Thursday, February 9, 2012

Hippotherapy—Just Horsin' Around?

Guest post by Alyson who blogs at wordsofhisheart. (Make sure you check out her blog. She has a wealth of great speech resources there.)

The first time I heard about hippotherapy, I didn't take it very seriously. I envisioned children who should have been in physical therapy instead donning cowboy hats and going for a leisurely trail ride.

But when Noah turned 5 and still wasn't speaking, I remembered posts I had seen on our local Down syndrome network from parents singing the praises of hippotherapy. After doing online research and watching some amazing YouTube videos of children participating in speech, occupational, and physical therapy while riding, it became clear that these therapies were successfully coordinated into the hippotherapy session, mimicking real life experiences.

Seeing the integration peaked my interest because Noah was having a difficult time processing the information necessary for speech along with all the other skills he was acquiring. When his speech therapist confirmed a diagnosis of apraxia, I knew it was time to pursue hippotherapy.

Was it grasping at straws? Maybe. But the amazing results we’ve seen in the four weeks Noah has been participating in hippotherapy have convinced me of its value as a legitimate therapeutic modality.


The Four Week Scoop
Week 1: An adult rode on the horse with Noah. They spent a few minutes in the arena walking and then throwing balls into a basketball hoop where Noah worked on color identification. Next they rode outside on the trail where the trees were full of hanging animals—a perfect opportunity to work on vocabulary and signing. I was worried that he would be terrified; he wasn't.

Week 2: Noah rode the horse by himself. His therapist and the arena volunteers walked along either side of the horse. During this session Noah's posture had improved. Instead of the common low tone slouch, Noah was sitting straight and tall. This was an instinctual posture correction that was necessary to feel the most secure on the horse. No prompting was necessary.

Week 3: Noah couldn't get on that horse fast enough. When his time on horseback ended, Noah’s PT had him do some running, throwing, and climbing using onsite equipment.

Week 4. Noah rode that horse backward! The PT actually had him sit facing the horse's tail for part of the session. He rode in from the trail in that position, and it was evident by his posture and expression that his confidence level was very high. After the ride, he continued his running, throwing, and climbing.

The Results
The biggest change for Noah has been the area of speech. Prior to hippotherapy, he could say only a few words clearly and would attempt speech only if it was modeled for him. After only four sessions, Noah speaks about 20 words clearly and is making approximations of several more, sometimes spontaneously. Something extraordinary happens to Noah when he is up on that horse and it carries over to his daily living. The feeling of the rhythm of the horse walking seems to be helping Noah’s brain organize what it needs to make speech happen.

Hippotherapy Vs. Horseback Riding
There is a notable difference between hippotherapy and horseback riding. In hippotherapy, the horse is used as the treatment tool to achieve physical, speech, and occupational therapy goals. In horseback riding, the rider's focus is to improve on their horsemanship skills, and in the process develop companionship, responsibility, confidence, and leadership skills.

Getting Started
So, you're interested in hippotherapy for your child... now what? If your child is at least 2 years old and currently receiving early intervention services, ask his or her therapists if they offer board-certified hippotherapy or if they know of a local therapist that does. I was not even aware Noah's center offered it until I asked. You can also visit the American Hippotherapy Association to find a therapist in your area. Remember, this is not just a physical therapy option; speech and occupational therapists can also be board certified to conduct hippotherapy sessions as well.

And now for the question everyone wants answered: Will insurance pay for it? Under some policies, yes insurance will pay for it. When submitting therapy claims, the insurance company is not usually interested in what equipment is used in therapy; they just want to know who provided the service and that the therapy did take place. Unless a policy specifically excludes equine-assisted (horse) therapy, they will likely cover it. Unfortunately, Medicaid is an insurer who specifically excludes hippotherapy. The good news is that many of the hippotherapy centers offer scholarships, so don't hesitate to ask if you need one.

Happy Trails!

Your Turn
I was so excited after reading Alyson’s post that I went straight to the AHA and located a few therapists in our area. We are going to pursue hippotherapy! How about you? Has your child participated in hippotherapy? If so, were you impressed with the results? If your child hasn’t done it yet, are you interested in checking out hippotherapy?


  1. We have something like this in our area. I was told at three Vada could participate. I am glad I ran across this post because I really need to look back into it. She will be two soon but I like to have things like this organized! I am very eager to do this with and for her!!!

  2. I'm so glad I found your blog on the day I did because today I am overwhelmed with my little guy. He's 17 months old and has always been the happiest, easy-going baby ever. Lately he has been showing communication frustration. He cries more, throws actual fits(I'm talking arms whacking and legs kicking kind of fits). We have been doing sign language for 10 months now, and he still doesn't sign. I know he understands them, and he has signed for more a number of times, but that's it…and apparently he doesn't like to even sign "more" anymore. Argggg. But it's refreshing to hear a little bit about your experiences, and to know that you have faced I'm sure similar challenges for FAR LONGER than I have. Patience is hard some days!

  3. Hey Amber. Just keep up the good work. Unfortunately children with Down syndrome tantrum and whine and demand, just like neurotypical children. Some of the best advice I ever got was "Treat Noah just like your other children and have the same expectations of his behavior as you would from your others." So, of course, modify as is appropriate for his understanding, and come along side him to help him with communication, but don't ever forget you are training up a little man who will walk in this world and will need to have the same refinement and self-control as anyone else - it may just take him a little longer to get there. Children learn to communicate in sign language just like they would with speech. Your little guy will grow accustomed to it and learn it just by being around it. Do hand over hand to help him learn the signs BEFORE he starts resisting. Noah didn't really use sign language except as a novelty until he was about 3-1/2 or so. But it's been nonstop ever since. "Early Communication Skills for Children with Down Syndrome" is the best book available for getting communication going. Good luck!


  4. I was very surprised at how fast therapeutic horseback riding affected my son's speech, communication, balance and stamina when we signed up for some sessions at his early intervention center. I thought it would be fun for him but it was the best therapy he had ever experienced.

    I am so glad you are sharing your story with other families!

    Pam W
    SE of Seattle

    Equine Therapy for Communication Delays

  5. Nice to know. I have a sister who was also born with Down syndrome. There is a lot of services out there. Have you tried aqua therapy as well. It also works we have her swimming twice a week once for pt and the other ot. It is fun and educational as well.
    If you are interested, you can check out my blog. I am always updating it on my sister.

  6. Great post. My little guy is not old enough for this yet, but it is definitely something I will look into when he is. I have heard nothing but great things about it.

  7. Wonderful post! Enjoyed reading it! And so ironic that it's the second post I've come across today that mentions hippotherapy. The other was at

    It takes a huge amount of patience and love to care for a special needs child. God bless you all in your endeavors!

  8. Never heard of hippotherapy before, but "riding for the disabled" is a big thing in my area. My son Jamie (DS) loves riding. A lot of people talk about swimming with dolphins as a therapy, but I can certainly believe that using horses could be just as effective, and more accessible.

  9. I am an adoptive mom to 8 special needs children (soon to be 10, we are adopting 2 girls with Down Syndrome!!) and we LOVE hypotherapy. We have been doing it for 5 years and it has been by far the most effective therapy for our children.


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