Adaptations and Teaching Techniques for Riders with Severe Disabilities, Part 3: Cognitive Challenges

Adaptations and Teaching Techniques for Riders with Severe Disabilities, Part 3: Cognitive Challenges

As an instructor the first thing you should address is the physical postural challenges of a rider, because only when they are in good posture can they correctly apply the aids. However, posture is impacted by both the rider’s physical condition as well as their mental condition. We see this in how a nervous rider gets stiff and loses their soft relaxed posture, or in how when a rider doesn’t understand what you are asking them to do they cannot perform it.  In the last part we talked about physical challenges, in this part I will share notes on cognitive challenges and suggestions for support.

Covered on this page:

General Teaching Techniques for All Cognitive Challenges

  • When you have a class full of riders with very different abilities, teach to the highest ability and modify to the lowest. Don’t assume they all don’t understand. This means explain all the aids to everyone, but modify them for each rider. This means give the minimally disabled rider the independence and challenge they need to be successful, and the most severely disabled rider the support they need to be successful. For example, when teaching the aids for walk on, you explain the aids to everyone (weight, voice, legs), and have rider one do all the aids, adapts for rider two who doesn’t speak to sign the voice aids and perform leg aids, and adapt for rider three who cannot speak or use their legs to look up which causes a weight shift while volunteers help with the leg aids in order to help make the cognitive connection with what the aid does and create muscle memory for them to possibly learn to do it on their own,
  • Have perspective that there is always potential for learning and growth with the right communication and strategies and support. Such as the support given to rider three in the above example.
  • Focus on their abilities, not their disabilities.
  • Make information clear.
  • Make sure they understand (ask clarifying questions, for them to repeat it back to you, etc.)
  • Maintain their dignity – don’t talk down.
  • Give opportunities for decision making.
  • Provide appropriate feedback that they can understand and respond to – if they’re not responding, adjust.
  • Provide structure.
  • Provide clear behavioral expectations.
  • Use simple 1-2 step directions, then proceed to more as they are ready.
  • Provide modeling.
  • Use prompts and cues.
  • Give time to process. (Count to 5 or 10 in your head).
  • Use pictorial cues or systems.
  • Encourage exploration. The horse is a large, gentle, rhythmic, predictable being – invite the rider to explore, and assist them.
  • Look at them when you speak (so they know you are talking to them).
  • Figure out their motivation. Do they like their horse walking but don’t like exercises? Then do exercises at the halt and walk on for reward.
  • Cater to learning style (Auditory, Kinesthetic, Visual)
  • Use a consistent hierarchy of prompts. Get the whole team on board so they can facilitate instead of depending on you.
    • 1) Wait = get to gate but it’s closed, wait and see what they do
    • 2) Ask = “What should we do?”
    • 3) Verbal prompt = “Open _____”
    • 4) Add gesture = “Open _____” + gesture
    • 5) Add hint = “Open _____” + gesture + “ga___”
    • 6) Add modeling = “Open gate” + gesture
    • 7) Provide as much hands on learning as possible
  • Use Multi-sensory teaching techniques
    • Demonstrations
    • Touch
    • Gesture
    • Verbal
    • Hand over hand guidance
  • Chaining
    • = teach behavior by building up a series of related behaviors, each is a cue for the next, the last reinforces
    • Forward Chaining = Begins with first, progresses to last. Once he can perform the first well, do the first and second and reinforce, taught together (A and B) not separately (A then B). When these are mastered add C.
    • Backward Chaining = Teach backwards, effective for complex sequences. Example: You put the puzzle together and let him do the last piece. Then you put it together and let him do the last 2 pieces. And so on. Once they learn the last step, reinforce it. Once they learn the last 2 steps, only reinforce them when done together.
    • To use chaining, 1) Define the target behaviors, 2) Identify the steps – small and manageable, 3) Reinforce successive elements of the chain, 4) Monitor results – determine when to move on or practice more. Use your task analysis!
  • Shaping
    • = reinforce successive approximations toward a target behavior to slowly shape it.
    • Reinforce behavior that is closer to the target than the last one.
    • If the same behavior is repeated several times, withhold reinforcement to encourage a new closer approximation.
    • If a new approximation does not occur, or a child regresses, you may need to reinforce the old behavior and start again.
    • If they’re stuck, withholding reinforcement often induces different behaviors, one of which will be an approximation for you to reinforce.
    • Ex) One rider touches the horse’s neck for walk on. At first we reinforce by having the horse walking on if she reaches forward a little. I start asking her to stretch farther forward to actually touch the horse’s neck. Once she does this, the horse will only walk on if she reaches forward all the way. If she gets confused, we go back to just reaching forward a little.

Cognitive Challenges, Adaptations & Activities

Delayed Processing & Poor motor planning

  • Directions should be brief & clear.
    • Use less words.
    • Make statements or short commands. Questions can be harder to understand.
    • Rephrase it. Think up new simple ways to ask them to do things. Ex) instead of “airplane arms” say “arms out”
    • Use pictures. Make signs with pictures to choose from. Ex) trot or rings – they pick which one they want to do
    • Give explicit and systematic instruction, step by step, with ongoing prompting, feedback and support. Use the same wording every time. Plan out the method with your sidewalkers before the lesson so everyone can work together.
  • Give them time to process by waiting for a response.
    • Wait! Wait till the count of 5 in your head. Give them time to understand, formulate a response, and motor plan.
    • Wait quietly. Speaking to them can compete with their thought and motor planning process.
    • Make sure the whole team knows to wait so volunteers don’t jump in to help too soon. Ask the sidewalkers to wait 5-10 seconds before prompting. Then give another verbal prompt, count to 5 or 10. Then a visual or physical prompt, etc.
    • If they look away they may be thinking about it, not just ignoring you. How often do you look off into the distance when you’re thinking about something?
  • Give them choices. Ex) Instead of asking “What do you want to do?” give them 2 choices.
  • Repetition
  • Task analysis
  • Ask questions to ensure understanding
  • Prepare rider – “prepare to walk/halt/etc.”
  • Don’t over repeat yourself, this may lead to overload
  • Visual cues
    • Use reference points in the ring – Dressage letters, Put up colors, shapes, posters to direct gaze
    • Colors/clips on horse’s mane for stretching
    • Colors on reins to hold
    • Find out their favorite color and use it as motivation
    • Put a marker on a target to get to (walk to a point on the lift)
    • Put a marker on the reins for where to hold every time
    • Put a marker on the mane for stretches
    • Put a marker near the ears to look at
    • 20141016_155630 (example of tape in the horse’s mane to look at)
    • 20141016_155638 (example of markers on the reins to hold)
  • If delayed righting response:
    • Use a steady horse
    • Do gradual transitions
    • Prepare the rider for transitions
    • Prepare the team for when to help

Impaired balance/Decrease body awareness

  • Progress slowly
  • Use task analysis
  • Teach self-correction
    • Practice feeling weight even on both seat bones
    • Practice lengthening legs
    • Practice looking forward
    • Practice moving from off center to center
      • Ex) One young rider had trouble maintaining midline and understanding what “don’t lean, stay in the middle” meant, so every warm up I began having him pass rings back and forth having to stretch really far, while saying “leeeeean for the ring! And back to the middle!” making sure he had to pause in each position. Within a few weeks he understood what “stay in the middle” meant and had improved core strength enough to respond to such prompts when he started to lean.

Short attention span/Limited Focus

  • Keep active engagement
  • Minimize distractions – stay close, use private lessons, or if a group keep them close to you using half the arena
  • Use eye contact – have their attention and eye contact before talking
  • Use hands on learning opportunities
  • Change activities often
  • Ask questions
  • Initially don’t make them wait much – gradually add planned waiting to teach patience
  • Keep class moving – don’t stand much
  • Increase proprioceptive input
    • Choppy horse
    • Faster gaits
    • Frequent gait changes
    • Frequent direction changes
  • Vary tone of voice
  • Multi sensory teaching methods to all learning styles
  • Simple 1 step instructions
  • Break tasks into small unites, do 1 at a time
  • Start easy, then add more
    • Ex) to walk on, first hold reins. Later add sit tall.
    • Ex) for exercises, halt, do one exercise, then walk on; later add two exercises, then three, etc.

Impaired memory

  • Repetition and consistency
  • Use same setup several weeks in a row, then change or add 1 thing
  • Use Visual cues – cards, diagrams, maps, latter, demo riders, dry erase board
  • Use music, rhymes, songs for recall
  • Use movement and input to aid memory
  • Use Clear, simple instructions – ask to repeat to increase memory skills
  • Send home vocab list of horse terms, with pictures – or any learning material

Decreased problem solving

  • Keep activities appropriate
  • Use task analysis to determine at what point they are having problems and need additional help
  • Encourage problem solving in steps
  • Give them options to choose from
  • Use obstacle courses and fun activities
  • Allow safe mistakes and talk them through learning from them
  • May mostly think in cause and effect, so:
    • Find their motivation
    • One thing at a time
    • Use “First…then…”

Difficulty sequencing

  • Use visual cue cards
  • Use routine
  • Give time
  • Task analysis
  • Use one step instructions, progress to multiple step instructions

Communication Challenges (Nonverbal, Limited Language, Impaired Speech)

  • Remember: as a TR Instructor your goal is communication so they can learn riding skills, not speech therapy.
  • See my post “Communication Techniques for Low/Nonverbal Riders”
  • My post “Speech Disabilities in Therapeutic Riding”
  • Use the horse’s movement to promote speech
    • The horse’s movement helps Breathing, Circulation, Rhythm, and Organization
    • Allow first part of lesson to focus on equine movement input, while monitoring their speech production and articulation
    • Combine horse’s rhythm with timing of speech tasks
  • Adapt your communication with them
    • Listen with interest – don’t finish sentences
    • Be aware of subtle communication, body language, etc.
    • Plan for talk time in your planning, since it make take longer than usual
    • If you don’t understand them:
      • Be honest and patient
      • Repeat back what you did get and ask for more “You said something about walking…”
      • If you don’t get it after 3 times, move on, so no one gets frustrated
    • Use less words
      • Shorter sentences are easier to understand and imitate.
      • Target core words to focus on. “Open gate” or “Feed horse carrots”
      • Ask questions that allow simple one word answers
    • Use music – may prompt singing
    • Wait (see above delayed processing)
    • Visual aids
      • Charts
      • Images
      • Visual schedules – can take Velcro images off when accomplished
      • Choice board – put pictures on board for them to choose from
      • Social stories
      • Anything else that helps communication!
      • For examples of the above see these resources from “Dynamic Collaboration: Maximizing Communication During Therapeutic Riding,” by Karyn Lewis Searcy, M.A. CCC-slp and Director of Crimson Center for Speech & Language, and Kaitlyn Siewert of R.E.I.N.S. Therapeutic Horsemanship Program, given at the PATH Intl. 2014 Conference:
    • Adapt their communication with you
      • Offer alternate communication methods
      • Provide writing tools
      • Sign Language
      • Draw
      • Cue Cards, Icons
      • Select picture or photo
      • Point to picture symbols
      • Gestures
        • Always back up verbal instruction with visual cue/gesture – something they can imitate
        • Use Gestures for words the rider can imitate to later use on their own
        • Synchronize syllables with gestures (match the number of syllables to the number of gestures used) – this can help them organize motor planning and imitation. Ex) “open” = “o” hands together + “pen” hands apart
        • If the rider does not respond in 5 seconds, use hand over hand to help them imitate the gesture.
      • Augmentative communication device
        • Use iPads – communication apps such as touch chat, proloquogo – Add a horse page for things they learn at the barn. Use these pages during lessons, and encourage family/teachers/therapists to utilize them at home and school.
      • Environment
        • Encourage communication in the environment.
        • Create communicative temptations, such as setting up the ring with something they want (a ball) then encourage their communication to ask to play with it.
        • The silent stop or turn (click here for more on that)
        • Do activities that engage the rider and encourage spontaneous communication, instead of just demanding they verbalize certain words.
      • Other
        • Have parent/caregiver present to identify pain, discomfort, frustration, needing to go to the bathroom
        • Don’t speak for them
        • Don’t dominate the conversation
        • Don’t talk about them in front of them
        • Don’t always correct

Coming up next: Adaptations and Teaching Techniques for Riders with Severe Disabilities, Part 4: Skills & Activities

See the last page for a full list of sources

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Note: This is not professional advice, this is a blog. I am not liable for what you do with or how you use this information. The activities explained in this blog may not be fit for every rider, riding instructor, or riding center depending on their current condition and resources. Use your best personal judgement!

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One thought on “Adaptations and Teaching Techniques for Riders with Severe Disabilities, Part 3: Cognitive Challenges

  1. Thanks, for the concise info on teaching special needs-cognitive challenged riders. Going into my notebook for teaching riding.

    Becke Williams PATH Instructor in Training

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