Hippotherapy is the inclusion of equine movement in occupational, physical & speech therapy

Hippotherapy

What is hippotherapy?

According to the American Hippotherapy Association, "the term 'hippotherapy' refers to how occupational therapy, physical therapy, and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement to engage sensory, neuromotor, and cognitive systems to achieve functional outcomes.  In conjunction with the affordances of the equine environment and other treatment strategies, hippotherapy is part of a patient's integrated plan of care." 


The term hippotherapy originates from the Greek word, “hippos” meaning horse (or equine), and roughly translates as "treatment with the help of the horse". 


Hippotherapy is a treatment tool that can be incorporated into speech therapy, occupational therapy or physical therapy as part of a larger, comprehensive total plan of care.  When including hippotherapy in treatment, the therapist purposefully selects, uses and modifies the horse's movement to facilitate the neuromotor systems that support human function. The therapist also purposefully selects and uses different developmental positions for the client while on the horse to maximize the benefits of the movement and to target specific functional outcomes.  A walking horse produces highly organized multi-dimensional movement at an average rate of 100 steps per minute.  

Speech language pathologists may incorporate hippotherapy into treatment to:

  • Increase client motivation, engagement and participation. 
  • Provide graded and rhythmic sensory and motor input to the physiological and neuromotor systems that impact:
    • Speech production (articulation, phonology, voice/volume, fluency and resonance).
    • Language development (receptive language/the language we understand and expressive language/the language we use)
    • Social communication skills (pragmatics and non-verbal communication)
    • Cognitive-communication abilities (organizing thoughts, paying attention, remembering, planning, and/or problem-solving)
    • Swallowing (oral motor abilities and feeding skills)

To learn more about the use of hippotherapy in speech, check out these articles from The Speech in Motion Blog:

Best Practice:

SLPIM follows the “Best Practice Statements” set by the American Hippotherapy Association and the recommendations of the American Speech Language and Hearing Association when incorporating hippotherapy into speech treatment.  It is considered best practice for hippotherapy to be included as part of a larger total plan of care.  It is offered in conjunction with other speech therapy treatment tools, strategies, approaches, and methods in order to provide the best possible results for our clients.  


Practicing skills in multiple environments and during various activities supports generalization of skills and helps our clients make progress faster.  Patients who receive speech therapy incorporating hippotherapy at SLPIM are also seen in our Hauppauge clinic and in onsite treatment areas at the Islandia location as part of their treatment plan.  It is at the therapist’s discretion how often and how long hippotherapy is used, if at all, during each speech therapy session.  


SLPIM is Long Island's only AHA Inc. Facility Member.  

Research related to hippotherapy

There are 8 systematic reviews, 86 peer reviewed articles, and 10 peer reviewed case studies that show support for the use of equine movement in treatment on The American Hippotherapy Association bibliography.  Further, there is a significantly larger body of research related to the conceptional framework tied to hippotherapy, which includes dynamic systems theory, motor learning principles and sensory processing.  


There are over 350 articles listed related to the use equines in activities and therapies here.  In addition, there are numerous articles related to the benefits of incorporating animals in therapy.  According to the Human Animal Bond Research Institute (HABRI),  "people are happier and healthier in the presence of animals.  Scientifically-documented benefits of the human-animal bond include  decreased blood pressure, reduced anxiety, and enhanced feelings of well-being." 


Research related to therapy incorporating hippotherapy shows evidence of the following:

  • Improved postural stability
  • Increased motivation
  • Improved participation
  • Increased adaptive behaviors
  • Improved motor control
  • Improvements in muscle symmetry
  • Improved social-emotional behavior
  • Increased social awareness
  • Increased social skills and behaviors
  • Increased display of social behaviors including talking, making physical contact and looking at faces
  • Improved positive social behaviors including becoming more receptive to social advances from peers.

Considerations for determining if hippotherapy is an appropriate speech therapy treatment strategy:

When determining if the incorporation of hippotherapy into speech therapy is appropriate, the speech language pathologist considers a number of factors. 


The incorporation of hippotherapy in treatment may be contraindicated for some patients for medical reasons (see our FAQ page for a list of precautions and contraindications).  


Based on information from your doctor and your case history we will determine if there are any contraindications and precautions present. 

Precautions & Contraindications

Hippotherapy Myths:

  • Hippotherapy is NOT the same as "therapeutic riding" or "adaptive horseback riding".  It is NOT a horseback riding lesson.  It should not referred to as "equine therapy" or "horse therapy".  To learn more about the differences between Hippotherapy and therapeutic/adaptive riding lessons click here.
  • Hippotherapy is NOT a program.  Use of the term "hippotherapy program" is incorrect.  
  • There is no such thing as a "hippotherapist" in the U.S. 
  • Hippotherapy is not a separate service or a procedure.  For more information please see the American Hippotherapy Association position statement on billing.
  • Doctors should NOT write prescriptions for "hippotherapy".  Prescriptions should be written for speech therapy regardless of the treatment strategies that will be used.  The treatment strategies or tools will be selected by the therapist and may be changed at any time in order to most effectively treat the patient.

Read more common hippotherapy myths and misconceptions here

Therapist Training

According to the American Hippotherapy Association, licensed speech language pathology, occupational therapy and physical therapy professionals are the only personnel who have the prerequisite knowledge and training needed to understand, apply and use hippotherapy effectively.  The highest credential one can obtain in hippotherapy is to become a Board Certified Hippotherapy Clinical Specialist (HPCS).  To become a board certified Hippotherapy Clinical Specialist is a lengthy process requiring the successful completion of the Hippotherapy Clinical Specialist Certification Exam.  Only physical therapists, occupational therapists, and speech and language pathologists who have been practicing in their profession for at least three years (6,000 hours) and have 100 hours of hippotherapy practice within the three years prior to application may take the exam.  To learn more about this certification visit the American Hippotherapy Certification Board website. 

The Hippotherapy Team

During treatment incorporating hippotherapy, the speech language pathologist is assisted by a team.  Each member of the team plays an important role. The team is made up of a specially trained:

  • Speech-language pathologist
  • Horse
  • Horse handler
  • Side-walker

Watch: Gigi's nomination video for the American Hippotherapy Association Horse of the Year Award!