I am doing a research paper and chose to go the informative route regarding children with disabilities and hippotherapy. I need feed back on grammar, proper citations and the overall flow of the paper. How can I help improve it?
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Helping with Horses
The Center for Disease Control estimates that 1 in 88 children are affected by some form of Autism. In fact many people know someone with Autism or know of someone with Autism; but what they do not know is what exactly Autism is. Many times Autism is thought of to just be one specific problem and it tends to be very generalized. However, Autism is not just one kind of disorder. In actuality it is a spectrum of many different kinds of disorders ranging from Cerebral Palsy to Asperger's Syndrome. Just as there are many different types of Autism, there are many different types of therapies to aid in treating it. These therapies range from the well-known physical and speech therapy to the lesser known aquatic therapy, music therapy and the focus of this paper hippotherapy.
To begin with, what exactly is Autism? Autism is defined as "a complex neurobehavioral disorder that includes impairments in social interaction and developmental language and communication skills, and rigid, repetitive behaviors" (Understanding Autism par 1). Basically Autism can affect all aspects of a person's life, ranging from their social skills to their speech and body movements. Since there is not just one type of Autism physicians have developed a way to diagnose it by placing all the types of Autism on a spectrum. This spectrum is known as the Autism Spectrum of Disorders or the ASD. On the ASD the different types of Autism range from Autistic Disorder to Asperger's Syndrome to Rett Syndrome. Diagnosing autism can be a difficult task since there are many differing signs and symptoms that need to be looked for. Some of these signs and symptoms can be anything from difficulty communicating to difficulty adjusting to changes within the environment. Other warning signs can include a child not making any sounds or gestures by a year old and not saying any words by sixteen months old. Although there is no cure for autism, there are many treatment options available. With all of the differing types of autism there has to be many types of treatment options available. Special education, medication, and many forms of physical and occupational therapy are some examples of these types of treatment.
One form of autism that many children suffer from is Cerebral Palsy. In fact 1 in 278 children are affected by Cerebral Palsy. Cerebral Palsy (CP) affects the ability for a person to move purposely and in a coordinated way; it affects all "muscle tone, movement, and motor skills" (Cerebral Palsy par 1). Basically cerebral palsy attacks the muscles and the ability to talk. A lot of children that are diagnosed with CP are confined to a specially made chair that gives them the abilities to move around. While there is not a specific known cause for cerebral palsy, many physicians believe it is usually caused by brain damage that occurs before birth up until the ages of three to five years. Cerebral Palsy also can be broken down into three different types, spastic, athetoid and ataxic. Spastic Cerebral Palsy causes a person to have difficulties moving and to be stiff. Athetoid Cerebral Palsy causes a person to have involuntary movements. The third type of CP mentioned, Ataxic Cerebral Palsy, creates an upset within the sense of balance and depth perception. As you can see, even though Cerebral Palsy is known as one condition there are varying types of it. Simple movements that many people take for granted, such as standing and breathing, are even affected by Cerebral Palsy. Cerebral Palsy can be very difficult to diagnose. Some of the symptoms doctors have to look for include abnormal muscle tones to a child not reaching for toys by four months of age. Many forms of therapy, such as speech and hearing, can help a child affected with Cerebral Palsy.
There are also types of autism that are classified as high functioning. One of the predominant types of high functioning autism is Asperger's Syndrome. Asperger's Syndrome was first discussed in the year 1944 by an Austrian doctor, Hans Asperger, thus giving the disorder its name. In fact, Asperger's Syndrome is more common than autism and affects anywhere from two to six in every 1,000 children. Asperger's is a form of pervasive developmental disorder and affects the development of many basic skills. A pervasive developmental disorder or PDD is a "group of conditions that involve delays in the development of many basic skills, most notably the ability to socialize with others, to communicate, and to use imagination" (Asperger's Syndrome par 1). One of the biggest areas affected is the ability to socialize. However people with Asperger's do still tend to have normal intelligence. Children that have Asperger's tend to show signs of communication difficulties, repetitive behaviors, or unusual rituals. Some children with Asperger's will have limited interests and may develop an obsessive interest in a few areas, such as music, sports or maps. A lot of children with Asperger's are also skilled in a certain area, such as math (Asperger's Syndrome par 2). As for the causes of Asperger's Syndrome, physicians say that there really is no known cause. To diagnose a person with Asperger's they have to be put through various tests and a rigorous medical history examination. Just like Autism, Asperger's cannot be cured but can be treated through special education and medication.
All forms of Autism can be treated with different types of therapy, ranging from speech therapy to musical therapy. However one of the lesser known therapy options for the treatment of autism is Hippotherapy. Hippotherapy is the technical term for equine assisted therapy. Simply it is a form of physical therapy that involves horses. Dating back to the B.C. era, specifically 460- 377 B.C. hippotherapy began being mentioned by Hippocrates in ancient Greece. Some of the first descriptions of hippotherapy mention the walking gait of a horse as being the most beneficial. Since 1900 hippotherapy, even though still widely unheard of, has taken off across the world. Liz Hartel told the world that riding a horse helped her to recover from polio thus leading her to win a silver medal at the 1952 Helsinki Olympics (History of Hippotherapy par 4). Starting in the 1960's hippotherapy riding centers started developing all throughout the United States, Canada and Europe. Starting in 1969 hippotherapy began to really take off in the US, with the establishment of the North American Riding for the Handicapped Association or the NARHA. After the establishment of the NARHA physical therapists began studying hippotherapy and developing a "standardized hippotherapy curriculum" (History of Hippotherapy par 9). Hippotherapy has an astonishing past for such an unheard of therapy.
Hippotherapy does not have just one goal in mind, in actuality it is a complete treatment program. Hippotherapists utilize the movement of the horse to improve motor abilities and speech skills, as well as many other problems someone may be suffering with. Why is the horse the best for the job? A horse's walk provides a repetitive rhythm; this gait actually mimics a humans movement pattern while walking. The repetitive rhythm of the horse's walk works to "improve muscle tone, balance, posture, coordination, strength, flexibility and cognitive skills" (Horse Power par 8). Basically hippotherapy helps improve all aspects of a person's life. Some people may get hippotherapy and therapeutic riding confused, but there is a huge and important difference. Therapeutic riding is supervised recreational riding, whereas hippotherapy is "a medical therapy provided under a physician's prescription" (Horse Power par 11). Hippotherapy is aimed at various therapeutic goals by having the participants ride in different positions, such as lying forwards, backwards, standing in the stirrups or riding without holding anything at all. To add to this, therapists also have participants stretch and even play games all while on horseback. The typical hippotherapy session usually last half an hour and is done on a weekly basis. The horses that are chosen for hippotherapy must be extremely gentle, patient and have 'bomb-proof' training, meaning that nothing is going to startle or scare them so the patient does not get hurt. Additionally horses that are chosen for hippotherapy are usually small so as to more easily accommodate children, some even being as young as eighteen months old. Many patients start out in hippotherapy and do eventually move to therapeutic riding. Why is hippotherapy so effective as a treatment for children with disabilities? Many kids with disabilities are used to being stuck in hospitals and a lot of them come to dislike therapists in traditional settings. However take those same children and put them up on a horse and it causes a drastic change and they light up. Ellen In, a physical therapist for EquiTherapy states that they sometimes "don't even realize they're working, because just sitting on a horse is comparable to working on a ball. Riding a horse presents constant yet engaging balance and postural challenges" (Horse Power par 17). The biggest reason hippotherapy works is simple: kids absolutely love the experience they get with it. Riding a horse is something a lot of children with disabilities think that they will never be able to do, hippotherapy not only makes this an obtainable dream but also helps them out in the long run.
Even though hippotherapy has a mind blowing past and amazing results there is still a huge amount of skepticism regarding it as a treatment option. One of the biggest reasons for skepticism is the lack of hard research. The reason hippotherapy is so hard to study is because it is hard to measure the impact it has objectively. A very mind blowing study that was done by Bill Benda MD who is an associate research scientist at the University of Arizona in Tucson, took 15 children with spastic Cerebral Palsy and investigated how only eight minutes of hippotherapy affected them. The way they obtained results was by measuring the "truncal and upper leg muscle activity during sitting, standing and walking using remote surface electromyography" (Horse Power par 25). The 15 participants were randomized to either sitting astride a barrel that was stationary or to an eight minute hippotherapy session. The way they calculated the results was by taking the difference between the pre- and posttest asymmetry and converting it to a percentage score. The results were amazing. In the short eight minutes of the hippotherapy there was a mean change of 65% compared to no change for the ones chosen to sit astride a barrel. These results further solidify the fact that more research needs to be conducted on this type of therapy. Dr. Benda is hoping to conduct a larger study that is followed by a 12 week multicenter study.
Another reason people tend to be skeptical of hippotherapy is the animal itself. Horses are huge and powerful animals. A lot of the horses that are used probably weigh in around 1000 pounds and that in itself is enough to scare off someone. Many times someone will look at a horse and only see what could go wrong. They see the possibility of falling off, the horse taking off or even scarier than that, getting bucked off. There is always a possibility something could go wrong with a horse; they are animals with minds of their own. However what people fail to see is that the horses chosen for hippotherapy are not your typical horse. These horses are chosen based on personality traits, how trained they are, their size, and how well they fit the needs of the program. A hippnotherapist will only chose the best horse for their program and typically refer to them as babysitter horses. The term 'babysitter horse' refers to a horse that will literally watch out for their rider. This horse is really special and hard to come by. They will not buck, spook, or run away with their rider on their back. They will not take advantage of their rider what so ever and they will be extremely gentle in every aspect. These fears that many people have regarding this therapy can be irrational; but once they allow their child to participate in one session and see the difference it will make they will never think twice about it again.
To conclude hippotherapy is one of the best options for an alternative therapy for children with autism. Not only does hippotherapy provide children with a sense of self fulfillment. It gives them the opportunity to accomplish something many people have probably told them they would never be able to do. The benefits that arise from treatment with horses far outweigh any negative thoughts towards this type of treatment. Just look at the statistics from the study that was done! Seeing the smiling faces of the children who go through a therapy session is enough to make anyone think twice about not giving hippotherapy a chance.
Thank you in advance :)
