Hippotherapy: The Lived Experience of Parents of Children With Autism

BACKGROUND AND PURPOSE: Hippotherapy, defined as occupational, physical, or speech-language therapy using the horse as a treatment strategy, for children with autism spectrum disorder (ASD) has been studied for over 20 years. Researchers have reported that hippotherapy improves motor control, social functioning, and adaptive behaviors in children with autism (Ajzenman et al., 2013). Families of these children spend countless time and finances on therapies for their children. However, limited research has addressed the meaning and value that parents of these children attribute to the hippotherapy experience. This phenomenological study examined the lived experience of parents of children with autism who received hippotherapy.

METHOD: All children were recruited from a local hippotherapy practice in South Florida that is accredited by the Professional Association of Therapeutic Horsemanship. Inclusion criteria for the study were English-speaking parents of children with ASD aged 6–18 and child attendance at hippotherapy for at least 5 mo. Flyers were distributed at the barn by staff therapists. Interested families were contacted by the research team, and informed consent was obtained.

Occupational therapy students conducted the parent interviews at the barn and observed the children during hippotherapy sessions. Interview questions were open ended and adapted from a similar study with a different population (Debuse et al., 2009). Field and observation notes were taken at each visit. Interviews were taped and transcribed to a password-protected file. Pseudonyms were used. The research team read through each transcript, making margin notes to form initial coding. Significant statements were identified and grouped into codes and themes to develop textural and structural experiences. Method triangulation was accomplished through review of interviews, field notes, and observation notes. Member checking was done with phone calls to participants after final data analysis.

RESULTS: Eleven parents (10 moms and 1 dad) were interviewed; the children ranged in age from 7 to 12 yr. Consistent with the literature, these parents reported improvements in their child’s attention, physical abilities, and anxiety. New findings from this study relate to family dynamics. The parents reported feeling proud of their child’s engagement in hippotherapy and subsequent relationship with the horses that added meaning to the child’s life. Additionally, this setting allowed children to have responsibilities and procedural routines for caring for animals that generalized to daily occupations and responsibilities for pets. Many parents found their child open to new experiences (as never before) as a result of hippotherapy and demonstrated more flexibility, which had a positive impact on the family’s routines.

CONCLUSION: The findings of this study speak to the unique benefits of hippotherapy as perceived by families that may not be available in occupational therapy clinic settings and address the research priorities of family and caregiver needs and health care utilization. For these parents, the occupation of hippotherapy provided a new and meaningful childhood pursuit for children who often have limited engagement in typical childhood activities. Parents enjoyed seeing their child interact, enjoy, and participate in all the aspects of hippotherapy. Additionally, the children learned new instrumental activity of daily living responsibilities related to animal caregiving with carryover to pets at home. When occupational therapy practitioners are considering treatment for children with ASD who have limited participation in typical childhood activities and social interaction, hippotherapy may have added benefits over therapy in the typical clinic setting. Practitioners can provide parents with information on factors to consider when looking at different treatments to best meet their child’s needs, consistent with the client-centered approach that is a hallmark of occupational therapy.

References

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, 653–663. https://doi.org/10.5014/ajot.2013.008383

Debuse, D., Gibb, C., & Chandler, C. (2009). Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Physiotherapy and Practice, 25, 174–192. https://doi.org/10.1080/09593980902776662