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Parental Perception of Changes in Basic Life Needs of Children with Disabilities after Six Months of Therapeutic Horseback Riding: A Qualitative Study.

ABSTRACT: Therapeutic horseback riding (THR) has a positive effect on the physical, cognitive, and psychosocial functioning of children with disabilities. Parents' reports of the effects of THR on their children support professionals in individualizing the THR program. With this qualitative study, we aimed to explore parents' perceptions of changes in the basic life needs of their children with disabilities after six months of THR lessons and to survey parents' explanations for the causes of these changes. The study involved parents of 13 children with disabilities who were enrolled in a six-month THR program. Parents continuously monitored their children and wrote a report on possible changes in their child's needs according to Virginia Henderson's need theory. Qualitative content analysis of parents' reports indicated only positive changes in 11 children. Most codes were identified in categories "relationships and communication with other people" and "movement and posturing". Other categories identified codes such as easier breathing, a better quality of sleep, better appetite, better elimination of stool and urine, more independence in clothing and maintaining personal hygiene, and greater interest in play and learning. Parents' reports are further supported by the assessments of professionals. Most parents think THR is responsible for the noticeable improvements in their children's quality of life.

SUBMITTER: Lovric R

PROVIDER: S-EPMC7068330 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Parental Perception of Changes in Basic Life Needs of Children with Disabilities after Six Months of Therapeutic Horseback Riding: A Qualitative Study.

Lovrić Robert R Farčić Nikolina N Mikšić Štefica Š Gvozdanović Debeljak Aleksandra A

International journal of environmental research and public health 20200213 4

Therapeutic horseback riding (THR) has a positive effect on the physical, cognitive, and psychosocial functioning of children with disabilities. Parents' reports of the effects of THR on their children support professionals in individualizing the THR program. With this qualitative study, we aimed to explore parents' perceptions of changes in the basic life needs of their children with disabilities after six months of THR lessons and to survey parents' explanations for the causes of these changes ...[more]

PMID: 32069999

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Project description:BACKGROUND:Multimodal rehabilitation interventions delivered in late phase of stroke recovery involve physical (motor and sensory), social, and cognitively challenging activities. Horseback riding can be incorporated within such interventions, leading to meaningful long-term improvements when applied to individuals with moderate levels of disability. There is a lack of research illuminating stroke survivors' experiences and perceptions of horseback riding in the context of multimodal interventions. AIM:To explore stroke survivors' experiences of participation in a multimodal group-based intervention that included horseback riding. METHODS:An explorative interview study was conducted with individual face-to-face interviews performed on a single occasion, utilising a semi-structured interview guide. Eighteen participants were purposively selected from a larger trial (mean age 62, 12 men, 6 women) within four weeks after treatment completion. The interview duration was between 17 and 50 minutes. The data was analysed using a qualitative content analysis method. FINDINGS:Four broad themes were identified from the analysis. These themes were: transformative experiences; human-horse interaction; togetherness and belonging; and the all-in-one solution. Interacting with the horse and peers had a profound emotional impact on the participants. The participants also reported having learned new skills, increased self-efficacy and self-esteem, and improvements in balance and gait, all of which could be transferred to everyday life. The horse itself played a central role, but other components, such as the other group members, the instructors, and the challenging tasks on the horseback, were also important. CONCLUSION:A multimodal rehabilitation intervention that includes horseback riding may provide stroke survivors in a late phase of recovery with rich pleasurable experiences that may have life-changing and profound impacts on their emotional and physical state.

Project description:IntroductionLiterature on parental experiences after childhood critical illness has limited representation from diverse ethnic backgrounds. Parents from global ethnic majority groups have reported worst psychological outcomes and required more social support after childhood critical illness.AimTo explore the experiences of Chinese, Malay, and Indian parents in the first six months after Pediatric Intensive Care Unit (PICU) discharge of their child in Singapore.MethodsSequential semi-structured qualitative interviews were conducted to collect data from a convenience sample of 28 parents at one month (n = 28) and at six months (n = 22) after their child's discharge from a multidisciplinary PICU. Framework Analysis was adopted as the qualitative analysis strategy. The PICS-p framework was applied a priori in the Framework Analysis.FindingsThree interdependent domains and seven themes framed the 28 accounts in which ethnically diverse parents reported psychological stressors (PICS-p: emotional health), support received (PICS-p: social health) and practical challenges (transitional health) in the first six months after childhood critical illness. In the emotional health domain, parents were affected by different stressors and had different priorities over their child's survivorship. Only Indian parents reported experiences of stress symptoms, at six months post discharge. Malay parents sought solace from their religion more than Chinese and Indian parents. In the social health domain, parents reported various sources and degree of support received. Familial supports were strong across all groups, while community support was more prominent in Malay as compared to Chinese and Indian parents. A third domain, transitional health, was introduced to capture the difficulties parents faced during the transition from PICU survival to home. Parents from non-Chinese families were more likely to report financial challenges and more involvement of spouses after discharge. Complementary medicine or commercial health products were utilized by Chinese and Malay families.ConclusionThese findings reveal preferred strategies that parents from a global ethnic employ to address the emotional, social and transitional health impacts of their child's critical illness. Future care delivery may consider tailored care plans, communication strategies, and emotional support in PICUs that address the unique ethnic needs of parents during the critical six-months post their child's illness.

Project description:Interactive apps delivered on touch-screen tablets can be effective at supporting the acquisition of basic skills in mainstream primary school children. This technology may also be beneficial for children with Special Educational Needs and Disabilities (SEND) as it can promote high levels of engagement with the learning task and an inclusive learning environment. However, few studies have measured extent of learning for SEND pupils when using interactive apps, so it has yet to be determined if this technology is effective at raising attainment for these pupils. We report the first observational study of a group of 33 pupils with SEND from two primary schools in Malawi that are implementing a new digital technology intervention which uses touch-screen tablets to deliver interactive apps designed to teach basic mathematical skills. The apps contain topics that align to the national curriculum. To assess learning gains, rate of progress (minutes per topic) for each pupil was determined by calculating the average time taken to complete a topic. Progress rate was then correlated with teacher ratings of extent of disability and independent ratings of pupil engagement with the apps. Results showed SEND pupils could interact with the apps and all pupils passed at least one topic. Average progress rate for SEND pupils was twice as long as mainstream peers. Stepwise regression revealed extent of disability significantly predicted progress rate. Further exploratory correlations revealed pupils with moderate to severe difficulties with hearing and/or language made slower progress through the apps than those with greater functionality in these two domains because the use of verbal instructions within the apps limited their capacity to learn. This original quantitative analysis demonstrates that interactive apps can raise learning standards in pupils with SEND but may have limited utility for pupils with severe difficulties. Software modifications are needed to address specific areas of difficulty preventing pupils from progressing.

Project description:We aimed to determine whether results of our prior randomized control trial [RCT; NCT02301195, (1)] of Therapeutic Horseback Riding (THR) for children and adolescents with autism spectrum disorder (ASD) could be replicated at a different riding center and if treatment effects also included differences in the expression of associations between problem behavior and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants with ASD (N = 16) ages 6-16 years were randomized by nonverbal intelligence quotient to either a 10-week THR group (n = 8) or no horse interaction barn activity (BA) control group (n = 8). Outcome measures were a standard speech-language sample and caregiver-report of aberrant and social behaviors. Participants' saliva was sampled weekly at a consistent afternoon time immediately pre- and 20 min' post-condition (later assayed for cortisol). Intent-to-treat analysis revealed that compared to controls, THR participants had significant improvements in hyperactivity, and social awareness, and significant improvements at the 0.1 significance level in irritability and social communication behaviors. There were no significant improvements in number of words or new words spoken during the standard language sample. Linear mixed effects model analysis indicated that greater weekly pre-lesson irritability levels were associated with smaller post-lesson reduction in salivary cortisol levels, and greater weekly pre-lesson hyperactivity levels were associated with smaller cortisol reduction in the THR group, but not in the BA control group. The findings represent a partial replication of prior results (1), extend prior observations to include THR effects on biobehavioral relationships and suggest that cortisol could be a target mediator for THR effects on irritability and hyperactivity behaviors in youth with ASD. Clinical Trial Registration: Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov, identifier: NCT02301195.

Project description:This paper presents 6-month follow-up data of 44% (N = 64/116) of participants (ages 6-16 years) with a diagnosis of autism spectrum disorder, who participated in a previously-published randomized controlled trial of therapeutic horseback riding (THR) compared to a no-horse contact active control. The objective of this study was to examine whether significant improvements of irritability, hyperactivity, social, and communication behaviors observed in participants randomized to receive a 10-week manual-based THR intervention were sustained 6 months after the intervention conclusion. Participants' caregivers from both the THR (n = 36) and active control (n = 28) groups completed a measure of irritability and hyperactivity behaviors (primary outcome variables). Additionally, only the THR group participants completed the full battery of study outcomes assessments. Between group comparisons examining the extended interval from baseline (1-month pre-intervention assessment) to 6-months after the intervention revealed that the THR group maintained reductions in irritability behavior at a 0.1 level (effect size = 0.32, p = 0.07). (Effect size = 0.32, p = 0.07), which was 73% of efficacy preserved from the primary post-intervention endpoint (within 1-month post-intervention). Hyperactivity behaviors did not sustain this same trend. Comparisons from baseline and 6-months after the intervention revealed that the THR group sustained significant initial improvements made in social and communication behaviors, along with number of words and different words spoken during a standard language sample. This is the first known study to examine and demonstrate the longer-term effects of THR for individuals with ASD and warrants a more thorough evaluation of whether the effects of THR are maintained for at least 6-months after the intervention compared to a control.Clinical trial registration informationTrial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195.

Dataset Information

Parental Perception of Changes in Basic Life Needs of Children with Disabilities after Six Months of Therapeutic Horseback Riding: A Qualitative Study.

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Parental Perception of Changes in Basic Life Needs of Children with Disabilities after Six Months of Therapeutic Horseback Riding: A Qualitative Study.

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