April 2, 2024 • 20 mins
In this episode, Gina celebrates April as Occupational Therapy Month by delving into the Occupational Therapy Practice Framework (OTPF) and its application in the unique area of hippotherapy. She explores how hippotherapy promotes the development of activities of daily living (ADLs) and discuss the importance of utilizing equine movement as a therapeutic tool to achieve functional outcomes. Through real-life examples and insights, you learn the ways in which hippotherapy addresses core strength, sensory processing, motor planning, and sequencing—all essential components for enhancing independence in ADLs. This episode provides valuable guidance for occupational therapists seeking to integrate hippotherapy into their practice and effectively communicate its distinct value.
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Microphone (3- Logitech (00:02):
Welcome to our episode this week, we
are.
Going to be celebrating April asoccupational therapy month.
And I want to do a littleseries.
Created by taking a deep look atthe occupational therapy
practice framework.
And how we can apply it to theunique areas of practice that
we're working in and thebenefits that we can gain
(00:24):
through using the OTPF tocommunicate our distinct value.
So let's jump in together.
Hi, welcome to another episodeof animals and aquatics I'm
(00:46):
Gina, your cohost and happy tobe here with you today.
If this is your first timelistening.
I'm glad to have you here.
If you've been listening with usfrom the beginning.
Welcome back.
Today, we're going to be takinga look at how do you apply the
occupational therapy practiceframework to our areas of
practice.
And I really want to take a lookat how we can look at ADL's, our
(01:12):
bread and butter, when we'reusing hippotherapy, as a
treatment tool.
And I think that slowing down alittle bit and really taking a
distinct look at one area ofpractice.
And like I said, ADL's aresomething that occupational
therapists are known for.
So I think.
As a way of celebratingoccupational therapy month.
(01:33):
Stopping and looking at ADL'sin-depth.
And how using equine movementcan really promote the
development of ADL's is a greatplace to start.
So April serves as anopportunity to shine a spotlight
on everything that occupationaltherapy does.
(01:53):
We have a chance to educate thepublic around us, our community
and family members.
We can look at policies andother healthcare professionals
and let them know about whatoccupational therapy is and what
we do such as promoting health,wellbeing, wellness and
participation in daily lifeactivities, especially those
(02:14):
ADL's.
The American occupationaltherapy association officially
designated April as theoccupational therapy month to
coincide with the founding ofthe organization.
AOTA was established on April7th in 1917, making April a
fitting month to celebrate ourhistory.
April is a time to celebrate theachievements and accomplishments
(02:37):
of your practice.
Occupational therapist,occupational therapy assistance.
Our educators, researchers andstudents who we work with that
are there to improve the livesof our clients, of our families
and to celebrate all the uniquethings about occupational
therapy.
Today again.
(02:58):
I said, I wanted to take areally important look at ADL
specifically, right.
Because a lot of times whenother professionals think about
occupational therapists, like.
Other than where the handpeople, which we're not, but
that ADL's right.
Is what we do.
And I wanted to take a littlebit of a look into ADL's and the
(03:21):
occupational therapy practiceframework.
Now I'm using the OTPF 4.
It defines activities of dailyliving or ADL's as essential
tasks that individuals performevery day to take care of
themselves and participate intheir communities.
So the ADL's that are outlinedby OTPF 4 are bathing and
(03:42):
showering.
Toileting and toilet hygiene.
Dressing.
Eating and swallowing.
Functional mobility.
Personal hygiene and groomingand sexual activity.
So just putting those out thereas we get started with this so
you have a reference point tothink of when I'm talking about
(04:06):
ADL's.
Now I'm going to talk about avariety of different areas that
we work in, but I'm going tofocus on.
hippotherapy, today.
So let's also get a startingpoint with that.
So according to the Americanhippotherapy, association or
AHA.
hippotherapy, is described as aphysical occupational and speech
(04:27):
language therapy treatment tool.
That utilize his equine movementas part of an integrated
intervention program to achievefunctional outcomes.
So, again, we're really focusedon that outcome.
Of our use of equine movementand not so much maybe what we're
seeing within the session or anyriding or horsemanship skills.
(04:50):
That's not our focus reallyfocused on the therapeutic
effects of the horse's movementunder the guidance of a skilled
therapist.
And that the therapist isassessing the client's needs and
tailoring the interventions toaddress specific or discipline
specific goals.
That have a functional outcome,as well as incorporating
(05:13):
hippotherapy, with othertreatment tools within our
practice.
So when we think about.
How might that interaction withequine movement or with the
horse affect those ADL's that Ihad talked about or went through
the list.
Right.
I went through the list ofADL's.
So how might equine movementimpact some of those ADL's?
(05:36):
Well, we can think about itthrough a number of areas.
We can look at.
Core strength and stability now.
And if we think about somethinglike dressing, we need.
A certain amount of corestrength in order to be able to
stand up and put a pair of pantson.
Or sit at the edge of the bed inorder to reach down and put
(05:56):
socks on.
So dressing, when we think aboutit from that core strength and
stability.
Side of things.
There's a number of areas thatwe need to have enough
stability.
In order to manage our clothes,as well as the core strength
piece.
And so one of the things wethink about when we think about
hippotherapy, is addressing thecore strength piece, and we can
(06:20):
do that through grading, theequine movement, lengthening the
stride.
Shortening the stride.
We also often introduce.
Circles or Serpentini so thatwe're strengthening both sides
of the body.
And this has a direct impact onthat ability to manage clothing.
(06:41):
To obtain clothing.
And to get dressed asindependently as possible.
Now we could also think aboutsomething like functional
mobility.
So this might sound a little bitPTs.
Like moving one from one placeto another.
But we can also think about itas bed mobility transfers.
(07:02):
So that is an area, right?
We might all feel a little bitmore comfortable in.
And again, we need to have thatcore strength and stability, but
we also need to have balance andcoordination because in order to
do a transfer, we need to bestrong, but we also need to be
able to coordinate our upperextremities, lower extremities.
(07:23):
We need to be able to weightshift.
And when we think about equinemovement, there is a lot of
opportunities to practicecoordinating the body.
To practice weight shifts.
So if I'm choosing a schoolfigure like a figure eight,
doing a lot of weight shiftsacross midline, and often that's
an area that our clients mightneed help with when they're
doing a transfer.
(07:45):
Another area that I certainlyspecialize in when I'm using
equine movement.
Is sensory processing andsensory integration.
And when we think about.
Sensory processing sensoryintegration.
One of the ADL's that oftenthere's two actually.
The one that comes up to me isthe personal hygiene and
(08:05):
grooming.
Feeding and eating.
And personal hygiene there areso many sensory aspects to it.
And a lot of our clients dostruggle with the sensory
aspects of feeding and eating.
So being able to manage food intheir mouth without pocketing.
(08:25):
Or being able to have enoughsensory input in the mouth to
chew something completely, toform a bolus and swallow it, or
being able to.
Bring the food to the mouth.
And get it into their mouth.
So they need to have, um, enoughtactile discrimination to manage
that food.
(08:46):
And on the personal hygiene andgrooming side of things often,
this is an area that can be veryproblematic for children that
are sensory sensitive.
So things like caring for theirnails on their hands and their
feet or brushing their hair.
And.
Brushing their teeth, right?
Applying deodorant, as we getinto our adolescents that we're
(09:08):
working with, these can all beareas where hypersensitivity to
sensory input can be reallychallenging.
So we have the modulation piece,right?
So we can be over-sensitiveunder sensitive, and we can see
that with the personal hygieneand grooming.
We can also see that in feedingand eating.
(09:29):
So in the case that the clientis having trouble, knowing what
is in the mouth or I'm beingreally hypersensitive to it, but
we can also see it in thediscrimination side of things.
So they just can't discriminatedifferent textures.
They have trouble discriminatingwhere things are at in their
mouth.
So that could be food or thatcould also be something like
(09:50):
brushing their teeth.
So they have a hard time beingable to brush all their teeth.
Because they have troublediscriminating where the brush
is within the mouth.
And.
As I make that description,you're like, okay.
But what in the world does thathave to do?
With hippotherapy, and I thinkthat's where a lot of times we
kind of missed the boat.
(10:11):
Or therapist have a harder time.
Putting what they're doingtogether with sensory processing
or sensory integration withequine movement, and then tying
it back to those ADL's.
And in this case, a a littleaside here, the American
(10:32):
hippotherapy, association,sensory connections course, we
are working really hard to getthat into a webinar format for
you.
So that's, a whole treatmentcourse based on this.
So if you're interested, let meknow, reach out to me.
That'll be a great motivator forme and my team to get that
finished up.
But in this aspect, It'simportant to look at.
(10:54):
Are we treating a modulationissue or are we treating a
discrimination issue?
And we can work on both of thoseareas utilizing equine movement.
We have lots of opportunities,both with the movement and also
in the equine environment toaddress these sensory issues.
And we often see the ability ofthe client to help with.
(11:17):
Personal hygiene and grooming ofthe horse.
Or feeding the horse that canhelp them overcome their own
sensory sensitivities andchallenges.
The last part I want you tothink through is the motor
planning and sequencing neededfor ADL's and whether that's
dressing or bathing andshowering.
(11:40):
There's a lot of components thatgo into sequencing.
And planning out how we're goingto bathe and shower or.
What do we need to do to use thetoilet?
So one of my children isbeginning potty training right
now.
And just the sequencing ofeverything.
(12:00):
In enough time not to have anaccident, right.
Is a big piece.
And the motor planning of whenyou're little, how do you get up
on a stool?
And then turn around to sit downis really quite complex.
So a lot of the kids that I workwith have trouble with motor
planning.
They have trouble withsequencing.
And when we think about dressingthere's.
(12:22):
A lot of components that go intoboth undressing and dressing in
a sequential fashion.
As well as then fasteners thatgo along with it.
So.
In all of these activities,right?
There's a number of areas wheremotor planning and sequencing is
really important.
And if we want to look at.
(12:43):
Some of the ways that we mightaddress that.
If we're doing our transfers onand off the horse.
That's a great time to work onmotor planning and sequencing
because a lot of our clientsthat are really struggling with
this will have trouble with thattransition.
And so thinking about is itideational Praxis that they're
(13:04):
having trouble with?
Is it the sequencing piece?
And that will depend on howwe're going to break it down for
them to help them be successful.
And the more times they have topractice the skill and practice
some novel motor planning.
The really nice thing about theequine environment and that
(13:24):
transfer on and off the horse isit is novel.
And particularly if we're onlyseeing our clients.
Once a week it's a novelexperience pretty much every
week.
And sometimes we think of thatoften as like a downside that
we're like, we're only able tosee them once a week and they
really do need a lot morepracticing of the motor planning
(13:46):
and the sequencing piece.
But in this case, we can thinkof it as an asset because
they're not planning thisparticular motor plan over and
over and over again.
And they have an opportunity todo some novel motor planning.
We get to see, is there morefluidity?
Are they able to start to linkthe sequence together?
Do they have an idea of how toinitiate the sequence for the
(14:06):
transfer?
And this is a great opportunity.
We can do it.
And static, that transfer ofstatically going from a static.
Ramp platform.
Stairs mounting block on to thehorse.
But we can also do some of thosesame transitions dynamically if
the horse is moving.
(14:27):
So that's another way to look atthat.
We've talked about equinemovement and client positioning.
So if we are doing.
A transition from a forwardsitting to side sitting, we have
that opportunity again, to dothe motor planning piece and
sequencing.
How am I going to move my bodyfrom this forward sitting
position to a side sittingposition.
(14:49):
Once we're in that side sittingposition, then we have a
different weight shift rightnow.
We're often weight shiftinganterior posterior because the
client is, is in a differentposition in relationship to
equine movements.
So very hard sometimes toexplain this.
In just words.
And I'm used to eitherexplaining it with my hands.
And so thinking about, we've nowchanged the clients access and
(15:13):
re.
Access in relationship to theequine movement.
And then we have the engagementin grooming and care activities
with the horse, which I was justtalking about as far as the
sensory piece, but also.
With the grooming and care ofthe horse, often there's motor
(15:34):
planning components to that.
And there's also sequencing tothat.
So those are all areas whereit's really nice to be able to
slow down a little bit, work onthat motor planning and
sequencing.
To target specific ADL's and.
It's really nice to have a realfocus that we are working on.
(15:56):
ADL's no.
What we want to do and bring inas far as whether it's the
transfers, the motor planning.
In grooming or addressingsensory issues with horse care
tasks or whether we're reallyjust focused on that equine
movement piece.
(16:16):
But those are all ways that wecan adapt.
hippotherapy, or the equineenvironment for the individual
client's needs.
Now, when we're looking atgoals, we're still setting our
typical client goals.
So maybe that the client candress.
Independently, what set upassistance.
(16:37):
And we're then going to betargeting our interventions in
how that will be done.
So there may be a component of ahome program.
We might be doing some parenttraining.
We're going to be incorporatingsequencing.
We're going to be incorporatingthe equine movement.
Right?
There's a lot of components thatmight be going into why that
client is not currently able todress.
(16:58):
Independently, just with somesetup assistance.
So when we think about this, Weneed to have a plan in place
for.
Our assessment.
Writing our goals.
Designing our treatment plan.
And then communicating all ofthis to.
(17:19):
Other care providers to theclient and family.
And when we think about howwe're going to put all that
together.
That's a big part of deliveringeffective occupational therapy
services in a non-traditionalenvironment.
And one of the things I reallylike for looking at ADL's is the
(17:42):
PEDI cat.
So that's a assessment thatlooks at a number of areas.
And one of the things I reallylike about it is it scaffolds
the skills.
And I can look when a parentfills it out, can be done as a
parent interview.
It can also be done in moreindependently by the parent.
And when I look, I can see ifthere's missing skills or like
(18:06):
what's the last skill that theclient has left off as achieved.
And what would be the next stepthat they would need to achieve.
And so that w is usually one ofthe assessments that I'm going
to use when I'm focused on ADLskill development.
Then I'm working collaborativelywith the family to develop the
goals and often I'll use theCOPM.
(18:28):
So that's the Canadianoccupational performance
measure.
And I will do that in aninterview format with the
parent.
So that way we can go throughwhat ADL's and goals are most
important to them.
Then I'm going back to mytreatment planning phase and I
want to know.
All the tools that I'm going touse and bring in.
(18:50):
For this particular client andI'm going to write that into the
plan of care.
And so it's going to say,occupational therapy plan of
care includes, but it's notlimited to, and maybe that's
another area I'll address withthis OTPF series because.
I definitely use the OTPF toscaffold my evaluations and how
(19:11):
I write up my evals and plan ofcare.
So they incorporate that inthere.
And then I'm sharing that withthe family so that they have an
understanding of, where are theareas that their child is
developing in?
What are the goals that we'veset together?
And then what are the tools thatI'm going to use to help us get
there?
Right.
So we can go together.
(19:31):
So, if you're interested inlearning more about this, I
definitely encourage you to goto the American hippotherapy
associations website.
You can find additionalinformation there about courses
about upcoming courses.
Look up the occupational therapypractice framework.
Again, I'm using version four.
(19:51):
So if you would like to, you canlook that up and download a
copy.
There are free PDFs out there.
So if you want to follow alongwith what we're doing this
month.
Go ahead and download that.
And if you're looking really fora clinical mentorship, certainly
reach out to me.
I run trailblazers quest andthat's a clinical mentorship
that really helps clinicians inunique practice areas put what
(20:14):
they know as an occupationaltherapist into practice in their
unique setting.
So I'm really excited that youjoined us today for one of our
April as occupational therapymonth episodes focused on the
occupational therapy practiceframework and applying it in a
unique setting.
This week, we focused on thevalue of hippotherapy, and
(20:36):
occupational therapy practice toaddress ADL's.
And as we get ready to wrap up,they hope that you'll leave us a
review, subscribe and share ourpodcast with other OTs who are
interested in animals oraquatics.
Have a fantastic occupationaltherapy month.
Welcome to our episode this week, we
are.
Going to be celebrating April asoccupational therapy month.
And I want to do a littleseries.
Created by taking a deep look atthe occupational therapy
practice framework.
And how we can apply it to theunique areas of practice that
we're working in and thebenefits that we can gain
(00:24):
through using the OTPF tocommunicate our distinct value.
So let's jump in together.
Hi, welcome to another episodeof animals and aquatics I'm
(00:46):
Gina, your cohost and happy tobe here with you today.
If this is your first timelistening.
I'm glad to have you here.
If you've been listening with usfrom the beginning.
Welcome back.
Today, we're going to be takinga look at how do you apply the
occupational therapy practiceframework to our areas of
practice.
And I really want to take a lookat how we can look at ADL's, our
(01:12):
bread and butter, when we'reusing hippotherapy, as a
treatment tool.
And I think that slowing down alittle bit and really taking a
distinct look at one area ofpractice.
And like I said, ADL's aresomething that occupational
therapists are known for.
So I think.
As a way of celebratingoccupational therapy month.
(01:33):
Stopping and looking at ADL'sin-depth.
And how using equine movementcan really promote the
development of ADL's is a greatplace to start.
So April serves as anopportunity to shine a spotlight
on everything that occupationaltherapy does.
(01:53):
We have a chance to educate thepublic around us, our community
and family members.
We can look at policies andother healthcare professionals
and let them know about whatoccupational therapy is and what
we do such as promoting health,wellbeing, wellness and
participation in daily lifeactivities, especially those
(02:14):
ADL's.
The American occupationaltherapy association officially
designated April as theoccupational therapy month to
coincide with the founding ofthe organization.
AOTA was established on April7th in 1917, making April a
fitting month to celebrate ourhistory.
April is a time to celebrate theachievements and accomplishments
(02:37):
of your practice.
Occupational therapist,occupational therapy assistance.
Our educators, researchers andstudents who we work with that
are there to improve the livesof our clients, of our families
and to celebrate all the uniquethings about occupational
therapy.
Today again.
(02:58):
I said, I wanted to take areally important look at ADL
specifically, right.
Because a lot of times whenother professionals think about
occupational therapists, like.
Other than where the handpeople, which we're not, but
that ADL's right.
Is what we do.
And I wanted to take a littlebit of a look into ADL's and the
(03:21):
occupational therapy practiceframework.
Now I'm using the OTPF 4.
It defines activities of dailyliving or ADL's as essential
tasks that individuals performevery day to take care of
themselves and participate intheir communities.
So the ADL's that are outlinedby OTPF 4 are bathing and
(03:42):
showering.
Toileting and toilet hygiene.
Dressing.
Eating and swallowing.
Functional mobility.
Personal hygiene and groomingand sexual activity.
So just putting those out thereas we get started with this so
you have a reference point tothink of when I'm talking about
(04:06):
ADL's.
Now I'm going to talk about avariety of different areas that
we work in, but I'm going tofocus on.
hippotherapy, today.
So let's also get a startingpoint with that.
So according to the Americanhippotherapy, association or
AHA.
hippotherapy, is described as aphysical occupational and speech
(04:27):
language therapy treatment tool.
That utilize his equine movementas part of an integrated
intervention program to achievefunctional outcomes.
So, again, we're really focusedon that outcome.
Of our use of equine movementand not so much maybe what we're
seeing within the session or anyriding or horsemanship skills.
(04:50):
That's not our focus reallyfocused on the therapeutic
effects of the horse's movementunder the guidance of a skilled
therapist.
And that the therapist isassessing the client's needs and
tailoring the interventions toaddress specific or discipline
specific goals.
That have a functional outcome,as well as incorporating
(05:13):
hippotherapy, with othertreatment tools within our
practice.
So when we think about.
How might that interaction withequine movement or with the
horse affect those ADL's that Ihad talked about or went through
the list.
Right.
I went through the list ofADL's.
So how might equine movementimpact some of those ADL's?
(05:36):
Well, we can think about itthrough a number of areas.
We can look at.
Core strength and stability now.
And if we think about somethinglike dressing, we need.
A certain amount of corestrength in order to be able to
stand up and put a pair of pantson.
Or sit at the edge of the bed inorder to reach down and put
(05:56):
socks on.
So dressing, when we think aboutit from that core strength and
stability.
Side of things.
There's a number of areas thatwe need to have enough
stability.
In order to manage our clothes,as well as the core strength
piece.
And so one of the things wethink about when we think about
hippotherapy, is addressing thecore strength piece, and we can
(06:20):
do that through grading, theequine movement, lengthening the
stride.
Shortening the stride.
We also often introduce.
Circles or Serpentini so thatwe're strengthening both sides
of the body.
And this has a direct impact onthat ability to manage clothing.
(06:41):
To obtain clothing.
And to get dressed asindependently as possible.
Now we could also think aboutsomething like functional
mobility.
So this might sound a little bitPTs.
Like moving one from one placeto another.
But we can also think about itas bed mobility transfers.
(07:02):
So that is an area, right?
We might all feel a little bitmore comfortable in.
And again, we need to have thatcore strength and stability, but
we also need to have balance andcoordination because in order to
do a transfer, we need to bestrong, but we also need to be
able to coordinate our upperextremities, lower extremities.
(07:23):
We need to be able to weightshift.
And when we think about equinemovement, there is a lot of
opportunities to practicecoordinating the body.
To practice weight shifts.
So if I'm choosing a schoolfigure like a figure eight,
doing a lot of weight shiftsacross midline, and often that's
an area that our clients mightneed help with when they're
doing a transfer.
(07:45):
Another area that I certainlyspecialize in when I'm using
equine movement.
Is sensory processing andsensory integration.
And when we think about.
Sensory processing sensoryintegration.
One of the ADL's that oftenthere's two actually.
The one that comes up to me isthe personal hygiene and
(08:05):
grooming.
Feeding and eating.
And personal hygiene there areso many sensory aspects to it.
And a lot of our clients dostruggle with the sensory
aspects of feeding and eating.
So being able to manage food intheir mouth without pocketing.
(08:25):
Or being able to have enoughsensory input in the mouth to
chew something completely, toform a bolus and swallow it, or
being able to.
Bring the food to the mouth.
And get it into their mouth.
So they need to have, um, enoughtactile discrimination to manage
that food.
(08:46):
And on the personal hygiene andgrooming side of things often,
this is an area that can be veryproblematic for children that
are sensory sensitive.
So things like caring for theirnails on their hands and their
feet or brushing their hair.
And.
Brushing their teeth, right?
Applying deodorant, as we getinto our adolescents that we're
(09:08):
working with, these can all beareas where hypersensitivity to
sensory input can be reallychallenging.
So we have the modulation piece,right?
So we can be over-sensitiveunder sensitive, and we can see
that with the personal hygieneand grooming.
We can also see that in feedingand eating.
(09:29):
So in the case that the clientis having trouble, knowing what
is in the mouth or I'm beingreally hypersensitive to it, but
we can also see it in thediscrimination side of things.
So they just can't discriminatedifferent textures.
They have trouble discriminatingwhere things are at in their
mouth.
So that could be food or thatcould also be something like
(09:50):
brushing their teeth.
So they have a hard time beingable to brush all their teeth.
Because they have troublediscriminating where the brush
is within the mouth.
And.
As I make that description,you're like, okay.
But what in the world does thathave to do?
With hippotherapy, and I thinkthat's where a lot of times we
kind of missed the boat.
(10:11):
Or therapist have a harder time.
Putting what they're doingtogether with sensory processing
or sensory integration withequine movement, and then tying
it back to those ADL's.
And in this case, a a littleaside here, the American
(10:32):
hippotherapy, association,sensory connections course, we
are working really hard to getthat into a webinar format for
you.
So that's, a whole treatmentcourse based on this.
So if you're interested, let meknow, reach out to me.
That'll be a great motivator forme and my team to get that
finished up.
But in this aspect, It'simportant to look at.
(10:54):
Are we treating a modulationissue or are we treating a
discrimination issue?
And we can work on both of thoseareas utilizing equine movement.
We have lots of opportunities,both with the movement and also
in the equine environment toaddress these sensory issues.
And we often see the ability ofthe client to help with.
(11:17):
Personal hygiene and grooming ofthe horse.
Or feeding the horse that canhelp them overcome their own
sensory sensitivities andchallenges.
The last part I want you tothink through is the motor
planning and sequencing neededfor ADL's and whether that's
dressing or bathing andshowering.
(11:40):
There's a lot of components thatgo into sequencing.
And planning out how we're goingto bathe and shower or.
What do we need to do to use thetoilet?
So one of my children isbeginning potty training right
now.
And just the sequencing ofeverything.
(12:00):
In enough time not to have anaccident, right.
Is a big piece.
And the motor planning of whenyou're little, how do you get up
on a stool?
And then turn around to sit downis really quite complex.
So a lot of the kids that I workwith have trouble with motor
planning.
They have trouble withsequencing.
And when we think about dressingthere's.
(12:22):
A lot of components that go intoboth undressing and dressing in
a sequential fashion.
As well as then fasteners thatgo along with it.
So.
In all of these activities,right?
There's a number of areas wheremotor planning and sequencing is
really important.
And if we want to look at.
(12:43):
Some of the ways that we mightaddress that.
If we're doing our transfers onand off the horse.
That's a great time to work onmotor planning and sequencing
because a lot of our clientsthat are really struggling with
this will have trouble with thattransition.
And so thinking about is itideational Praxis that they're
(13:04):
having trouble with?
Is it the sequencing piece?
And that will depend on howwe're going to break it down for
them to help them be successful.
And the more times they have topractice the skill and practice
some novel motor planning.
The really nice thing about theequine environment and that
(13:24):
transfer on and off the horse isit is novel.
And particularly if we're onlyseeing our clients.
Once a week it's a novelexperience pretty much every
week.
And sometimes we think of thatoften as like a downside that
we're like, we're only able tosee them once a week and they
really do need a lot morepracticing of the motor planning
(13:46):
and the sequencing piece.
But in this case, we can thinkof it as an asset because
they're not planning thisparticular motor plan over and
over and over again.
And they have an opportunity todo some novel motor planning.
We get to see, is there morefluidity?
Are they able to start to linkthe sequence together?
Do they have an idea of how toinitiate the sequence for the
(14:06):
transfer?
And this is a great opportunity.
We can do it.
And static, that transfer ofstatically going from a static.
Ramp platform.
Stairs mounting block on to thehorse.
But we can also do some of thosesame transitions dynamically if
the horse is moving.
(14:27):
So that's another way to look atthat.
We've talked about equinemovement and client positioning.
So if we are doing.
A transition from a forwardsitting to side sitting, we have
that opportunity again, to dothe motor planning piece and
sequencing.
How am I going to move my bodyfrom this forward sitting
position to a side sittingposition.
(14:49):
Once we're in that side sittingposition, then we have a
different weight shift rightnow.
We're often weight shiftinganterior posterior because the
client is, is in a differentposition in relationship to
equine movements.
So very hard sometimes toexplain this.
In just words.
And I'm used to eitherexplaining it with my hands.
And so thinking about, we've nowchanged the clients access and
(15:13):
re.
Access in relationship to theequine movement.
And then we have the engagementin grooming and care activities
with the horse, which I was justtalking about as far as the
sensory piece, but also.
With the grooming and care ofthe horse, often there's motor
(15:34):
planning components to that.
And there's also sequencing tothat.
So those are all areas whereit's really nice to be able to
slow down a little bit, work onthat motor planning and
sequencing.
To target specific ADL's and.
It's really nice to have a realfocus that we are working on.
(15:56):
ADL's no.
What we want to do and bring inas far as whether it's the
transfers, the motor planning.
In grooming or addressingsensory issues with horse care
tasks or whether we're reallyjust focused on that equine
movement piece.
(16:16):
But those are all ways that wecan adapt.
hippotherapy, or the equineenvironment for the individual
client's needs.
Now, when we're looking atgoals, we're still setting our
typical client goals.
So maybe that the client candress.
Independently, what set upassistance.
(16:37):
And we're then going to betargeting our interventions in
how that will be done.
So there may be a component of ahome program.
We might be doing some parenttraining.
We're going to be incorporatingsequencing.
We're going to be incorporatingthe equine movement.
Right?
There's a lot of components thatmight be going into why that
client is not currently able todress.
(16:58):
Independently, just with somesetup assistance.
So when we think about this, Weneed to have a plan in place
for.
Our assessment.
Writing our goals.
Designing our treatment plan.
And then communicating all ofthis to.
(17:19):
Other care providers to theclient and family.
And when we think about howwe're going to put all that
together.
That's a big part of deliveringeffective occupational therapy
services in a non-traditionalenvironment.
And one of the things I reallylike for looking at ADL's is the
(17:42):
PEDI cat.
So that's a assessment thatlooks at a number of areas.
And one of the things I reallylike about it is it scaffolds
the skills.
And I can look when a parentfills it out, can be done as a
parent interview.
It can also be done in moreindependently by the parent.
And when I look, I can see ifthere's missing skills or like
(18:06):
what's the last skill that theclient has left off as achieved.
And what would be the next stepthat they would need to achieve.
And so that w is usually one ofthe assessments that I'm going
to use when I'm focused on ADLskill development.
Then I'm working collaborativelywith the family to develop the
goals and often I'll use theCOPM.
(18:28):
So that's the Canadianoccupational performance
measure.
And I will do that in aninterview format with the
parent.
So that way we can go throughwhat ADL's and goals are most
important to them.
Then I'm going back to mytreatment planning phase and I
want to know.
All the tools that I'm going touse and bring in.
(18:50):
For this particular client andI'm going to write that into the
plan of care.
And so it's going to say,occupational therapy plan of
care includes, but it's notlimited to, and maybe that's
another area I'll address withthis OTPF series because.
I definitely use the OTPF toscaffold my evaluations and how
(19:11):
I write up my evals and plan ofcare.
So they incorporate that inthere.
And then I'm sharing that withthe family so that they have an
understanding of, where are theareas that their child is
developing in?
What are the goals that we'veset together?
And then what are the tools thatI'm going to use to help us get
there?
Right.
So we can go together.
(19:31):
So, if you're interested inlearning more about this, I
definitely encourage you to goto the American hippotherapy
associations website.
You can find additionalinformation there about courses
about upcoming courses.
Look up the occupational therapypractice framework.
Again, I'm using version four.
(19:51):
So if you would like to, you canlook that up and download a
copy.
There are free PDFs out there.
So if you want to follow alongwith what we're doing this
month.
Go ahead and download that.
And if you're looking really fora clinical mentorship, certainly
reach out to me.
I run trailblazers quest andthat's a clinical mentorship
that really helps clinicians inunique practice areas put what
(20:14):
they know as an occupationaltherapist into practice in their
unique setting.
So I'm really excited that youjoined us today for one of our
April as occupational therapymonth episodes focused on the
occupational therapy practiceframework and applying it in a
unique setting.
This week, we focused on thevalue of hippotherapy, and
(20:36):
occupational therapy practice toaddress ADL's.
And as we get ready to wrap up,they hope that you'll leave us a
review, subscribe and share ourpodcast with other OTs who are
interested in animals oraquatics.
Have a fantastic occupationaltherapy month.
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