Presentation of the "Step-by-step in communication” equine-assisted therapy intervention program for children with autism

Pedra, Amanda de Carvalho; Celeste, Leticia Correa

doi:10.1590/1982-0216/20222455922

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CASE REPORTS • Rev. CEFAC 24 (5) • 2022 • https://doi.org/10.1590/1982-0216/20222455922 copy

Presentation of the "Step-by-step in communication” equine-assisted therapy intervention program for children with autism

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The objective of this paper is to present the “Step-by-step in communication” equine-assisted speech-language-hearing rehabilitation program to treat language impairment in children. The program was developed in three stages: literature analysis, pilot application, and clinical analysis. The literature was analyzed by searching, reading, and discussing articles and books on the topic, published up to 2018. After this stage, the first version of the program was developed. This version addressed: participants’ language assessment, application of 10 sessions, monitoring and record of activities in each session, participants’ reassessment, and adjustment of techniques and activities. The clinical analysis took place after the pilot application with the following procedures: analysis by three judges, revision of the approach by the authors, and development of the final version of the “Step-by-step in communication” program, comprising eight theme modules with 24 sessions, and based on four main pillars, which are applied in equine-assisted therapy activities. Each pillar has specific objectives and strategies. The activities aim at formal (semantic and morphosyntactic) and pragmatic aspects of language. Their theoretical/practical framework is grounded on functional grammar, and the strategies are based on equine-assisted therapy experiences that open the way for communication.

Keywords:
Equine-Assisted Therapy; Autism Spectrum Disorder; Language; Communication; Speech, Language and Hearing Sciences

MODULE 1 - EXPERIENCING EQUINE-ASSISTED THERAPY
Module sessions and general themes	General objectives	Examples of strategies
Session 1: Welcoming and Horsemanship	I. Presenting the environment, people, and rules of the equine-assisted therapy center. II. Approaching children and families to the horse.	I. Developing a notebook for each child with the family’s help. Sticking pictures of the people and settings on the notebook. As the notebook is developed, specific objectives must include the presentation of the team, place, and rules. II. Walking about the center, presenting the place. The experience must include specific contextualized objectives related to semantics and morphosyntax, according to the child’s assessment. III. While still on the ground and in an appropriate place, each family must be individually introduced to the horse. The interaction between the child, horse, and equestrian at this moment must include mutual attention, conversation with eye contact, and semantic expressions of physical (e.g., parts of the horse) and emotional aspects (feelings related to the moment).
Sessions 2, 3, 4: Discovering the equine-assisted therapy	I. Helping patients experience all initial psychomotricity and emotions involved in introducing them to the horses: physical and emotional contact with the horse. II. Semantics: Introducing a semantic field related to equine-assisted therapy. III. Morphosyntax: Allowing patients to use morphosyntactic structures according to assessment results. IV. Pragmatic functions, experiencing them according to assessment results; choosing pragmatic functions. Interactive, instrumental, and heuristic functions can be more easily experienced in the module.	I. Introducing the horse that will be with the child throughout the therapeutic process, naming the animal to increase verbal expression, and petting and greeting it to enable the use of pragmatic functions. Allowing the child to ride the horse or guide it from the ground, according to their preference. II. Presenting the material used in the equine-assisted therapy sessions, such as helmet, saddle, saddle blanket, stirrup, bridle, and tack. The level of grammar to be used and encouraged must be based on the child’s assessment. III. The horse may be instructed to walk only after the child’s verbal command. The complexity of the verbal production is recruited according to assessment results. E.g., “Walk, horse”, “Now, let’s walk, horse”. Phrase use must be encouraged to develop more complex grammar structures to reach morphosyntactic objectives. IV. Different session activities are suggested for each pragmatic function. Interactive example: therapists must create a routine with greetings and goodbyes to the horse at the beginning and end of each session. Instrumental example: therapists must place the helmet where the child cannot reach it, allowing them to ask the others for what they want.
Observation on the specific grammar objectives: in all objectives exemplified above, the mediator must consider the state of the child’s linguistic expression and comprehension to use strategies compatible with their grammar use. For instance, the general objective in Module 1 (approaching children and families to the horse) can be addressed in three different cases: • Nonverbal child, or who preferably expresses themselves vocally: the communication must be based on gestures, isolated words, or very short phrases. Phrases such as “Look, the hook of the horse”, reinforcing with “The hoof”, “Touch the belly”, and “Touch the tail” are examples of experiences adapted to the child’s grammar level. • A child who expresses and understands objects and their characteristics: the communication between the mediator and the child must go beyond naming and address physical characteristics. Phrases such as “Look, the hoof of the horse. It’s big!”, “Touch the belly of the horse. It’s warm!”, “Touch the tail of the horse. It’s long!”. • A child who expresses and understands the relationship between events: the communication between the mediator and the child must be more encompassing. For instance, they can make comparisons such as “Look at the hoof of the horse. Look at your feet. Are they the same or different? What are they like?”

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[1] Corresponding address: Leticia Correa Celeste, Campus Universitário - Centro Metropolitano, Ceilândia Sul, CEP: 72220-275 - Brasília, Distrito Federal, Brasil, E-mail: leticiaceleste@unb.br