By Charlene N. Rivera-Bonet | Waisman Science Writer
“In the wild, horses’ hearts sync up. That’s how in the herd, if one notices a mountain lion, a horse a mile away notices it too, and they all start running together. They sync their heartbeats to each other. They do that with humans as well,” says Emily Gonzalez, a certified occupational therapist assistant and certified therapeutic riding instructor at Three Gaits in Stoughton, WI. She provides equine-assisted services (EAS) to children with disabilities and older adults living with dementia. “So, part of why we all think horses are so good at this is because they sync up with the person they’re helping.”
Horses are big, majestic animals. Yet, they can be gentle and calming. “Humans have this innate desire to be in natural environments and be around animals,” says Beth Fields, PhD, OTR/L, BCG, an assistant professor of kinesiology at UW-Madison, describing the biophilia hypothesis. All of this combined makes horses suitable for helping people with disabilities in a variety of ways.
EAS uses certain characteristics of horses, such as movement, warmth, and size, to enhance an individual’s well-being. In addition to hearts synching, horseback riding requires a person to adjust their bodies to match the horse’s movement. “They have this rhythmic movement. If you’re sitting on a horse, you’re adjusting yourself to match the movement of the horse. They have different gaits. You’re constantly adjusting to their body movement,” says Benazir Meera, PhD, a postdoctoral research associate in kinesiology in Fields’ lab. Their warm body temperature is also carried over to the rider. “It’s a holistic overall experience,” Meera adds.
The ubiquitous benefits
Research at the Waisman Center in the lab of Brittany Travers, PhD, associate professor of kinesiology, and elsewhere has identified motor difficulties as a core characteristic of autism. This difficulty in motor performance can lead to reduced participation in physical activity, which can affect overall health outcomes. Labs such as Travers’, Fields’ and Luis Columna’s, PhD, professor of kinesiology and Waisman affiliate, research ways to enhance motor function in children with autism and other intellectual and developmental disabilities using non-pharmacological interventions such as balance, yoga, and adapted physical activity. In Fields’ lab, Meera researches the benefits and mechanisms of using EAS for autistic individuals and is expanding to other conditions such as Down syndrome.
The horses at Three Gaits go through a special and rigorous training process, and a long trial period before they begin working with the children. According to Gonzalez, it is incredibly hard to find horses for this job. “We need the horses to understand that no matter what’s happening, they should just be good, right? But also, don’t just be good, enjoy your job,” she says. “The horses that we end up keeping,” after trainings and months of testing, “they honestly love their job.” Knox, their senior horse, is their all-around, do-any-type-of-work-and-enjoy-it guy. The more playful the children are with him, the happier he gets.
EAS has been proven beneficial for enhancing coordination, strength, balance, posture, overall motor skills, communication, and social outcomes, and more in autistic children and other developmental disabilities.
As Meera said, riding a horse forces your body to follow their rhythmic movement. “The added bonus for therapy is that a horse’s pelvis mimics ours with the motions that we make, forward, backward, side to side and rotational,” Gonzalez explains. Especially for children or adults who have difficulty walking or a weak core, being on a horse forces their hips to make thousands of movements in a single therapy session, strengthening their core muscles and improving their balance. “You’re using all the play-based game activities that you would in traditional therapy and then adding that really good strengthening balance tool with it,” Gonzalez adds. She has seen children take their first unassisted steps after being in therapy in the equine environment.
In Gonzalez’s experience providing EAS, she has observed growth in balance, direction following, and communication in some of the children she sees. “One [improvement] we’ve been seeing a lot of lately is kids starting to use their tablets for more talking. So, they’re nonverbal, and they have tablets for talking. They don’t want to use them in school. They don’t want to use them at home. Well, guess what? Knox [the horse] is not going to move until you push your button to go,” she says.
Riding a 1,000-pound animal that responds to their commands also gives children with disabilities a sense of control that they usually don’t get elsewhere. “Parents would come up to me after the fact, and they would just say, ‘my kid never gets to feel in control of anything, and they never get to be the person in charge,’ and when they’re riding a horse, you’re up above everyone else, you’re up high, you’re directing that horse, and you’re leading. And that is incredibly powerful,” says Fields, who has experience providing therapy in this unique practice setting.
Tailored to different needs
EAS is an umbrella term that encompasses three main areas: therapy, learning, and horsemanship. Therapy is delivered by licensed clinical professionals such as occupational therapists, physical therapists, and speech-language pathologists, and is used to meet specific goals for each rider and improve health, fitness, and physical functioning. When used for learning, qualified professionals use experiential learning activities involving horse interactions for diverse individuals such as students. Lastly, in horsemanship, specialized equine professionals provide nontherapy services to individuals and groups with special needs. “We don’t work on activities of daily living, but the skills can be used for instrumental activities of daily living. So, patience, direction following, those sorts of things,” Gonzalez says.
Seven-year-old Jensen Fletcher arrived for his weekly therapy session at Three Gaits with Elizabeth Hesse, OTD, OTR/L. “This child makes me sing to him as a heads up. Okay, we like nursery rhymes and we don’t like them played. We like them sung. So, I’m sorry in advance for [my voice]. I made a list of them on my phone so that I can remember what they are,” Hesse told everyone who was going to be part of the session with her and Jensen. Part of this type of therapy is that it can be individualized to meet the specific needs of each child, and for that, the professionals need to get to know them well. “Liz [Hesse] has definitely picked up on what Jensen needs and how he communicates and the little ways that he approves and the ways he disapproves,” says Alex Fletcher, Jensen’s mom.
Jensen has Dup15q, a rare genetic disorder resulting from the duplication of chromosome 15. It is characterized by low muscle tone and motor delays, variable intellectual disabilities, autism spectrum disorder, and epilepsy, although the symptoms may differ among affected individuals. “But our family, we are full of a lot of faith and love and joy, and Jensen definitely brings that out of us,” Fletcher says.
They sought out therapy in the equine environment to help Jensen with his different sensory needs.
This therapy can stimulate the proprioceptive and vestibular systems involved in body awareness, balance, coordination, and spatial orientation. It can also provide visual and tactile stimulation for an overall sensory-rich experience, which many children with disabilities seek. By trotting, riding a horse backward, and laying their whole body on the horse, each individual can use different methods to get their sensory input needs met.
After arriving at the barn, volunteers helped Jensen put his helmet on and hop on the horse. With two volunteers holding him from each side, one equine professional, and Hesse, they started the session to the tune of Itsy-Bitsy Spider. They did a few activities inside the barn with different toys, guiding the horse in different directions and paces and riding backward. They then decided to head outside to take advantage of a warm October afternoon.
Each session looks different for each individual, and the specifics of it are tailored to the person’s abilities, needs, and functional goals. They can use the horses’ speed and direction as tools, toys, sensory objects, and obstacle courses and play games such as Red Light and Green Light on the horse.
Jensen and his crew took Knox on a walk through the large Three Gaits field and came back to do some trotting in the barn. Jensen reacted with the biggest smile that showed off his dimples. “He actually is loving being on the horse, giving lots of smiles and claps and singing. So that leads me to believe that he’s really actually enjoying himself,” Fletcher says.
A fun type of therapy
For many children with disabilities, their days and weeks are filled with therapies and appointments that can be daunting and exhausting, sometimes even a little boring. Therapy in the equine environment provides a break from that while still offering a plethora of health, emotional, and social benefits. “You tell a kid that they get to go out to a farm and interact with a horse, and they forget that it’s therapy, even though therapy is happening,” Fields says.
This is one of the reasons Fletcher keeps bringing Jensen. “What I want it to be for Jensen is something fun, something he looks forward to. We do plenty of therapies that are not super fun, like feeding and physical therapy. It’s hard work. It’s very hard work for him. So, to have something like this, where it’s fun, I’m eager to continue it,” Fletcher explains. She can already observe improvements in Jensen after a few weeks of sessions, like the way he communicates and how he has better control of some of his self-injurious behaviors, such as head hitting.
“At first, it was very nerve-racking. I was very anxious, especially having a child with special needs,” says Fletcher about letting Jensen ride a horse. She was particularly worried about his feeding tube and the fact that he has low muscle tone. “I think just in the last week or so, I’ve been able to put some of that to rest, thinking, okay, he’s doing okay.” In addition to the highly trained and tested horses, the volunteers and staff provide a lot of security. “He has tried to get down, but those volunteers are great; they hold him in place. As time has gone on, I’ve gained trust in the professionals and improved communication with them too, of what Jensen needs, because I’m his biggest advocate,” she adds.
Horses in the media
Horses have a lot of symbolism in stories, history, and the media – which isn’t an insignificant detail when it comes to the effects of EAS, Fields says. They represent strength, like Secretariat, and courage, like Spirit. EAS can be highly motivating for children with disabilities as it helps them become stronger and feel more empowered through a therapy session that feels more like fun than work.
If you or someone you know may be interested in participating in an EAS at Three Gaits, please contact info@three-gaits.org or 608-877-9086. For a list of other EAS in Wisconsin, visit PATH International.
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