Attention Deficit Disorder and Therapeutic Riding
Reprinted from NARHA Strides magazine, October 1997 (Vol. 3, No. 3)
Attention Deficit Disorder (ADD) is a developmental disability estimated to affect between 3-5% of all children (Barkley, 1990). The disorder is characterized by three predominant features: inattentiveness, impulsivity, and in many but not all cases, restlessness or hyperactivity. The disorder is most prevalent in children and is generally thought of as a childhood disorder. Recent studies, however, show that ADD can and does continue throughout the adult years. Estimates suggest that approximately 50-65% of the children with ADD will have symptoms of the disorder as adolescents and adults (Barkley, 1990).

Medical Considerations for Therapeutic Riding
Reprinted from NARHA Strides magazine, October 1997 (Vol. 3, No. 3)
Many parents of riders enrolled in a therapeutic riding program marvel at their child's newfound skills. The riding center may be one of the first places where their child experiences success and acceptance. The motivating lure of the large, gentle animal, the calm and consistent support of the therapeutic riding team, and the naturally accepting environment of the "stable" provide opportunities for the child to learn and develop. These opportunities may help to turn the often disparaging label of ADD into a child who is Absolutely Delightfully Driven.

Autism and Therapeutic Riding
Reprinted from NARHA Strides magazine, July 1996
Autism is a developmental disability that often appears during the first three years of life. Autism is associated with abnormalities in brain structure and neurological disorder of the brain's function. It vacillates between being the third and fourth most common developmental disabilities. It occurs in approximately 5-15 per 10,000 births. It is four times more common in boys than it is in girls. Autism is not determined by racial, ethnic, social, lifestyle, educational or psychological factors.

Medical Considerations for Therapeutic Riding
Reprinted from NARHA Strides magazine, July 1996
The extraordinary value of the horse in working with those with autism begins with human-animal bonding. Therapy horses have first and the foremost a temperament that provides a safe, nonjudgmental and tolerant base that is conducive to exploration by the rider. Those with tactile sensitivity have an opportunity to work through their defensiveness through the sensory processing work on horseback. It has been noted from teachers and parents that autistic children have improved in most areas of sensory processing and their reaction to the world around them much more completely after riding.

Brain Injuries and Therapeutic Riding
Reprinted from NARHA Strides magazine, April 1996 (Vol. 2, No. 2)
Traumatic brain injury (TBI) is defined as an insult to the brain caused by an external physical force that may produce a diminished or altered state of consciousness. This results in an impairment of cognitive abilities and/or physical functioning. The term TBI does not apply to brain injuries that are congenital or degenerative, or brain injuries induced by birth trauma.

Medical Considerations for Therapeutic Riding
Reprinted from NARHA Strides magazine, April 1996 (Vol. 2, No. 2)
What is it about therapeutic riding that is so helpful to people with TBI? As always in therapeutic riding, it is the unique problems faced by the person post-TBI, not the diagnosis itself, which may be improved through the use of the horse. In spite of their balance, movement, posture, communication and behavioral problems, horses can provide a strong motivating, consistent, multi-sensory input that appears to help the rider's brain organize itself. Gradual recovery from TBI can continue for years, making therapeutic riding a source of stimulation to continue that recovery over a long period of time. A well-planned, carefully implemented riding program can not only facilitate the rider's recovery from TBI, but also provide a much-needed source of pleasure, risk and self-esteem to a person who really needs it. The attraction of and bonding with the horse can be a positive and stabilizing experience in that person's life; it also can be an activity in which the whole family can participate. Helping people with TBI to help themselves, through the unique qualities of the horse, is rewarding for everyone.

Cerebral Palsy and Therapeutic Riding
Reprinted from NARHA Strides magazine, October 1995 (Vol. 1, No. 1)
Cerebral palsy is a condition caused by damage to the brain, usually occurring before, during or shortly following birth. "Cerebral" refers to the brain and "palsy" refers to a disorder of movement or posture. Cerebral palsy is neither progressive nor communicable. It is also not curable, although education, therapy and applied technology can help people with cerebral palsy lead productive lives.

Medical Considerations for Therapeutic Riding
Reprinted from NARHA Strides magazine, October 1995 (Vol. 1, No. 1)
Recent articles by Ruth Dismuke-Blakely, SLP/CCC, in AHA News and NARHA News, indicate that the movement of the horse in hippotherapy sessions can increase the quantity, quality and volume of vocalization in the rider. For children with cerebral palsy, the horse is a wonderful motivation for speech, while the horse's movement can improve the coordination of breathing, swallowing and sound production. The horse naturally motivates children with cerebral palsy to move, explore and touch. Using the horse as a large, gentle, rhythmic and predictably moving gross-motor platform, where the child is invited and assisted to explore, can be even more useful than learning to ride. Instructors can encourage movement and hopefully "disconnect" it from the fear of failure. The result is self-confidence and courage on and off the horse.

Down Syndrome and Therapeutic Riding
Reprinted from NARHA Strides magazine, October 1996 (Vol. 2, No. 4)
Down Syndrome is the most common and readily identifiable chromosomal condition associated with mental retardation. It is caused by a chromosomal abnormality: for some unexplained reason, an accident in cell development results in 47 instead of the usual 46 chromosomes. The extra genes cause certain characteristics known as Down Syndrome. Individuals with Down Syndrome also have all the other genes given to them by their parents. As a result, they have a combination of features typical of Down Syndrome on top of the individual features from their parents. This includes some degree of mental retardation, or cognitive disability and other developmental delays. The extra chromosome changes the orderly development of the body and brain. In most cases, the diagnosis of Down Syndrome is made according to results from a chromosome test administered shortly after birth.

Medical Considerations for Therapeutic Riding
By Liz Baker, PT, Medical Committee Chairman
Serving people with Down Syndrome in the therapeutic horseback riding setting can be a source of great joy and satisfaction to riders, instructors, therapists and volunteers. These riders are often among the most talented and competitive a program may ever serve. It is helpful to be familiar with a few characteristics of Down Syndrome which will influence the operating center's decisions as to how to best serve this population.

Learning Disabilities and Therapeutic Riding
Reprinted from NARHA Strides magazine, January 1996 (Vol. 2, No. 1)
The term "learning disabilities" is all embracing; it describes a syndrome, not a specific person with a specific problem. Individuals with learning disabilities are not mentally retarded. Learning disabilities are neurologically based disorders and do not affect a person's intelligence. The most frequently displayed symptoms are: short attention span; poor memory; difficulty following directions; inadequate ability to discriminate between and among letters, numerals or sound; eye-hand coordination problems; difficulties with sequencing; disorganization; and numerous other problems that may affect all the sensory systems.

Medical Considerations for Therapeutic Riding
Reprinted from NARHA Strides magazine, January 1996 (Vol. 2, No. 1)
The horse can also help improve the rider's sensorimotor difficulties and the learning problems by providing a means of improving awkward movement. It is thought that our early learning of good movement skills is closely related to our self-concept and self-confidence. Poor movement and clumsiness makes play difficult. Children with learning disabilities and motor dysfunction are ostracized by their peers, made fun of and picked last (or not at all) for group games. Thus, socialization skills are impaired as well. The horse can act as a great "equalizer," providing sensorimotor input and opportunities to practice many skills in a non-threatening way and equally with others.

Mental Retardation and Therapeutic Riding
Reprinted from NARHA Strides magazine, January 1997 (Vol. 3, No. 1)
Many authorities agree that people with mental retardation develop in the same way as people without mental retardation, but at a slower rate. Others suggest that persons with mental retardation have difficulties in particular areas of basic thinking and learning such as attention, perception or memory. Depending on the extent of the impairment-mild, moderate, severe or profound - individuals with mental retardation will develop differently in academic, social and vocational skills.

Medical Considerations for Therapeutic Riding
By Liz Baker, PT, Medical Committee Chairman
There is great variety in abilities, motivation and functional life skills within the group of people diagnosed as mentally retarded. In fact, "People with mental retardation are as different from one another as are people without mental retardation--perhaps even more so." This is a consideration for the therapeutic riding program and its staff planning to serve this population; it is arguably easier to plan for riders who have similarities rather than so much diversity!

Multiple Sclerosis and Therapeutic Riding
Reprinted from NARHA Strides magazine, April 1997 (Vol. 3, No. 2)
Multiple Sclerosis (MS) is an illness diagnosed in over 350,000 persons in the U.S. today. MS is that it is signified by more than one (multiple) areas of inflammation and scarring of the myelin in the brain and spinal cord. Myelin is the tissue that covers and protects our nerve fibers. When this occurs, nerve "communication" is disrupted. The cause of multiple sclerosis is not yet known. There is no one group of people who "get" MS. Considered a lifelong disorder, trends show that MS often strikes between the ages of 30 and 50, and mostly women. MS is not considered a fatal, contagious or directly hereditary illness, although a susceptibility to MS may be inherited.

Medical Considerations for Therapeutic Riding
By Liz Baker, PT, Medical Committee Chairman
Multiple Sclerosis is one of a growing number of diseases that has a dual identity in therapeutic riding: it can be both an indication for riding, and a precaution or contraindication. This duality, an apparent contradiction, is created by the type of symptoms and problems caused by the disease; its signs and symptoms can be improved by therapeutic riding, worsened by riding, or even preclude riding altogether. In general, however, people with MS are often good candidates for riding, and this activity can help retain functional ability on and off the horse.

Spina Bifida and Therapeutic Riding
Reprinted from Strides Magazine, July 1997 (Vol. 3, No. 3)
By Liz Baker, PT, Medical Committee Chairman
Spina Bifida is a descriptive diagnosis that also goes by the names myelomeningocele, spina bifida cystica, and myelodysplasia. It is diagnosed at birth by the presence of an external sac on the child's back along the spine. This sac contains the spinal cord and the meninges, the protective layers of tissue that enclose the spinal cord. Surgery is usually performed within days after birth to close the causative defect in the vertebrae so that the myelomeningocele (and the spinal cord) is no longer exposed, and less likely to be injured.

Medical Considerations for Therapeutic Riding
Reprinted from Strides Magazine, July 1997 (Vol. 3, No. 3)
By Liz Baker, PT, Medical Committee Chairman
In the past, riders with spina bifida have been considered to be the least problematic, most capable and most likely to benefit from horseback riding. Although the center's instructors and therapists need to closely monitor the rider for the problems …, therapeutic riding continues to be in most instances a very healthy, beneficial and therapeutic activity for all people with spina bifida. Many such people can progress to high levels of independence in their riding skills and go on to competition. Therapeutic riding can be an excellent lifelong way for the person with spina bifida to maintain or improve functional life skills, fitness and strength, while providing a rewarding experience for the rider and the entire therapeutic riding team.