Frequently Asked Questions.

FAQs for Therapists

  • 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 as a therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes.

    Best practice dictates that occupational therapy, physical therapy, and speech-language pathology professionals integrate hippotherapy into the patient’s plan of care, along with other treatment tools.

  • “Hippos” is the Greek word for horse. Hippotherapy literally means ‘treatment with the help of a horse.'

  • The horse’s movement has much to offer the patient and is a powerful tool. The horse should have the capability of providing medical quality movement. The movements are multi-dimensional, and in many ways are similar to movements that a human makes. By experiencing the horse’s very organized movement, the patient has plenty of opportunity to practice the ‘right way’ to sequence movement for tasks like walking. The horse takes, on average, 100 steps per minute or 3000 steps during 30 minutes of equine movement.  That practice, which is naturally variable, is key to learning or re-learning tasks.  

    The horse also offers sensory input, particularly proprioceptive, vestibular, tactile and visual, as he moves the patient through space. That multi-channel input, which happens simultaneously with the biomechanical input, helps to regulate an otherwise disordered sensory system. The AHA, Inc.’s Conceptual Framework and multiple research papers help to explain the reasons that equine movement has such a powerful impact on the patient in treatment.

  • Hippotherapy is the opportunity for the patient to absorb and benefit from the movement of the horse, with improved function as the goal. The patient is not in control of the horse, rather the horse professional on the team controls the movement under the therapist’s direction.  

    Horseback riding, in contrast, is the rider controlling the horse to the best of their ability. It is a horsemanship discipline and may have social, recreational, or healthful benefits while the individual is learning how to ride. 

  • Yes, the American Occupational Association (AOTA), American Physical Therapy Association (APTA), and the American Speech-Language-Hearing (ASHA) have all stated that hippotherapy/skilled equine movement is within the scope of practice for OT, PT, and SLP practitioners. Please click here to view  copies of these letters. The use of equine movement as a treatment tool has been acknowledged by these professional organizations for more than 30 years and therefore is no longer considered investigational but is mainstream practice for the licensed professional. 

  • The treating therapist will determine at what age the inclusion of hippotherapy may be appropriate for the patient. Consideration for the youngest patients may include assessing developmental status as well as having the appropriate treatment team, including a horse with gradable movement. AHA, Inc. recommends that the therapist working with children under 3 years old have their HPCS certification and significant experience in Early Intervention.

    There is no upper age limit for the patient and, in fact, many elders have benefitted from the movement, exercise, and balance training provided by the horse that is low impact and skillfully applied by the therapist.

  • There are more than 100 articles in peer reviewed publications investigating hippotherapy across many patient populations. The research includes hippotherapy used prospectively as a treatment tool, as a viable intervention included in meta-analysis, and as the treatment in single-subject case studies. This work has been published internationally, gaining ground over the last 30 years. Click here for the AHA, Inc. Bibliography and Reference List. 

  • The AHA, Inc. routinely updates our Terminology for Healthcare document to include comprehensive explanations of terminology related to hippotherapy. This helps to ensure that you are using the most up-to-date terminology in documentation, social media, and marketing materials. 

  • The AHA, Inc. offers a foundational series, Hippotherapy Treatment Principles Part I and Part II. These courses include the basic theory and treatment principles for the licensed healthcare professional interested in incorporating hippotherapy into their clinical practice.  

    For a full list of AHA, Inc. courses and any prerequisites required, click here

  • The AHA, Inc. is a continuing education (CE) Approved Provider for the American Occupational Therapy Association, Inc. (AOTA) and the American Speech-Language-Hearing Association (ASHA) for Hippotherapy Treatment Principles Part I and Part II, the International Conference and other AHA educational events. Multiple state physical therapy boards have approved CEUs for physical therapy professionals. Questions regarding CE units may be directed to the AHA, Inc. office.

  • All certification is conducted through the American Hippotherapy Certification Board. The AHCB currently offers two levels of certification exams: AHCB Hippotherapy Certification Exam for OT, OTA, PT, PTA, SLP, and SLPA professionals and the Hippotherapy Clinical Specialist Exam for PT, OT, and SLP professionals. If you are interested in one of the AHCB certification exams, contact the AHCB directly at hippopt@aol.com.  

  • Yes, the American Hippotherapy Certification Board (AHCB) has its own website with all the information needed regarding certification and exams.

FAQs for Families

  • The cost for therapy should be consistent whether hippotherapy is included or not and should be in line with other similar OT, PT or SLP services. Cost greatly depends on geographic location, your insurance coverage, or if services are private pay. Some clinics offer financial aid or scholarships depending on specific financial situations. It’s best to follow up with the preferred facility and insurance carrier to determine costs.

  • Horses with medical quality movement, specialized training, and the ability to tolerate a variety of human interactions make good therapy horses. Size and shape come into play, as well. Often horses working in the discipline of hippotherapy show great longevity because of the conditioning, training and care given to these invaluable team members.

  • It’s quite common for a child to be intimidated by a horse. When hippotherapy is being considered the child may be introduced to the horse in a variety of ways. Doing activities around a horse but not on a horse is one option to help introduce equine interaction. A child who has never seen a horse may actually do well once on the horse and feeling the rhythmic movement input with support provided as needed. The therapist and parent should work together to come up with an approach appropriate for that child. There are occasionally patients for whom the horse/equine movement creates too much fear or anxiety. Hippotherapy may not be the tool of choice for that individual.

  • It is unlikely that the horse will be incorporated into every treatment. The therapist will choose which tools/strategies are most appropriate for the patient at any given time. Additionally there may be circumstances which preclude safe access to the horses such as inclement weather/temperature, a sick or lame horse or limited team members. It’s important to acknowledge that the horse’s movement is a therapeutic tool and may not be appropriate at every session.

  • The therapist carefully chooses a horse for each patient based on the type of movement the horse produces, the sensory experience the horse provides, and the horses’ ability to grade their movement during a treatment session. The therapist is always looking for the ‘just right challenge.'

    A well trained horse and handler are ideal, as that team will be able to provide the scope of medical quality movement required by the therapist to achieve patient specific treatment goals.

  • Many patients develop a strong bond with the horse. In order to maintain this connection or to pursue equestrian activities to maintain the benefits achieved in therapy, the therapist may have referrals to adaptive riding or other equestrian facilities to transition from a therapy focus to a recreational focus.

  • The term “hippotherapist” is not used in the United States. Individuals are identified by their profession of licensure: OT, PT, SLP. For example, Andrea is a physical therapist who incorporates hippotherapy into her clinical practice.

  • There are inherent risks when working with horses and in an outdoor environment. Therapists mitigate those risks by working with horses that have been thoroughly screened and trained for this discipline. The therapy team is trained in safety protocols and appropriate safety equipment is used during treatment such as helmets or belts. Constant supervision, monitoring, and communication are key to providing a safe and beneficial treatment.

  • Although hippotherapy can be beneficial for many, there are some considerations regarding whether hippotherapy is the best tool for a particular patient. The therapist will consider many factors such as patient allergies, behaviors, medical conditions (uncontrolled seizures, unstable joints, recent surgeries, skin conditions, etc), the size of the patient, sensory sensitivities, painful conditions aggravated by movement, along with other variables. The therapist and physician familiar with the application of equine movement in treatment are the best ones to weigh the benefits and risks of this tool.

  • Physical therapists, occupational therapists, speech-language pathologists, physical therapy assistants, occupational therapy assistants, and speech-language pathology assistants who have received specialized post graduate continuing education training through taking the AHA, Inc. Part I and Part II (foundation courses) would be the best at providing these services in the USA. Therapists who take AHA, Inc. courses are taught the principles, application and clinical decision skills to apply skillfully manipulated equine movement (hippotherapy) into a plan of care for a patient.

  • Effective use of equine movement as a treatment tool/strategy requires extensive knowledge of the interaction of human and equine physiology when a patient is placed on a moving horse.

    Therapy professionals need in depth understanding of equines and equine movement to safely and effectively integrate the impact of equine movement with other therapy tools/strategies to achieve their patients’ treatment goals.

    Since 1992, the American Hippotherapy Association, Inc. has offered the only standardized curriculum dedicated to hippotherapy as a treatment tool within occupational therapy, physical therapy and speech-language therapy. AHA, Inc. trained therapists are expected to follow the American Hippotherapy Association, Inc. Statements of Best Practice for the Use of Hippotherapy by Occupational Therapy, Physical Therapy, and Speech-Language Pathology Professionals.

    Voluntary certification in the inclusion of hippotherapy as a treatment tool/strategy within occupational therapy, physical therapy or speech language pathology services is available from the American Hippotherapy Certification Board (AHCB).  

    Click here to Find a Therapist or facility near you.

  • Hippotherapy is the opportunity for the patient to absorb and benefit from the movement of the horse, with improved function as the goal. The patient is not in control of the horse, rather the horse professional on the team controls the movement under the therapist’s direction.  

    Horseback riding, in contrast, is the rider controlling the horse to the best of their ability. It is a horsemanship discipline and may have social, recreational, or healthful benefits while the individual is learning how to ride. 

  • At the start of therapy services, an initial evaluation should be completed by your therapist, and an appropriate treatment plan will be developed.  Hippotherapy is intended to be one part of an overall occupational therapy, physical therapy or speech language pathology treatment plan, which means your therapist will likely include a variety or treatment tools, strategies and approaches in treatment.

    Families/patients should expect that treating occupational therapy, physical therapy and speech language pathology professionals who include equine movement into a therapy session have made a sound clinical judgement as to the appropriateness of hippotherapy integrated into the plan of care and that they are addressing the patient’s functional limitations and treatment needs through provision of medically necessary therapy services.

    AHA, Inc. trained therapists determine the potential value of including hippotherapy into the patient’s occupational therapy, physical therapy or speech-language therapy treatment. The therapist will carefully select a horse for the client, based on the horse’s temperament, movement, and conformation. The movement of the horse is purposefully manipulated to impact the client. In addition, skilled and licensed therapists may use various developmental positions to further enhance this movement.