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Step 1: 

To begin the registration process, please submit the Participant Application. Once these forms are received, we will reach out to schedule an evaluation ride. Please make sure to read our Frequently Asked Questions below to learn about our polices, costs, and what to expect in our program.

Step 2: 

Once the necessary forms are received, the Great and Small Program Director will reach out to schedule an evaluation. 

Forms & Manuals (needs updating for OT)

How to Participate:
Occupational Therapy Patient Application Process


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How to Participate

Why Occupational Therapy using Horses as Treatment Strategy?

Therapeutic Riding vs Occupational Therapy Services 

At Great and Small we offer both Therapeutic Riding and Occupational Therapy services. While the services may sound similar they are actually completely different services. 

Occupational therapy services are offered for children and adults ages 2 and up. Occupational therapists help children and adults to improve in deficit areas including: fine motor control, gross motor control, strength, balance, visual-motor skills, social-emotional skills and cognitive skills. Based on a patient/their family’s goals occupational therapists create individualized treatment plan. Occupational therapists utilize evidence-based treatment approaches to address deficit areas that impact participation in meaningful and functional activities. 

Diagnoses commonly treated included: Autism Spectrum Disorder, Sensory Processing Disorders, Neurological Disorders, Genetic Disorders, ADD/ADHD, Vision Related Disorders, Psychological Disorders, Chronic Pain and more. 

A variety of treatment tools/techniques are utilized to improve functional outcomes including: neuromuscular re-education techniques, visual-motor integration techniques, sensory integration techniques, patient/caregiver education, therapeutic exercises, techniques to improve cognitive functioning, utilizing equine movement as a treatment tool and more. 

Occupational Therapy utilizing equine movement as a treatment tool may be appropriate for a wide variety of diagnoses and ages (beginning at age 2). Sessions are typically 1 time a week, 1 hour long. Sessions will consist of both equine movement and traditional outpatient therapy techniques. The amount of time utilizing equine movement is under the discretion of the therapist leading the session based on the client's sensory/motor needs.

For more information on utilizing equine movement as a treatment tool: 

Hippotherapy is an evidence based  treatment tool utilized by Occupational Therapists, Physical Therapists and Speech Language Pathologists. This unique tool emphasizes utilizing equine movement to engage sensory, neuromotor, and cognitive systems. 

Hippotherapy is utilized in combination with other treatment tools and strategies in the patients plan of care. 

Many systems are influenced with the use of equine movement as a treatment tool. Some of these systems include: motor, musculoskeletal, nervous/limbic, respiratory, circulatory, sensory processing, cognition, and speech and language. 


Frequently Asked Questions about Occupational Therapy at Great and Small

How much does Occupational Therapy cost and how is it structured?

Therapy sessions are structured in 8 or 14 week lesson blocks ($150 per lesson). First evaluation sessions, which includes intake and evaluation, are $175.


Sessions blocks must be paid for in advance of the session unless other arrangements have been made with the Program Director.

What is your payment and cancellation policy for Occupational Therapy? 
Beginning the Spring Session of 2023, patients enrolling in Occupational Therapy incorporating Hippotherapy will be provided a credit for a maximum of ONE therapy visit per 8 week enrolled session or TWO per 14 week enrolled session, only if provided a minimum of 24 hours advance notice. Patient cancellation credits must be utilized in the next session (i.e, summer session for a spring session credit) or will be forfeited. Refunds are not provided for patient-cancelled sessions and credits are not provided if cancellations are made within the 24 hour window.

In the event that Great and Small must cancel a lesson for any reason (ex: Instructor illness, weather related cancellation, or facility emergency) a credit for the following session or refund will be issued. 

What is the difference between Therapeutic Riding and Occupational Therapy utilizing horses as a treatment strategy?
Therapeutic riding is run by our certified therapeutic riding instructors and  focuses on learning how to ride your horse. Each lesson is tailored towards that specific rider’s goals and the skills necessary to work towards those goals.

Occupational therapy utilizing horses as a treatment strategy (sometimes called "hippotherapy") is run by a licensed occupational therapist.  Hippotherapy utilizes the movement of the horse to give the participant core strengthening, vestibular input, sensory input  and more. Hippotherapy focuses on the individual client’s therapy goals as opposed to learning how to ride the horse. 

Why horses?

Conducting therapy on the farm offers a unique environment that offers a variety of opportunities for patients. 

The movement of the horse offers unparalleled practice and repetition of motor skills. Equine movement offers rhythmic, repetitive and fluid practice as patient's experience repetition of the movement up to 100 times per minute. 

Patient's functional communication skills are challenged through use of communication with an equine partner/team, and appropriate behavioral strategies are tested and applied to changing context. 

Patients gain life skills through caring for/mimicking daily living tasks in the equine environment. 

 For more information on Occupational Therapy incorporating hippotherapy as a treatment strategy and our current availability please contact our Interim Program Director, Lisa Gatons.

How do I get started as a patient in Occupational Therapy?
The first step is to complete the following paperwork:

  • Participant Application (link below)

  • Physician's Consent Form (link below - must be completed by a doctor)

  • Once these forms are completed we will be in touch to schedule a tour and evaluation.

  • After the evaluation lesson is complete you will be contacted for next steps.

What is your weather policy for Occupational Therapy?
Great and Small follows Montgomery County Public Schools (MCPS) for weather-related delays and closures. A delay cancels all lessons before noon. An early release cancels all lessons after noon. A cancellation of school cancels all lessons on that day. Great and Small may cancel lessons for extreme heat or extreme cold in the winter and summer months. 

  • WINTER: If the actual temperature for Boyds, MD (20841) is forecast to be 25 degrees or less at the time of your lesson, the Occupational Therapy session will be fully unmounted.

  • SUMMER: If the actual temperature for Boyds, MD (20841) is forecast to be 95 degrees or more at the time of your lesson, the Occupational Therapy session will be fully unmounted.

Other cancellations may be made due to severe thunderstorms, tornado warnings and other local weather patterns that make it unsafe to hold therapy sessions. Great and Small reserves the right to cancel lessons based on the availability of our Occupational Therapists, volunteers, and/or horses. Further, any factor or situation considered by Great and Small staff to be a threat to the safety of students, volunteers, staff, or horses is reason for cancellation.

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