Therapeutic Riding and Hippotherapy: What Is It and How Does It Work?

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Offering clients with mild-to-severe physical, developmental, cognitive, or emotional disabilities a unique and innovative clinical experience is often challenging. Consider the possibility of equine-assisted activities as a meaningful alternative or addition to your existing treatment regimen. The need to communicate effectively transcends disability, and the consequence of communicative limitations for the child with disabilities frequently compounds a host of other problems. According to the 2000 US Census (as cited by The Center for an Accessible Society, n.d.), 49.7 million Americans have a certified disability and children, age 5 to 20, account for 8% of this number, which is indicative of the serious need for effective treatment. Speech-language pathologists providing services within the context of the conventional clinical setting for children with a wide range of disabilities often struggle to provide effective motivational and naturalistic interventional strategies that translate into life skills and communicative enhancement and incorporate multimodal outcomes. Therapeutic riding/hippotherapy may offer a unique solution for clients who might otherwise languish in the conventional clinical setting due to limitations imposed by their disabilities or the therapy environment itself.

Literary references to the physical and emotional benefits of horseback riding date back to writings from the 1600s. However, when Liz Hartel of Denmark won the silver medal for dressage at the 1952 Helsinki Olympic Games, despite having paralysis from polio, medical and equine professionals took active notice (Adams, 2009). Soon afterwards, therapeutic riding was used for rehabilitation in Norway and then in England. The first centers for therapeutic riding in North America began operation in the 1960s. Today, there are more than 1,000 NARHA-affiliated centers in the U.S. and Canada. NARHA, formerly known as the North American Riding for the Handicapped Association, certifies both centers and individuals in therapeutic riding and the American Hippotherapy Association certifies individuals in hippotherapy.

Children with physical, cognitive, and developmental disabilities can be very effectively served through equine-facilitated activities resulting in improved balance, range of motion, and muscle control; more efficient motor planning while strengthening muscles, joints, and tendons; and improvements in respiration, circulation, appetite and digestion, concentration, patience, self-discipline, motivation, interpersonal skills, self-esteem, and self-confidence (Johnson, 2009). Equine-assisted activities also help to provide a stronger foundation upon which traditional therapies can be more effectively implemented.

Currently, there is a growing trend in speech and language intervention literature toward developing naturalistic approaches to add to or replace the traditional, more drill-like clinician-directed methods for pediatric speech-language pathology (Duchan & Weitzner-Lin, 1987; Fey, 1986; Owens, 2003; Fey et al., 2006; Mancil, Conroy, & Haydon, 2008). Referred to as naturalistic or milieu types of instruction, these therapeutic methods comprise the pragmatics approach to language intervention. This pragmatic or naturalistic emphasis encourages using everyday events, interactions, and conversation as a context for language learning. Several investigations have found that incidental or milieu instruction with children diagnosed with language delay was as effective as direct language instruction (Cole & Dale, 1986), and Fey et al. (2006) found significant increases in the amount of communication in children, aged 24 to 33 months, with 10 or less expressive words or signs. Furthermore, the research indicated that in addition to the speech-language professional, parents, as well as support personnel, have been shown to make effective use of the naturalistic approach (Girolametto, Weitzman, & Greenberg, 2003).

Therapeutic riding/hippotherapy is worth considering as an alternative setting for the provision of speech-language remediation. A number of studies and anecdotal reports now support the role of equine-assisted therapy as an effective form of treatment for physical, cognitive, and emotional deficits (Murphy, Kahn-D'Angelo, & Gleason, 2008). Intrinsic to the therapeutic and recreational components of the program, improved mental health, confidence, and self-esteem are natural by-products of the loving relationships fostered between horses and humans. Additionally, equine-assisted therapy centers commonly strive to include family, caregivers, and therapists in goal setting and activities (Johnson, 2009).