s)? Where will you hold the program? It is also an excellent idea to try and get an attorney to volunteer his/her services as council to your efforts. |
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III. Mechanics of the Program (Execution)
| A. Professionalism. It is advisable for new programs to join the North American Riding for the Handicapped Association (NARHA) and the PA Council on Therapeutic Horsemanship. The Pennsylvania State University, College of Agricultural Sciences, Department of Agricultural and Extension Education maintains an interest in equine facilitated therapy and has staff available to advise and lecture on all aspects of the topic. |
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North American Riding for the Handicapped Association, Inc.: This nonprofit organization encompasses the United States and Canada. Their purpose is to promote the well being of people with disabilities through the provision of horseback riding, to provide training, to conduct research, set standards, and certify approved programs. Membership in N.A.R.H.A. will put you in touch with many experts in the field as well as keep you in touch with what is happening in programs throughout the United States, Canada, and other parts of the world as well as supply you with valuable information via their publications. N.A.R.H.A. also offers a comprehensive insurance policy to its member operating centers. The mission of NARHA : To promote and support equine -facilitated activities for individuals with disabilities. NARHA, Post Office Box 33150, Denver, CO 80233 1-800-369-RIDE (7433) FAX 303-252-4610 |
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| PA Council on Therapeutic Horsemanship:
This organization, previously known as the Pa Council on Horseback Riding for the Handicapped, came into being in the late 1970's. Professor James P. Gallagher, Extension Horse Specialist at Penn State, and Richard C. Ely (a state 4-H Horse Program Leader) recognized a need to better inform individuals who were engaging in riding lessons for people with disabilities. The "Council" was formed in cooperation with Penn State and the Pennsylvania Easter Seal Society. An Executive Director position was formed and located within the 4-H department. The Council serves as a resource for information, promotion and education regarding all aspects of therapeutic horseback riding. Members of the Council received a periodical newsletter and may attend an annual conference and other meetings. Pa Council on Therapeutic Horsemanship, Post Office Box 628, Franklin, PA 16323 814-437-2318 |
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The Pennsylvania State University: Penn State has maintained an active role in the development of therapeutic riding programs, the inclusion and integration of therapeutic riding into the state 4-H Horse Program and the development of formal and non-formal educational opportunities related to equine facilitated therapy. Personnel are on staff to assist with educational, developmental, technical and industry related activities. Coordinator - Therapeutic Riding, Room 323 Ag Admin, University Park, PA 16802-2601 |
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B. The Instructor
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C. Therapist
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Having a physical, occupational, recreational or other type of therapist on your staff is not a necessity (but certainly is beneficial). However, it is strongly suggested that you involve a therapist in one way or another. Usually you can find someone who will donate his/her services. It is imperative to have initial and periodic therapy evaluations. It is important that these evaluations be in written form and included in the students' records. If your therapist is not a rider, it is a good idea to teach him/her if at all possible. He/she will be able to make more accurate recommendations if there is an understanding of the mechanics of riding and the movements of the horse.
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D. Facility
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The arrangements that you choose will depend on your budget and local conditions. The basic rule of thumb - the facility must be safe and accessible. In choosing a site consider some of the following: Will the program be year-round or seasonal? Will the animals live on-site or be trailered in? Will the hours that the facility is available be convenient to students, parents and volunteers? Is the site close enough to the majority of students? Are the grounds reasonably maintained? Is there an accessible rest room? Is there a suitable place for holding lessons? Is there accessible parking? The riding area itself should be enclosed in a safe manner. If the facility does not have a first aid kit, you will need to purchase one. When approaching property owners regarding the use of their facilities, make sure that you fully explain the scope of your program and the type of students that will be included. Be sure that they know everything they need to know before you begin the actual program. Surprises are nice but not in this case. Also, be sure to name the property owner as an additional named insured on your insurance policy.
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Media coverage detailing your plans will be most helpful in acquiring riders/students. Work with your local Easter Seal Society, School Districts, parent groups, and area agencies serving the disabled. Who can ride? Almost anyone with their physician's permission can benefit from a therapeutic riding program. The final decision on rider selection should be a joint decision between the referral source, the physician, and the Instructor(s) and be based on the instructor's ability to work competently with the type(s) of disabilities involved, as well as the appropriateness of riding therapy for that particular student. Some programs limit their enrollment to certain types of disabilities. Others accept all types of riders with disabilities, grouping students as closely to age and abilities as possible. The types of riders that you accept are the decision of your group. A word of advice however - start small. There are certain forms that should be completed before a student rides. (See Appendices A, B, C, D). Each student's file should contain his physician's form, permission slip, photo release, and physical therapy assessment. Accurate records of the students' progress should be included as well. (See Appendix E).
F. Recruiting Volunteers Most programs operate on limited budgets. Therefore, most can not afford to pay all the personnel that it would take to conduct a quality program. They rely on the dedicated support of volunteers. The volunteers are the backbone of the effort. Criteria - It is suggested that volunteers be no younger than 14 years of age. This age guideline is certainly dependent on maturity, physical size and ability. Horse experience is desirable but not necessary (unless volunteering as a horse leader). Volunteers should also be able to walk (often on thick or uneven terrain) for at least an hour and be able to jog occasionally. Since each student will begin with three volunteers (two sidewalkers and one horse leader), the number of volunteers you will need will be proportional to the number of students that you will be serving at any given time. Besides the actual lesson, volunteers can help in a number of other ways. They can work on public relations, help with fundraisers, do stable work, clean tack, mow grass, work with children waiting for lessons, etc. How do you find these wonderful people? Talk to church groups, clubs, 4-H clubs, horse associations, colleges, high schools, etc. Again, get media coverage detailing your plans and ask for help. All volunteers should have some basic training before they actually become physically involved in the program. A training session (or sessions) should be held to familiarize prospective volunteers with their responsibilities. Sessions should include: program structure and objectives, special equipment, basics of handicapping conditions, tour of the facilities to be used, demonstration of horse handling, safety precautions, handling handicapped riders, practice session, and opportunity for discussion. It would be most helpful to give volunteers a packet which not only might include some of the material just listed but also the phone number of the Instructor/Coordinator, Stable, a schedule, safety rules, and so on. Once you get good volunteers, how do you keep them? You must show them that the work they do is appreciated. Besides the daily "thank you's", it is a nice idea to occasionally do something a little special. Perhaps a special ceremony might be in order, a covered dish dinner, a T-shirt, riding lessons, etc. The list is endless. See "Volunteer Information" for specific volunteer responsibilities.
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G. Horses
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H. Special Equipment
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More about equipment: Saddles - Well balanced English all purpose saddles and dressage style saddles are commonly used in therapeutic riding for the following reasons:
There are, however, certain disabilities that may benefit from the deep seat of a well balanced Western saddle (i.e., spinal cord injuries, muscular dystrophy, etc.) All saddles should be balanced on the horse and create a "neutral pelvis." Bareback pads - For use with small children with a high degree of spasticity. The body heat of the pony in combination with movement may facilitate relaxation Bridles - Usually snaffles and other mild bits are advisable Leads - Attached to halter, cavesson, or bit below the reins. Can be single or divided. Reins: Many types of reins are suitable and excellent teaching tools. Often times the reins are attached to the halter to facilitate the student "turning" the horse even though the horse leader is in true control. Most often students do not need direct contact with the mouth of the horse. Seat saver pads - Fits over the saddle to protect riders with limited sensation or inconvenience Devonshire Boots (covered stirrup) - Foot cannot run through stirrup. Mounting Block - Should be large enough to accommodate student and an adult. Mounting Ramp - Invaluable for mounting nonambulatory riders, especially adults. Driving: Carriage/cart driving for people with disabilities is a growing area of the discipline. A very well train driving horse or pony is required. An experienced driver always accompanies the driving student. It is recommended that two sets of lines be attached to the bridle with one set being held by the able-bodied assistant. There are many adapted vehicles on the market. More information may be obtained by contacting the chair of the national driving committee of NARHA. |
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I. Insurance:
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It is essential that liability insurance be obtained to cover the program, the riders, the volunteers, the instructors. Insurance coverage is available through the North American Riding for the Handicapped Association (N.A.R.H.A. 1-800-369-RIDE)) or many private carriers. 4-H Insurance: The blanket policy carried by 4-H organizations covers riders and volunteers who become 4-H members and includes general horse-related activities normal to the 4-H program. Therapeutic riding is covered. |
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J. Lesson Content:
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A lesson period determined by the instructor, most often not exceeding 30 to 45 minutes. The lesson may include may include grooming, tacking up, and ground work as well. Allow plenty of time for mounting as many students will need time to relax. Never rush the mounting procedure, as it should be a gradual process. Use extreme care and always remember to make the student's safety and comfort your foremost concerns. Riders with spastic scissoring legs should be mounted on a narrow-backed animal. The riding instructor should always be present and assist with the mounting procedure and in the initial stages of your program it is a good idea to include the physical therapist in the mounting procedure. Students should be encouraged to be as independent as possible. The rider's self-help abilities should be taken into consideration when determining the mounting technique to be used:
Instruction The length of time that any rider spends in the saddle must be determined on an individual basis. The type of disability, the student's age, physical ability, cognitive ability, medication, weather, and attention span are some factors to be considered when planning the lesson. The instructor designs the lesson to meet the educational, medical and recreational goals of the rider. Age appropriateness is a vital concern for all group lessons as well as in content planning. Once the riders are relaxed in the saddle and have had some opportunity to have some "warm-up" time (i.e. riding at the walk, chatting with volunteers etc.) you are ready to begin. Keep in mind that your goal is to help each student reach their maximum potential. Your basic horsemanship teaching will not vary greatly from your teaching able-bodied students. Your riders will be able to do far more than they think they can. Ask them to reach for more but be sensitive enough to see when they are frustrated. Encourage and praise them. (See Appendix G and H). Exercises Since you are conducting riding therapy, a portion of the lesson will be devoted to mounted exercise. Working with a physical therapist and/or medical personnel is recommended before designing individual programs for your riders. Some exercises commonly used:
Exercises are begun at the halt and some can be gradually introduced at the walk as balance and ability improve. This is also a procedure that must not be rushed. Your riders need lots of encouragement and enthusiasm from the instructor and his/her helpers. The above list of exercises certainly is not comprehensive so don't limit the exercise session to those alone. Utilize your therapists ideas and consult with him/her on your own ideas. Games: Games can be utilized not only to break up boredom but as a creative teaching aid and a method of testing the riders abilities. Suggestions:
Be creative. Keep it safe. Make it fun. |
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Portions adapted from "The NARHA Guide" published by the North American Riding for the Handicapped Association, Inc. and "It's Ability That Counts" by Lida L. McCowan, Cheff Center for the Handicapped. Revised by B.H. Nolt, Jr. , Coordinator, 4-H Animal Science Programs 1995. Original document by K. H. Appleman, Coordinator, Riding for the Handicapped, 1982 |
Appendix A: Medical Evaluation
YOUR PROGRAM NAME HERE
A nonprofit, therapeutic, horseback riding program.
GENERAL MEDICAL EVALUATION
NAME: DATE:
ADDRESS: ZIP:
AGE: DATE OF BIRTH: PHONE:
PARENT/LEGAL GUARDIAN:
DIAGNOSIS:
DATE OF ONSET: CAUSE (i.e.. congenital, traumatic, etc.):
SURGICAL PROCEDURES:
MEDICATIONS TAKEN AND DOSAGE:
ALLERGIES?
HIGH BLOOD PRESSURE? FAINTING? SEIZURES?
BLADDER PROBLEMS OR DRAINAGE DEVICES?
VISUAL DEFECTS? AUDITORY DEFECTS?
SPEECH DEFECTS? CIRCULATION?
NEURO-SENSATION?
BALANCE? COORDINATION?
SPASTICITY AND/OR RIGIDITY?
ASSISTIVE DEVICES?
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GENERAL MEDICAL EVALUATION
| In my opinion this patient can receive horseback riding instruction under appropriate supervision. In conjunction with the riding program I concur in the referral of the patient to the physical therapist or instructor for evaluation of his/her physical abilities and/or limitations in performing exercises. |
PRECAUTIONS OR CONTRAINDICATIONS TO PHYSICAL THERAPY:
Signed
Address
Phone
PARENT/GUARDIAN RELEASE AGREEMENT
YOUR PROGRAM NAME HERE
A nonprofit, therapeutic, horseback program
NAME OF PARENT
ADDRESS
PHONE
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If the student is of legal age (21), he/she may complete this form without the signature of the parent/guardian. NO LIABILITY will be accepted by any organization associated with <the program>. The undersigned, as parents/guardians of <rider name>, a minor, for and in consideration of the agreement of <the program>to provide therapeutic riding instruction to said minor, do release, acquit, discharge, and hold harmless <the program>, its officers, trustees, agents, employees, representatives, successors and assigns, for all manner of claims, demands and damages of every kind and nature whatsoever which the undersigned or said minor may now or in the future have against <the program>, its officers, trustees, agents, employees, representatives, successors or assigns, including but not limited to their negligence or gross negligence, in rendering the services above described or in any way incidental thereto. |
Dated:
WITNESS: PARENT/GUARDIAN:
APPROVED FOR INSTRUCTION BY
TITLE
PHOTO RELEASE FORM FOR
YOUR PROGRAM NAME HERE
A nonprofit, therapeutic, horseback riding program.
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For valuable consideration given and which is hereby acknowledged, the undersigned hereby grants to to take or have taken still and moving photographs and films including television coverage or our/my (daughter-son-ward) , and consents and authorizes its advertising agencies, news media, and any other persons interested in and its work, to use and reproduce the photographs, films and pictures, and to circulate and publicize the same by all means including without limiting the generality of the foregoing newspapers, television media, brochures, pamphlets, instructional material, books, and clinical material. With respect to the foregoing matters, no inducements, promises, have been made to us/me to secure our/my signature(s) to this release other than the intention of to use or cause to be used such photographs, films and pictures for the primary purpose of promoting and aiding and its work.
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Dated this day of , 20_____
APPENDIX D: Physical Therapy Assessment
YOUR PROGRAM NAME HERE
A nonprofit, therapeutic, horseback riding program.
PHYSICAL THERAPY AND/OR TEACHER ASSESSMENT
NAME AGE DATE
DISABILITY SCHOOL
PHYSICAL THERAPIST OR TEACHER
ADDRESS
PHONE NUMBER WHERE YOU CAN BE REACHED
EVALUATION SUMMARY (include what you see as a future goal)
SUGGESTED MOUNTING PROCEDURE
SUGGESTED EXERCISES TO IMPROVE ANY WEAKNESS IN STUDENT (state weakness)
PRECAUTIONS AND/OR RESTRICTIONS (include any behavior or attitude difficulties and method of treatment)
SIGNED
RIDING ASSESSMENT
NAME AGE DATE
POSITION 1 POSITION 2
_____ HEAD _____
_____SHOULDERS_____
_____ ARMS _____
_____ HANDS _____
_____ TRUNK _____
_____ SEAT _____
_____ THIGHS _____
_____ LEGS _____
_____ FEET _____
POSITION 3 POSITION 4
_____ HEAD _____
_____SHOULDERS_____
_____ ARMS _____
_____ HANDS _____
_____ TRUNK _____
_____ SEAT _____
_____ THIGHS _____
_____ LEGS _____
_____ FEET _____
KEY: S-SATISFACTORY; U-UNSATISFACTORY; R-DEVIATION TO RIGHT;
L-DEVIATION TO LEFT-DEVIATION FORWARD; B-DEVIATION BACK;
HU-HEALS UP; HD-HEELS DOWN.
COMMENTS:
RECOMMENDATIONS:
Signed
(Made available by the Cheff Center)
APPENDIX G: Rider Proficiency Standards
RIDER PROFICIENCY STANDARDS
(To be used as a teaching aid)
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LEVEL I: (Leader and assistance from side walkers permitted throughout test.)
Horsemanship knowledge:
Horsemanship Abilities:
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Level II: (Leader and assistance from side walkers permitted throughout test.)
Horsemanship knowledge:
Horsemanship Ability:
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Level III:
Horsemastership Knowledge:
Horsemanship Ability:
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Level IV:
Horsemastership Knowledge:
Horsemanship Ability:
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