FAQs For Families

FAQs for Families

Is hippotherapy in treatment safe?

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.

Is hippotherapy for everyone?

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.

Who can provide therapy services that include hippotherapy?

Physical Therapists, Occupational TherapistsSpeech-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.

Why choose an AHA trained therapist?

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).  

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How does hippotherapy differ from Adaptive or Therapeutic riding?

The term “Hippotherapy” refers to the inclusion of purposefully manipulated equine movement into a client’s plan of care as a treatment tool or strategy.  This can be done by occupational therapy, physical therapy, or speech language pathology professionals while working within their scope of practice. Occupational therapy, physical therapy, and speech language pathology services are all healthcare services, which require medical necessity. They are intended to provide habilitation or rehabilitation.

Hippotherapy should not be confused with riding lessons for individuals with special needs. It is the position of AHA, Inc. that when describing riding lessons for individuals with special needs, the term “therapeutic riding” may imply “therapy” and may be misleading. Therefore, in the best interest of consumers and public protection, the preferred term of AHA, Inc. to describe this activity is “adaptive horseback riding”.

Adaptive horseback riding is a riding lesson for individuals with special needs. Adaptive horseback riding lessons are provided under the guidance of a horseback riding instructor.  The purpose of adaptive horseback riding lessons is to teach riding skills and/or allow for participation in horseback riding for individuals with a variety of needs.  Adaptive riding instructors may provide adaptations to tack, equipment, physical supports or their teaching style, to allow for participation in horseback riding for individuals with a variety of needs. Riding instructors do not provide habilitation or rehabilitation.  If seeking therapy for yourself or your family member, be sure to seek out a licensed therapist who has completed continuing education in the use of hippotherapy in treatment.

What should families/patients expect?

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.

How much does therapy cost?

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.

What makes a therapy horse?

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.

What if my child is scared of the horse?

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.

Will the horse be a part of each treatment?

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.

How are patients matched to a horse?

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.

What happens when hippotherapy is no longer medically necessary?

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.

Are there hippotherapists in the U.S.A.?

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.


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