Hippotherapy uses the horse’s movement and associated sensory stimulation to promote neurophysiologic change. It is performed by a registered occupational, physical or speech and language therapist to achieve various functional outcomes such as sitting independently or catching a ball. The horse functions as a treatment tool much in the same way a therapy ball does. However, the horse-human bond is unique in the way it motivates children to communicate and perform motor tasks.
Children do not need to know how to ride a horse to participate in hippotherapy, although they may end up learning riding skills as part of the treatment. For example, learning to pull the reins to steer is a basic riding skill that the therapist might teach in order to promote bilateral coordination. Separate from Hippotherapists, therapeutic riding instructors are trained to teach people with disabilities how to ride a horse, perhaps even compete in the Special Olympics.
Achieving Sensory Input
The therapist controls the sensory input by choosing the horse’s speed, direction of movement (i.e. straight lines or curves) and transitions (i.e. from walk to halt). Positions such as prone, facing backwards or kneeling alter vestibular input. The child also receives a great deal of proprioceptive and tactile input from the movements and physical contact with the horse. Therapists individualize their treatments to meet the child’s sensory needs, often resulting in improved body awareness, eye contact, speech and motor planning.
Barbara has seen many children increase speech production due to the sensory stimulation and because she is constantly prompting them to make choices such as going fast or slow or what animal to sing about. Kids with gravitational insecurity may be having so much fun they forget about their fear of falling. She once worked with a 3-year-old girl who started out much afraid of movement become confident enough to do a 360 degree turn while standing on top of a horse. That was great for her self-esteem.
Barbara has worked with children as young as 14 months. Preschool-aged children with mild disabilities may “graduate” from hippotherapy and be integrated into a class with typically developing children. Children with complex disabilities may benefit from hippotherapy for several years. However, insurance reimbursement depends on whether or not the child is developing functional skills as a result of the treatment.