THE EQUINE ASSISTED THERAPY AS STRATEGY IN SPEECH LANGUAGE PATHOLOGY INTERVENTION Pedro Melo Pestana 1 ; Susana Vaz Freitas 1, 2 1 Universidade Fernando Pessoa Faculdade de Ciências da Saúde 2 Centro Hospitalar do Porto Hospital de Santo António
Introduction The SLP approach must be the same as traditional (e.g., assessment, intervention, etc.) Speech Language Pathology (SLP) Main service Equine Assisted Therapy (EAT) Strategy The physician must tell us that the person is available to be on the horseback. Using EAT strategy we must determine traditional goals of our professional area. We just change the procedures and activities!
Introduction THEORETICAL FOUNDATIONS Traditional therapy Equine Assisted Therapy SENSORY INTEGRATION HUMAN-ANIMAL BOND VOLITION/MOTIVATION SOCIAL INTERACTION NEURODEVELOPMENT
Introduction Meredith% Bazaar% Beth% Macauley% Ana%Melo% Neves% 2013 1981 Ruth% Dismuke, Blakely% 32 years
Introduction hippotherapy adaptive riding therapeutic riding animal assisted therapy pet therapy animal assisted activities equinotherapy nature based therapy TERMS COMMONLY USED WHEN ANIMALS ENGAGE IN HEALTH AND EDUCATION
Introduction Animal Assisted Therapy (AAT) as: Intentional and therapeutic act, whereby the animal s role is integral in assisting with mental health, speech, occupational therapy or physical therapy goals Criteria in AAT: Animals must meet specific criteria that fit the therapeutic goals (e.g., behavior); Animals considered a necessary part of the treatment; Therapy is conducted by a qualified professional or practitioner; Therapeutic intentions include physical, social, emotional, or cognitive gains; Therapy can occur in group or individual sessions; and, all treatment must be assessed and documented. Let s do this with Equines! (Cole,. 2009, Kruger & Serpell, 2009)
Introduction Scientific publications about using horses The lack of scientific evidence in this particular field and the inherent difficulty to prove the efficacy of this powerful strategy was the motivation for the authors. in health 76...to attain goals of SLP scope 15 Evidence levels I-III 25% Evidence levels IV-VI 75%
Some of our work out there FP134 Melo Pestana and Vaz Freitas IALP 2013
Objectives With this study we intend to justify the presence of a speech therapist in an equine assisted therapy facility. This study aims to: a) Understand the contribution of EAT in goal achieving of speech therapy b) Analyze the relationship between the necessity and priority of speech language pathology fields and its fulfillments in an EAT program c) Analyze the relationship between the priority of speech language pathology fields among different diagnosis and distinctive age classes. If these hypothesis are proven, then the inclusion of a SLP in an Equestrian Center is well justified.
Methods Data collection: two Equestrian Centers from the north of Portugal, where the therapeutic role is present. Transversal study, with retrospective analysis of data. Population: all the cases in private practice of that Equestrian Centers. The speech pathologist has acquired advanced equestrian skill which enables him to apply with confidence and safety this strategy he is present in every sessions 13 years showjumping riding; Level I American Hippotherapy Association
Methods Variables were collected and analyzed for the 24 subjects. Descriptive statistic measures are pointed for: Age class Functional diagnosis Need for Speech Therapy Presence of SLP goals Inferential statistic: Pearson Chi-square.
Results - Age Class Distribution It was found a prevalence of cases under the age of 7 years old (41,7%) >13 21% 7-13 37% <7 42%
Results Functional Diagnosis The most common functional diagnosis was the communication disorders due to autism spectrum disorder (37,5%) What is the functional diagnosis? Frequency Percent Communication Disorder / Autism 9 37,5 Motor Speech Disorder 6 25 Comorbidity 4 16,7 Speech Sound Disorder 3 12,5 Speech Delay 1 4,2 Childhood Apraxia of Speech 1 4,2 Total 24 100 0 2 4 6 8 10
Results When communication, language and speech goals are a priority, they must probably be included in the EAT program (x 2 =11,679, p=0,001). 18 16 14 12 10 8 6 4 2 0 Yes 4 13 No 7 0 Is Communication, Language and Speech goals a priority? No Is Communication, Language and Speech goals a priority? Yes Does the child benfits of Speech Therapy goals at EAT facility?
Results It was also noticed that the identification of this priority is different among age classes (x 2 =7,487, p=0,024); the oldest subjects have other concern areas. 10 9 8 7 6 5 4 3 2 1 0 3 3 7 6 5 0 <7 7-13 >13 Age Class Is Communication, Language and Speech goals a priority? No Is Communication, Language and Speech goals a priority? Yes
Results Correlation between the communication, language and speech goals and types of diagnoses is significant (x 2 =18,294, p=0,003): all the communication disorders due to ASD have these areas as priority, in opposition to motor speech disorders. What is the funtional diagnosis? Childhood Apraxia of Speech Comorbidity Speech Delay Motor Speech Disorder Communication Disorder / Autism Speech Sound Disorder 1 1 1 1 2 3 6 9 0 1 2 3 4 5 6 7 8 9 Is Communication, Language and Speech goals a priority? Yes Is Communication, Language and Speech goals a priority? No
Results With a significant result, we concluded that the cases with necessity of speech-language pathology intervention benefits of inclusion in a EAT program that covers these fields (x 2 =8,372, p=0,04). Does the child benefits of Speech Therapy goals at EAT facility? Total Does the patient needs conventional speech therapy? Yes No Yes 17 4 21 No 0 3 3 Total 17 7 24
Conclusions This research underscores the importance of integrating a speech therapist in the team of an Equine Assisted Therapy program, with greater relevance in preschool and school ages. More requested by patients with communication disorders due to ASD, although they have a role in all established diagnoses involving communication, language and speech impairments.
Final considerations Knowledge fields: Speech Pathology; Classical riding; Equine Assisted Therapy Although it is difficult, we need to research more, due to the results attained until this right moment. melopestana@gmail.com Speech Language Hippotherapy Blog (English) http://slhippotherapy.blogspot.com
IALP 2019 in Portugal!! FP134 Melo Pestana and Vaz Freitas IALP 2013