Posted in Autism, Down syndrome, Dual Diagnosis Down syndrome and autism

Blog #162~ Horseback Riding Therapy

Blog #162~ Horseback Riding Therapy


Horseback riding therapy, also known as Equine Assisted Therapy, involves interactions with horses for individuals with and without special needs, including those with physical, cognitive and emotional issues.  Hippotherapy is another term used by physical, speech, and occupational therapists to reach their patients on a personal level.


There are many benefits such as motor, emotional and sensory sensations that come with riding a horse. Horseback riding gently and rhythmically moves the rider’s body in a manner similar to a human gait, to improve  in flexibility, balance and muscle strength.

At age one, my son Nick was unable to sit up by himself due his low muscle tone, which is a trait of having Down syndrome.

Nick at age one…..


We had to prop him up in the high chair, so he wouldn’t slide down or slump to either side.  Nick was receiving physical, occupational and speech therapy in his early intervention program.  Shortly after his first birthday, we enrolled him in a horseback riding therapy program.

Person’s having Down syndrome please note:

“Prior to considering hippotherapy as a treatment strategy for your child, it is important that they have current cervical x-rays to ensure the atlantoaxial joint (or C1-C2) is not at risk for dislocation.  Some people with Down Syndrome also may have a condition known as Atlantoaxial Instability — a misalignment of the top two vertebrae of the neck. This condition makes these individuals more prone to injury if they participate in activities that overextend or flex the neck. Parents are urged to have their child examined by a physician to determine whether or not their child should be restricted from sports and activities that place stress on the neck injury.”

In less than nine months, of incorporating the horseback riding therapy, we noticed a vast improvement in Nick’s posture both in strength and endurance.  At first he couldn’t tolerate a helmet as it weighed him down, (as you can see in the first picture of this post).  But soon, he not only wore a helmet, but was able to keep his head upright, along with and sitting up better.

Nick with his brother, Hank, taken nine months after starting horseback riding therapy…


We decided on horseback riding therapy, initially to help our son gain trunk strength.  However, we soon realized there were many additional benefits that came along with it.  Not only did Nick ride on top of the horse, he also learned how to care for the horse by feeding, patting and brushing them.  This helped to create an emotional bond and opened up new sensory experiences that he couldn’t get in a clinical setting.  Riding a horse helped to wake up the sensory preceptors, making for a fun and motivating experience for him.

Horseback riding therapy was a wonderful experience for our son with special needs. The horses were gentle friends that helped Nick get stronger, build relationships through unspoken communication, and taught him about responsibility.  That’s what is in my noggin this week!


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Posted in Down syndrome, Physical Therapy and Special Needs

Blog #72~Down Syndrome and Low Muscle Tone

Blog #72~Down Syndrome and Low Muscle Tone

October is Down Syndrome Awareness Month.  In Blog #26, located in the October 2012 archives, there is a complete overview about Down syndrome.


This week I want to put a lens on one of the physical traits of having Down syndrome.  Hypotonia, or low muscle tone is common in almost all babies with Down syndrome.  The appearance is floppy and the muscles are flaccid. As soon as I touched my son Nick after he was born, I could feel this.  He felt like a rag doll.

The good news is that hypotonia generally improves over time with early intervention and physical therapy.   Within eight weeks, we met with the early infant intervention team and began the work to confront his low muscle tone.  Right away, we were instructed to roll up blankets and stuff them on either side of Nick when he was sitting in his carrier.  Since the muscles are so floppy, there is a tendency for the limbs to dangle open.  We then started from the top and worked down.  The first step was to get the neck strong.  We incorporated a lot of tummy time providing lots of bright, colorful, and contrasting toys that would be stimulating.  His brother Hank helped out by pushing the buttons on musical toys so that Nick would lift his head up.  This would help develop more alertness as under arousal is typical for babies having Down syndrome.

Everything is ready for tummy time, look at that scrawny baby 🙂 …….


Once he was able to support his head, the early infant team began to work on building strength in his trunk.  At first he had to be held at the shoulders while sitting on a play ball.  The facilitator would lead the group with songs and blowing bubbles.  The babies would both track the bubbles and try to pop them with their fingers.  Gradually, the therapist was able to hold Nick at the chest, and after several months hold his waist while he worked on the ball. The physical therapist told us that Nick would not be able to pull up to stand or walk until his core was strong.  This meant when he could sit on the ball supported with her hands down on his hips. This took a very long time for Nick.

We propped up pillows in his high chair so he would flop over to the side. His brother Hank, keeping him entertained…….


A special chair was provided by the early infant intervention program.  Nick’s trunk was still weak and he had a lot of trouble sitting upright…….


Take a look at the average gross motor milestones:

Sitting alone-

Typical age 5-9 months

Down syndrome 6-30 months

Nick 22 months


Typical age 6-12 months

Down syndrome 8-22 months

Nick 28 months


Typical age 9-18 months

Down syndrome 1-4 years old

Nick 3 ½ years old

As you can see, Nick’s low muscle tone affected his development in all of these gross motor areas.  After his first birthday, the physical therapist suggested we try doing horseback riding therapy with Nick. He was the youngest person they had ever tried at this facility.   We made the trek out to Tomball, Texas for these sessions for over a year.  Nick gained a lot of trunk strength during this time.  Keep in mind, not only were the muscles weak but also had less endurance.  Doing the sessions on the horse helped with increasing his endurance and the sensory input was very stimulating.

Giddy up Nick……


After a year of hard work, he finally sat on his own!  Nick with his cousin, Austin


Once Nick was able to sit up and crawl we began to find creative ways to get him up on his feet.  Hank would often dangle his favorite musical toy at the top of the bean bag chair.  As the music blared and lights flashed, Nick would climb up the makeshift mountain to reach the toy.  Around this time, I also began redecorating the living room.  I mounted several musical toys above the fire place so if he wanted to get to them, he had to pull up to stand.  His brother also enticed him, bouncing ping pong balls on the coffee table.  He would crawl over, pull up, play and laugh with Hank.

It was a long, slow rode to get him up and walking.  Nick had to work a lot harder to build his strength, endurance, alertness to defy the effects of low muscle tone and under arousal.  Hard work always pays off, and gets you to the top of the podium!

Nick in Middle School, brings home the gold 🙂


That’s what is in my noggin this week!