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PFA Tips: Hippotherapy

Written by Chelsea Whitaker, OTR/LFounder & COO, Taking The Lead, Inc.

Download a printable version of “Hippotherapy”


Hippotherapy has been shown to be an effective therapy for individuals with autism to help improve social skills, sensory integration, awareness of where their bodies are in relation to their environment, muscle strength, motor coordination, concentration, communication, self-confidence and more. So what is this therapy using horses?

What is Hippotherapy?
Hippotherapy is a treatment strategy used by licensed OTs, physical or speech therapists to help clients achieve therapy goals. The term hippotherapy is derived from the Greek word ‘hippos’ which translates to horse. Hippotherapy can be facilitated by a licensed occupational, physical, or speech therapist who has additional training. Experiencing the movement of the horse while participating in therapy treatments unlocks something physically and emotionally that erases boundaries.

What is the difference between Hippotherapy and Therapeutic Riding?
Hippotherapy is different from therapeutic riding because the participants’ therapy goals are addressed with a licensed occupational, speech, or physical therapist. Therapeutic Riding is typically carried out by a riding instructor who receives additional training to become certified to instruct people with disabilities how to safely move, steer, and balance on the horse. All of the goals are for riding the horse and for recreational purposes only.

Who Does Hippotherapy Benefit?
Hippotherapy is beneficial to children or adults who have various types of disabilities including ADHD, Anxiety, Autism, Down Syndrome, Cerebral Palsy, MS, etc. Hippotherapy is extremely successful for individuals with sensory needs and those who do not know where their body is in space because the movement of the horse motivates individuals to self regulate and participate in fun, successful, and functional therapy sessions.

Who Would Not Be Appropriate for Hippotherapy?
Many hippotherapy facilities require a signature from a physician indicating that the participant is medically cleared to participate. Talk to your doctor if you have any medical concerns. Individuals who have a shunt are not appropriate for therapy and there is typically a weight limit for participants to engage in mounted hippotherapy sessions. Weight limits vary depending on the horses’ size and abilities at each facility. Individuals who are very fearful or allergic to horses are not suitable for hippotherapy.

How does the rider stay safe?
During hippotherapy, the client works with a licensed occupational, physical, or speech therapist who leads the therapy sessions and identifies relevant and individualized therapy goals leading to independence and success at home, school, or in the workplace. In addition to the therapist, the client is supported by 1-2 assistants who walk along the horse and are trained in various holds to keep the participant secure on the horse while they are riding. As the participant becomes more balanced and safe, he or she can participate in hippotherapy as independently as possible.

What Therapy Goals Can Be Achieved?
Occupational, speech, and physical therapy goals can be achieved while participating in hippotherapy, but instead of being in a clinic, the participant is riding a horse! Goals may include clearly articulating commands to the horse and the therapy team, improving core strength, improving balance and endurance to facilitate functional walking and mobility goals, following multi-step directions and focus, self regulating emotions and actions while riding the horse, etc. Hippotherapy can help those who have difficulty engaging in other therapy sessions. The horse’s movement can be used as a motivation tool to engage the clients to be more verbal than usual, to learn focus and to teach things like cause and effect and sequencing. The participant’s body and mind are engaged throughout the session and confidence is naturally built as the participant’s therapy goals and ability to stay balanced on the horse are mastered.

Is Hippotherapy Covered By Insurance?
Insurance coverage depends on the facility. Since hippotherapy is carried out by a licensed therapy practitioner, some facilities accept insurance. Other facilities have their therapist write a receipt which can be used to petition your insurance company for reimbursement. Other hippotherapy facilities only accept private pay.

What should you look for in a facility?
When seeking out hippotherapy facilities, ensure that the therapist is licensed to practice occupational, speech, or physical therapy and has additional certifications from the Professional Association of Therapeutic Horsemanship (PATH) or the American Hippotherapy Association (AHA). The facility where hippotherapy is conducted should be safe and the horses and staff should undergo additional training to be as safe as possible. The focus should always be on the participants’ safety and therapy goals. The participant should be comfortable with the therapist and the horse so that success is unlimited.

Additional Resources

PFA Zoomcast Interview by Rob Long: Chelsea Whitaker, OTR/L – Chelsea Whitaker, OTR/L Founder & COO, Taking The Lead, Inc. discusses the basics and benefits of hippotherapy.

Professional Association of Therapeutic Horsemanship (PATH)

American Hippotherapy Association (AHA)

Pathfinders for Autism online provider database
Choose the category Therapy > Hippotherapy

Pathfinders for Autism does not endorse any treatments, therapies or products. 

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