Gelişimsel Koordinasyon Bozukluğu Olan Bir Olguda Hippoterapinin Duygusal Regülasyon ve Sosyal Beceriler Üzerine Etkisi

Yıl 2025, Cilt: 3 Sayı: 2, 46 - 60, 31.08.2025

İbrahim Erarslan , Elif Özçelik , Fatmanur Ata , Devrim Tarakcı

Öz

Çalışmada Gelişimsel Koordinasyon Bozukluğu olan 10 yaşındaki bir olguyla gerçekleştirilen ergoterapi destekli hippoterapinin, duygusal regülasyon ve sosyal beceriler üzerine olan etkisini incelemek amaçlanmıştır.
Çalışma Ocak 2024-Mart 2024 tarihleri arasında İstanbul ilinde yer alan bir at çiftliğinde gerçekleştirildi. Gelişimsel Koordinasyon Bozukluğu (GKB) olan olguya, 40 dakika olacak şekilde 10 seans hippoterapi seansı verildi. Olgudaki mevcut koordinasyon bozukluğunu ve motor performansı değerlendirebilmek için Gelişimsel Koordinasyon Bozukluğu Anketi, duygusal regülasyonu değerlendirebilmek için Çocuklar için Duygu Düzenleme Ölçeği (ÇDDÖ) ve sosyal becerilerini değerlendirebilmek için Sosyal Becerileri Değerlendirme Ölçeği (SBDÖ/7-12) kullanıldı. Testler 10 seanslık müdahalenin öncesinde ve sonrasında olmak üzere 2 kez uygulandı. Elde edilen veriler kaydedilerek karşılaştırmalar gerçekleştirildi.
Değerlendirme sonuçlarına göre, olgunun Gelişimsel Koordinasyon Bozukluğu Anketinden hippoterapi öncesinde aldığı puan 29 iken hippoterapi sonrasında 41’e yükseldi. ÇDDÖ’de ise 64 puandan 83 puana yükselerek olgunun duygusal regülasyonunu daha etkili gerçekleştirdiği gözlemlendi. SBDÖ/7-12 sonuçlarına bakıldığında ise müdahale öncesinde 150 olan ortalama değer, 10 seans sonunda 176’ya yükseldi. Testin konuşma ve yönerge parametresi haricindeki tüm parametrelerinde anlamlı farklara rastlanıldı.
Çalışmanın sonunda ergoterapi destekli hippoterapi seanslarında olgunun denge koordinasyonunu daha etkili gerçekleştirebildiği, at üzerinde kurulan birliktelikle duygusal regülasyonunun arttığı ve sosyal becerilerinin geliştiği gözlemlenmiştir. Yapılan çalışmalarda GKB tanılı bireylerde hippoterapi alanında ergoterapi müdahale çalışmalarının sınırlı sayıda olduğu sonucuna ulaşılmıştır. Bu çalışmanın literatüre katkı sağlamasıyla tanıya yönelik farklı çalışmaların da gerçekleştirilebileceği konusunda yol gösterici olabileceği düşünülmektedir.

Anahtar Kelimeler

Bağımsızlık , denge , ergoterapi , hippoterapi , regülasyon.

The Effect of Hippotherapy on Emotional Regulation and Social Skills in a Case with Developmental Coordination Disorder

Öz

The aim of this study was to examine the effects of occupational therapy-supported hippotherapy on emotional regulation and social skills in a 10-year-old patient with Developmental Coordination Disorder.
The study was conducted at a horse farm in Istanbul between January 2024 and March 2024. A patient with Developmental Coordination Disorder (DCD) was given 10 hippotherapy sessions of 40 minutes each. The Developmental Coordination Disorder Questionnaire was used to evaluate the current coordination disorder and motor performance of the patient, the Children's Emotion Regulation Scale (CRDQ) was used to evaluate emotional regulation, and the Social Skills Assessment Scale (SSAS/7-12) was used to evaluate social skills. The tests were applied twice, before and after the 10-session intervention. The obtained data were recorded and comparisons were made.
According to the evaluation results, the patient's score on the Developmental Coordination Disorder Questionnaire before hippotherapy increased from 29 to 41 after hippotherapy. It was observed that the patient's emotional regulation was more effective by increasing from 64 to 83 points on the CDRS. When the SSBS/7-12 results were examined, the average value, which was 150 before the intervention, increased to 176 after 10 sessions. Significant differences were found in all parameters of the test except the speech and instructions parameter.
At the end of the study, it was observed that the patient was able to perform balance coordination more effectively in hippotherapy sessions supported by occupational therapy, his emotional regulation increased with the togetherness established on the horse and his social skills improved. In the studies conducted, it was concluded that occupational therapy intervention studies in the field of hippotherapy in individuals diagnosed with DCD were limited. It is thought that this study will contribute to the literature and will be a guide for different studies to be carried out regarding the diagnosis.

Anahtar Kelimeler

Balance , hippotherapy , independence , occupational therapy , regulation.

Kaynakça

• 1. Fogel, Y., Stuart, N., Joyce, T., & Barnett, A. L. (2023). Relationships between motor skills and executive functions in developmental coordination disorder (DCD): A systematic review. Scandinavian Journal of Occupational Therapy, 30(3), 344-356. https://doi.org/10.1080/11038128.2021.2019306
• 2. American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™(5th ed.). American Psychiatric Publishing, Inc.. https://doi.org/10.1176/appi.books.9780890425596
• 3. Cantell, M. H., Smyth, M. M., & Ahonen, T. P. (2003). Two distinct pathways for developmental coordination disorder: Persistence and resolution. Human Movement Science, 22(4-5), 413-431. https://doi.org/10.1016/j.humov.2003.09.002
• 4. Tseng, M. H., Howe, T. H., Chuang, I. C., & Hsieh, C. L. (2007). Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder. International Journal of Rehabilitation Research, 30(4), 327-332. DOI: 10.1097/MRR.0b013e3282f144c7
• 5. Biotteau, M., Danna, J., Baudou, É., Puyjarinet, F., Velay, J. L., Albaret, J. M., & Chaix, Y. (2019). Developmental coordination disorder and dysgraphia: Signs and symptoms, diagnosis, and rehabilitation. Neuropsychiatric Disease and Treatment, 1873-1885. http://doi.org/10.2147/NDT.S120514
• 6. Lingam, R., Hunt, L., Golding, J., Jongmans, M., & Emond, A. (2009). Prevalence of developmental coordination disorder using the DSM-IV at 7 years of age: A UK population– based study. Pediatrics, 123(4), e693-e700. https://doi.org/10.1542/peds.2008-1770
• 7. Barnett, A. L., Law, C., & Stuart, N. (2019). Developmental progression in DCD. In Understanding motor behaviour in developmental coordination disorder (pp. 28-51). Routledge.
• 8. Kirby, A., Edwards, L., Sugden, D., & Rosenblum, S. (2010). The development and standardization of the adult developmental co-ordination disorders/dyspraxia checklist (ADC). Research in Developmental Disabilities, 31(1), 131-139. https://doi.org/10.1016/j.ridd.2009.08.010
• 9. Hill, E. L., & Brown, D. (2013). Mood impairments in adults previously diagnosed with developmental coordination disorder. Journal of Mental Health, 22(4), 334-340. https://doi.org/10.3109/09638237.2012.745187
• 10. Saban, M. T., Ornoy, A., & Parush, S. (2014). Executive function and attention in young adults with and without Developmental Coordination Disorder–A comparative study. Research in Developmental Disabilities, 35(11), 2644-2650. https://doi.org/10.1016/j.ridd.2014.07.002
• 11. O’Dea, Á., & Connell, A. (2016). Performance difficulties, activity limitations and participation restrictions of adolescents with developmental coordination disorder (DCD). British Journal of Occupational Therapy, 79(9), 540-549. https://doi.org/10.1177/0308022616643100
• 12. Tal-Saban, M., Zarka, S., Grotto, I., Ornoy, A., & Parush, S. (2012). The functional profile of young adults with suspected developmental coordination disorder (DCD). Research in Developmental Disabilities, 33(6), 2193-2202. https://doi.org/10.1016/j.ridd.2012.06.005
• 13. Geuze, R. H., Jongmans, M. J., Schoemaker, M. M., & Smits-Engelsman, B. C. (2001). Clinical and research diagnostic criteria for developmental coordination disorder: a review and discussion. Human Movement Science, 20(1-2), 7-47. https://doi.org/10.1016/S0167- 9457(01)00027-6
• 14. Wilson, P. H., Ruddock, S., Smits‐Engelsman, B. O. U. W. I. E. N., Polatajko, H., & Blank, R. (2013). Understanding performance deficits in developmental coordination disorder: a meta‐ analysis of recent research. Developmental Medicine & Child Neurology, 55(3), 217-228. https://doi.org/10.1111/j.1469-8749.2012.04436.x
• 15. Farhat, F., Denysschen, M., Mezghani, N., Kammoun, M. M., Gharbi, A., Rebai, H., & Smits-Engelsman, B. (2024). Activities of daily living, self-efficacy and motor skill related fitness and the interrelation in children with moderate and severe Developmental Coordination Disorder. Plos One, 19(4), e0299646. https://doi.org/10.1371/journal.pone.0299646
• 16. Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285. https://doi.org/10.1371/journal.pone.0299646
• 17. Van der Linde, B. W., Van Netten, J. J., Otten, B. E., Postema, K., Geuze, R. H., & Schoemaker, M. M. (2014). Psychometric properties of the DCDDaily-Q: a new parental questionnaire on children's performance in activities of daily living. Research in Developmental Disabilities, 35(7), 1711-1719. https://doi.org/10.1016/j.ridd.2014.03.008
• 18. Yildirim, C. K., Altunalan, T., Acar, G., Elbasan, B., & Gucuyener, K. (2019). Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire in Turkish children. Perceptual and Motor Skills, 126(1), 40-49. https://doi.org/10.1177/0031512518809161
• 19. Blank, R., Smits‐Engelsman, B. O. U. W. I. E. N., Polatajko, H., & Wilson, P. (2012). European Academy for Childhood Disability (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine and Child Neurology, 54(1), 54. https://doi.org10.1111/j.1469-8749.2011.04171.x
• 20. Wilson, B. N., Kaplan, B. J., Crawford, S. G., Campbell, A., & Dewey, D. (2000). Reliability and validity of a parent questionnaire on childhood motor skills. The American Journal of Occupational Therapy, 54(5), 484-493. https://doi.org/10.5014/ajot.54.5.484
• 21. Harmancı, S. T., & Aytar, A. G. (2023). Çocuklar için duygu düzenleme ölçeği çocuk formu (ÇDDÖ) ve yetişkin formunun (ÇDDÖ-YF) Türkçeye uyarlanması. Milli Eğitim Dergisi, 52(237), 71-106. https://doi.org/10.37669/milliegitim.1056054
• 22. Rydell, A. M., Thorell, L. B., & Bohlin, G. (2007). Emotion regulation in relation to social functioning: An investigation of child self-reports. European Journal of Developmental Psychology, 4(3), 293-313. https://doi.org/10.1080/17405620600783526
• 23. Rydell, A. M., Berlin, L., & Bohlin, G. (2003). Emotionality, emotion regulation, and adaptation among 5-to 8-year-old children. Emotion, 3(1), 30. https://doi.org/10.1037/1528-3542.3.1.30
• 24. Ataş, A. T., Efeçınar, H. İ., & Tatar, A. (2016). Sosyal Beceri Değerlendirme Ölçeği'nin geliştirilmesi ve psikometrik özelliklerinin incelenmesi. Turkish Psychological Counseling and Guidance Journal, 6(46), 71-85.
• 25. Akçamete, G., & AVCIOĞLU, H. (2005). Sosyal becerileri değerlendirme ölçeğinin (7-12 yaş) geçerlik ve güvenirlik çalışması. Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi, 5(2).
• 26. Koç, P., Altınkaya, N., & İnanç, G. (2023). Hippoterapinin Terapatik Yararları: Ergoterapi Bakış Açısı. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 12(1), 324-333. https://doi.org/10.37989/gumussagbil.931263
• 27. Meregillano, G. (2014). Hippotherapy. Physical Medicine and Rehabilitation Clinics of North America, 15 (4), 843- 854.
• 28. Gámez-Calvo, L., Gamonales, J. M., Léon, K., & Muñoz-Jiménez, J. (2021). Therapeutic effects of hippotherapy in the elderly: a review of the literature. Camp d, 198, 19. doi: 10.18176/archmeddeporte.00044
• 29. Demir, O. B., Yılmaz, F. T., Kablanoğlu, S., Balıkçı, E., & Dursun, E. (2024). Effects of hippotherapy on upper extremity functions in children with cerebral palsy. Cukurova Medical Journal, 49(1), 12-20. https://doi.org/10.17826/cumj.1385152
• 30. Yucel Sen AD, Carman KB, Yarar C, Yildirim C, Bilge U, Evaluation of the Effect of Hippotherapy on Balance and Motor Function in Children with Cerebral Palsy, Osmangazi Journal of Medicine, 2023;45(1):58-63 Doi: 10.20515/otd.1166252
• 31. Yeniceli, Z., & Abaoğlu, H. (2024). Pediatrik Ergoterapi Uygulamalarında Bir Literatür İncelemesi. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi, 7(3), 33-52. https://doi.org/10.51536/tusbad.1442110
• 32. Bruzek CE. (2014). Socioemotional Benefits of Animal-Assisted Occupational Therapy with Children: A Review of the Literature and Directions for Future Research.
• 33. Martin R, Graham F, Taylor W, Levack W. (2018). Mechanisms of change for children participating in therapeutic horse riding: A grounded theory. Physical & Occupational Therapy in Pediatrics, 38(5):510-26. https://doi.org/10.1080/01942638.2017.1400492