Juliette Koepp & Elizabeth Gatti, Supervisor: Kathleen Holman, M.A., CCC-SLP Department of Communication Sciences and Disorders, Elmhurst College

SPEECH-LANGUAGE PATHOLOGY AND HIPPOTHERAPY: THE NEED FOR EVIDENCE-BASED LITERATURE

References American Hippotherapy Association (2013). Present use of equine movement by PT, OT,

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Ajzenman, H. F., Standeven, J. W., & Shurtleff, T. L. (2013). Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study. American Journal of Occupational Therapy, 67(6), 653-663.

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Introduction According to the American Hippotherapy Association (AHA), hippotherapy refers to the use of the horse as a treatment strategy by physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) to address body structure, function, activity restrictions, and participation limitations in clients (2013). Currently, hippotherapy is being used in 24 different countries and is recognized by the American Physical Therapy Association, American Occupational Therapy Association, and the American Speech Language and Hearing Association (AHA, 2000). In hippotherapy, the client is affected by the multi-dimensional movements of the horse by sitting on the horse’s back (Macauley & Gutierrez, 2004). Research in the fields of PT and OT have found hippotherapy to be effective for individuals who have a wide range of disabilities, including autism spectrum disorder, cerebral palsy, cerebrovascular accident stroke, developmental delay, Down syndrome, multiple sclerosis, muscular dystrophy, spinal cord injuries, and traumatic brain injuries (Granados & Agís, 2011). However, limited evidence-based literature is found on the effects of hippotherapy on communication and language disorders.

Figure 1: SLP with child during Hippotherapy

Limited SLP Literature, Although… Three boys with language learning disabilities received one hour of hippotherapy for a total of six weeks (Macauley & Gutierrez, 2004). Parent questionnaires reported improvement in the children’s receptive and expressive language abilities, as well as their motivation, attention, and self-concept as a result of hippotherapy. The authors expressed the need for further research in this area.

PT/OT Literature Supporting Hippotherapy

Correlation to Speech-Language Pathology

Sensory integration à

Increased expressive output

Postural control à

Improved respiratory muscle strength, chest expansion, and respiratory pressure

Head and trunk stability à

Increased respiratory strength

Gross motor à

Increased receptive language

Respiratory and oral motor function à

Integrated activity of neural systems responsible for speech

Participation and engagement à

Increased social and cognitive skills

Receptive communication, specifically multistep directions

à

Language development

Self-esteem à Increased verbal expression Cognitive functions à Speech development

Cerquozzi, Cerquozzi & Darragh, 2012; Whalen & Case-Smith, 2012; Champagne & Dugas, 2010; Zadnikar & Kastrin, 2011; Shurtleff, Standeven, & Engsberg, 2009; Champagne & Dugas, 2010; Ajzenman, Standeven, & Shurtleff, 2013; Nobrega de Melo & Cruz de Lucerna, 2007; Cerquozzi, Cerquozzi, & Darragh, 2012

Preis & McKenna, 2014; Teodori, Negri, Cruz, & Marques, 2011; Jandt, da Sil Caballero Junior, & Dias, 2011; Belmonte, 2013; Kertoy, Law, Kinh, Petrenchik, & Rosenbaum, 2008; Washington, 2010; Ohala, 1990; McClean & Tasko, 2002; Wadman, Durkin, & Conti-Ramsden, 2008; Nijland, Terband, & Maaseen, 2015; Collison, Munson, & Carney, 2004

Cognition

Foundation for Communication/Language

Theoretical Support for Hippotherapy

Head stability Oral-motor

function

Self-esteem

Trunk stability

Gross motor Sensory

integration Respiratory function

Postural control Social participation

Conclusions Benefits of hippotherapy found in the OT and PT literature show positive effects in areas responsible for physical, cognitive, and social functions needed for speech and language. Hippotherapy led to improvements in sensory integration, postural control, head and trunk stability, motor skills, social participation, respiratory function, cognitive skills, self-esteem and receptive communication improvement, specifically multi-step directions in individuals with various disorders. These results are applicable to the field of speech-language pathology. It should be noted that the majority of the literature showing the benefits of hippotherapy were case studies that used qualitative measures rather than experimental. More experimental studies need to be completed in order to show evidence of the positive effects of hippotherapy in the area of speech and language.

Figure 2: Theoretical Support for Hippotherapy for Speech and Language Therapy