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Audrey

Occupational Therapist

I have been at ChildVision for almost 15 years. ChildVision, to me, is the best place ever to work.  In fact it’s not like work.

Audrey Personal Story image

A large part of my job is to work with children from across the campus providing therapeutic input.  To do that, we work through what children do best. That is playing.  We have a large Occupational Therapy Gym where we set up obstacle courses and do all kinds of fun things with children to help them develop to the best of their potential. I also get to work with children on horses.  It is an incredible experience to be in the outdoors doing something as powerful as working with children on horses, meeting goals and witnessing their development from session to session.

No two days are the same.  From the children that we see, the challenges that the children face that we help them surmount, participating in assessments with children from around the country and supporting them, their families and their therapy team to progress, and  from all the other projects that we as Occupational Therapists get involved in around the campus (such as development of new facilities, project groups for service development etc.).

The diversity of the kinds of activities that we can use as a medium for therapy in ChildVision surpasses what is available anywhere else.  We can work on sensory processing and gross motor skills in the playground or ball pool, we can work on awareness of others and tactile sensitivity in the farmyard with the animals, we can work on sensory processing / postural stability / social communication and many other things through Equine Assisted Therapy, and we also have our gym in which we work on many other aspects of the child’s development.

Here in ChildVision we work with the school calendar.  September is a very busy time preparing for the academic year ahead.  In the preschool we are setting children up in equipment needed for them to access activities over the coming months.  In the primary school we may be looking at seating and positioning, helping set up toileting programs for toilet training, supporting care staff to carry out programs with children to help them progress in school.

Currently we are expanding our Equine Assisted Occupational Therapy Service. September sees us setting up schedules of groups and individual sessions for the coming months.  We see about 40 children from the preschool and primary school on horseback throughout the year.  As this input is highly intense, this input is provided on a 1:1 basis for sessions lasting up to 20 minutes once a week.  Each child is assessed as to the goals that they would benefit from achieving through this input, and ongoing adaptation of the sessions is carried out as they progress.

We also provide some group therapies.  To date we have a group for children with Autism Spectrum disorders, in which OT goals are met through care of and riding the horse.  We also have a large group of children and young adults with diagnoses such as ASD, social challenges, anxiety, and behavioural difficulties.  This group works on riding skills, playing adapted pony games and also stable management skills once a week.

In this coming academic year, we hope to expand further to provide an OT assessment of children and young adults with a disability, goal setting, home programs, input through the use of horses for goal achievement, and step down to more mainstream classes as they are able.  As this service expands, it will be Ireland’s only service of Equine Assisted Occupational Therapy providing assessment and treatment for children and young adults with a range of disabilities.  It is very exciting being part of this pioneering service development in an area of special interest for me.

One of the things that makes me so fascinated and motivated by the area of Equine Assisted Occupational Therapy is the results that we have been getting. Over the years we have seen small and also transformational changes in the lives of the children that we work with. Some small changes like a child with autism hugging and kissing the horse in a way that children with autism don’t often do, or like a socially withdrawn child telling the horse to ‘trot on’ and singing to their hearts content as we trot around the arena.

There were also stories of great change like the little boy who had such poor posture from having no vision and cerebral palsy that he was highly unbalanced and kept falling over when he was walking.  He was being fitted for a helmet when we met him.  Through working with us on the horse his posture and a core stability improved so much that he never needed that helmet and started to walk more upright without falling.  He is now independently mobile with his cane.

There was also a girl with no vision and a diagnosis of autism. She was highly fearful of water to the point that if a drop of rain or water got on her she would strip all her clothes off in terror.  This was a source of distress within the family as they could not go to public places in case this happened.  Through working on the horse and introducing water to feed the horses, playing games with water whilst on horseback, she overcame these difficulties and can now even tolerate being out in the rain! This was a big change in quality of life for the family as they could then start to go out together again.

There are numerous heartwarming stories of the gains that children have made as a result of working on the horses with us.  As therapists we can see the many goals that we are achieving with the children.  However, we felt that it was important to prove scientifically through research that what we were doing was effective.  In 2014 we started with a small scale research project with 6 children from the primary school, and measured the effectiveness of the input they received through our Horse Sense Group ( a structured group incorporating car of the horse, sensory processing tasks, activities on horseback).  This research is currently being approved for publication.  Our next research project is starting this September so we will be busy with that.  We are looking at the effect of being with and riding horses on the heart rate of the children with whom we work.  Heart rate is a reliable indicator of stress levels, and also of sensory regulation in children.  So far we are noting significant positive effects for these children of being on and around horses in a therapeutic environment.  We are greatly looking forward to really getting going with this and seeing the results.

As I mentioned, ChildVision currently provides some group intervention for children from outside the service.  However, word is spreading and we are getting more and more referrals from individuals and services outside ChildVision to access the Equine Assisted Occupational Therapy Service.  Our expansion of this service is funding dependent, but we are optimistic that this will happen over the coming months.  In this case I will work primarily in the Equine Centre, helping children from both within and from outside ChildVision reach their potential.

A few years back I was fortunate enough to have been given the opportunity to represent our organisation on an international level at the International Society of Anthrozoology (ISAZ) 25th annual conference in Barcelona. Anthrozoology is the study of interactions between humans and non-human animals.  This organisation supports study of human – animal interactions and aims to promote the exchange of knowledge and expertise in this field.

My role was to present the findings of the research that shows that the Horse Sense Program that we developed in ChildVision is a highly effective therapeutic tool in goal achievement for children with a range of needs.  The presentation was well received, but it was also a great experience to attend other presentations of research, network with other agencies providing related therapeutic input, and to attend seminars with like-minded professionals.  I am very grateful for this experience, and it has given me the motivation to continue to be involved in research to validate the work that we are doing through EAOT in ChildVision.

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