Effects of a Collaborative OT Interactive Vaulting Program on Executive Function and Participation in Children With Disabilities

PURPOSE: Children with disabilities experience emotional and behavioral challenges that adversely affect executive function such as self-awareness, judgment, decision-making, and emotional regulation. These challenges have damaging collateral effects on the development of adaptive behaviors including communication and social skills. This study explored the effects of a collaborative interactive vaulting (IV) program on executive function and social participation to address these challenges. IV is an activity in which individuals work in groups to solve problems inherent in groundwork and individually perform gymnastic-like activities on horseback. Benefits of mounted and unmounted equine activities have been documented in self-regulation, social functioning, and self-esteem, but have not explored the benefits of integrating occupational therapy into an interactive vaulting program.

DESIGN: This pilot study utilized a one group pretest-posttest design. Fifteen children, with autism spectrum disorder, developmental delay, and attention deficit/hyperactivity disorder, participated in the program. All participants were ambulatory and able to follow directions. One weekly 60-minute session was facilitated by an equine instructor and occupational therapist for 10-weeks.

METHOD: The Cognitive Orientation to daily Occupational Performance (CO-OP) model was utilized as a framework for interventions. Per the CO-OP model, measurable social skill goals were developed collaboratively between parents and children, and once established, the global strategy of Goal, Plan, Do, Check were an embedded routine of the group. Children began each session by “checking-in” (Goal stage of CO-OP) and were asked to recall their individual social skills goals and cognitive strategies to address their goals (Plan stage of CO-OP). Sessions continued with various mounted and unmounted team and skill building activities (Do stage of CO-OP). Each session concluded with children “checking-out” with a session leader (Check stage of the CO-OP). Children were asked to recall their individual goals again, this time with a guided self-appraisal (Plan stage of CO-OP). The Behavior Rating Inventory of Executive Function, 2nd ed. (BRIEF-2) assessed behavioral, cognitive, and emotional functions in children, with separate pre and post-testing for parents and IV instructor. Additionally, Social Profile was used to assess level of cooperation of group members in the areas of activity participation, social interaction, and roles assumed in a group. Resulting data was compared using paired samples t-tests.

RESULTS: Positive trends were noted in 46% of the subscales of the BRIEF-2 parent ratings but were not statistically significant. BRIEF-2 IV instructor rating changes were statistically significant in 80% of the subscale categories, including inhibit, self-monitoring, emotional shift and control, initiate, working memory, plan and organize scales. Further, significant changes in group cooperation were noted on the Social Profile in activity participation and social interactions.

CONCLUSION: The preliminary results of this study offer preliminary evidence that professional collaborations have the potential to facilitate greater change in results, promote personal and team interactions of children in IV, and can maximize the therapeutic benefits of working as a team. Although these results should be interpreted with caution because due to a lack of a control group and small sample size, this pilot study lends support to further investigation into the efficacy of integrating occupational therapy into existing equine program models.

References

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Anderson, S., & Meints, K. (2016). Brief report: The effects of equine-assisted activities on the social functioning in children and adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(10), 3344-3352. https://doi.org/10.1007/s10803-016-2869-3

Anderson, L., Wilson, J., & Carmichael, K. (2018). Implementing the cognitive orientation to daily occupational performance (CO-OP) approach in a group format with children living with motor coordination difficulties. Australian Occupational Therapy Journal, 65(4), 295–305. https://doi.org/10.1111/1440-1630.12479

Trzmiel, T., Purandare, B., Michalak, M., Zasadzka, E., & Pawlaczyk, M. (2019). Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis. Complementary Therapies in Medicine, 42, 104–112. https://doi.org/10.1016/j.ctim.2018.11.004