By: Barbara Smith, OTR/L
Copyright 2011, Barbara Smith

Hippotherapy is a treatment strategy that utilizes equine movement and indeed the entire equine environment to achieve functional outcomes such as increasing bilateral hand skills, sitting balance or vocalizations. It is used by registered occupational (OT), physical (PT) therapists and speech-language pathologists (SLP) who may also have specific hippotherapy credentials depending on any given facility’s requirements. Although hippotherapy is an increasingly popular area of specialization, there are a limited number of facilities and experienced therapists available.
It is not unusual for a facility to lack a therapist from one of the three disciplines, making it a challenge to match clients to a therapist’s area of expertise. For example, as an occupational therapist I have worked with a child who demonstrated good strength and motor control but did not speak and a client whose impairment was primarily leg weakness (i.e. Charcot Marie Tooth Syndrome). I think that in an ideal world the first child would have worked with a SLP and the second one with a PT.
Rhythmic repetitive horse movement is similar to the human gait. Therefore, simply sitting on top of the walking horse enables a non-ambulatory child or child with an abnormal gait to experience what normal feels like. The average horse takes 120 steps per minute providing over 3,000 opportunities to make postural adjustments during a 30 minute hippotherapy session. Riding provides tactile, vestibular and proprioceptive sensory input that helps children to achieve sensory modulation-thus, promoting focus and speech output. So if riding does all of this- is the therapist’s discipline critical?
Well….. yes. To begin with clients often have a doctor’s referral for a specific type of therapy. However, when working with very young children referred from an Early Intervention program a child may benefit from a therapist trained in a transdisciplinary approach. I love working on communication skills and PT’s want to see improved hand use. But when working with older children whose parents seek insurance reimbursement it is important to work on discipline specific functional outcomes such as walking a specific distance, using action words or motor planning skills to manipulate clothing fasteners.
Many children demonstrate impairments that indicate the need for two or all three types of therapies. Insurance companies may pay for short term (i.e. eight weeks) of occupational therapy followed by another term of speech and language therapy. Communication between therapists who understand the child’s global needs can help make the transition a smooth one. But it is important that parents understand that matching the therapist according to the child’s specific needs is an important consideration in any clinical setting.
Featured Author: Barbara Smith, OTR/L
Many thanks to Barbara Smith for providing us with this article for our newsletter and website.
From the Author’s Website: I am the author of The Recycling Occupational Therapist published by Pro-ed.Inc. and also sold at Therapro Inc. (Theraproducts.com) This is a guide to making activities for individuals with developmental disabilities. I am also the author of Still Giving Kisses: A Guide to Helping and Enjoying the Alzheimer’s Victim You Love. I wrote this book to share my many ideas for therapeutic adaptations and activities that help loved ones enjoy spending time with an Alzheimers victim.
Please support our contributing guest authors. Please visit Barbara’s blogs HorseOT, The Recycling Occupational Therapist and Geriatric OT