Friday, April 24, 2015

Interview with Ruth Dismuke-Blakely, MS/CCC-SLP, HPCS

A few days ago I challenged my dear Ruth Dismuke-Blakely to be interviewed. She answered to my questions and here they are!

Ruth Dismuke-Blakely, MS/CCC-SLP, HPCS is an internationally known Speech Language Pathologist and the first person formally known working with horses and SLP together. She is also the author of the very first researches that boosted these fields. Ruth owns Skyline Therapy since 1980 - a therapeutic business which runs Speech Therapy, Occupational Therapy and Physical Therapy with the help of the horse.
I was there and I tell you it is a very busy clinic - its major therapy room is nothing but a big arena where everything happens!

Pedro - You are Speech Language Pathologist (SLP) since 1980. Why did you choose this profession?
Ruth - I received my Masters of Science in Speech-Language Pathology in December, 1980.  At the age of 15 years, I volunteered at a state residential school for the developmentally disabled and had some very wonderful experiences there that made me know I wanted to become a speech-language pathologist.  I never wavered from that goal.

You were the first SLP using horses as a therapy strategy. How did it began?
I grew up in a professional horse family.  We bred, raised and trained American Quarter Horses.  In addition, I had given riding instruction to children and young adults beginning when I was 16 years old.  I really believed in what horses can do for people.  When I was in graduate school at the University of New Mexico I put together a treatment plan for a little boy with hearing impairment that centered on using equine movement and the naturalistic context of the riding setting to address his speech and language deficits.  My clinical supervisor from the university would meet me with the family and the little boy at our local fairgrounds.  I would bring two of our lesson horses and my mother to help me as horse support.  I knew nothing of therapeutic riding or hippotherapy but we fashioned a very productive treatment plan for this little boy.  Based on that work, I was awarded two research grants – one for $8000 US for a pilot study and one for $80,000 US for a more comprehensive follow up study.  The results of both significantly supported the use of the horse as a treatment tool in speech and language therapy.
Following that research our local school district approached me to “contract” my services using the horse in treatment.  We incorporated what is now Skyline Therapy Services on September 21, 1982 and immediately had 52 clients to see with a range of diagnoses from the Albuquerque Public Schools Special Education program.  Soon after, our local rehabilitation hospital began referring adults with traumatic brain injuries.  Very quickly we were offering speech-language therapy, occupational therapy and physical therapy to children and adults with a range of special needs.

What kind of patients are most referred to Skyline Therapy?
Over the past 33 years we have treated children and adults with all manner of diagnosis including traumatic brain injury, stroke, neuromuscular deficits like cerebral palsy, apraxia, autism spectrum disorders, sensory processing deficits, a broad range of genetic disorders like Down syndrome and Rhett syndrome, specific language impairment, phonological processing deficits, attention deficit disorder, auditory processing disorder, and some spinal cord injury.  We have also seen individuals with hearing impairment and visual impairment.

Regarding Speech Therapy goals, what are the main benefits the horse brings?
First and foremost, equine movement can facilitate all of the neurophysiology that support speech production and language use.  In order for an individual to “talk” efficiently, they must have good core postural control, good sensory processing/modulation, good respiratory support for speech sound production, motor control and coordination/timing.  The multi-dimensional dynamic movement provided by a well-trained well managed therapy horse can be used to positively impact all of these systems.  The speech-language pathologist is then able to incorporate very standard speech/language therapy techniques with the movement of the horse to promote very strong gains in communication for the client.  The setting itself is rich in pragmatic loading so there are always ample opportunities for “talking” in naturalistic and meaningful environment.   We see excellent carryover into the client’s daily living as well.

After some years you still need to have an educative role about this field in the society and even with other health professionals. How do you do it?
I love to share my knowledge and experiences in using hippotherapy as a treatment strategy within my speech and language therapy services.  I have an outstanding team of therapists and horse professionals that work for me here at Skyline Therapy.  This makes it possible for me to travel and teach other health professionals about the value of equine movement as a treatment strategy in not only speech-language therapy but in occupational therapy and physical therapy as well.

During our career some patients are unforgettable. Can you highlight one special moment or patient from Skyline Therapy?
In 33 years of practicing, there have been so many wonderful “moments’.  So many patients have said their first words or taken their first steps here at Skyline.  One of my favorite stories involves a little boy who had very severe motor speech apraxia and was only able to produce a mid-vowel sound /uh/.  We began using the horse’s movement to impact his neurological system and within a five sessions he was able to produce more speech sounds.  At roughly the 7th session, we increased the amount of movement he was receiving dramatically.  It was a Thursday afternoon.  I was worried that we had possibly overwhelmed his system as he was pretty tired and grumpy afterwards.  On Saturday, his mother called me and was overcome with emotion.  This little boy had independently produced 10 intelligible words that day – literally began talking after that.  I have always believed that the horse’s movement “jump started” his neuromotor system and allowed him to overcome his motor speech apraxia to a large degree.

Hippotherapy is not a “miracle cure” but for many individuals with special needs, it has shown itself to be a powerful addition to their therapy plans – generating some very profound improvements to speech and language use.

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