Hippotherapy in Pediatric
Occupational Therapy

A typical occupational-with-hippotherapy session runs about 30 minutes to an hour. Of that, about 15-20 minutes of that time may be spent atop the horse (always with a therapist and handler present). This helps stimulate both their motor skills and related brain connections as they perform occupational tasks in the form of games, toys, and more. They’re also developing muscle strength and coordination skills by sitting in different positions.

Off the horse, activities like brushing/feeding their four-legged friend or handling the reins as they walk him around the pasture develop the fine motor skills central to their occupational goals. Completing simple tasks around the barn builds strength in their arms. These achievements give them more confidence in successfully performing the everyday activities that will make them more independent and sure of themself.

Being outside in nature and working with their horse provides something else to focus on besides themself. It’s a natural, less stressful environment that allows them to more easily develop increased self-control, social skills, and assertiveness.

The mix of occupational therapy with hippotherapy can often help kids and teens challenged by:

• Birth injuries
• Learning problems
• Traumatic injuries to the spine or brain
• Mental health or behavioral issues
• Sensory processing challenges
• Autism
• Juvenile rheumatoid arthritis

Here’s how the two work together.

Pediatric occupational therapy has the goal of making a child more adept and comfortable with their everyday tasks. These can include things like dressing or feeding themselves, and using a pencil or scissors. It requires strengthening the fine motor skills of the hands and arms. Occupational therapy is also helpful for children who use mobility devices or prosthetics.

This form of therapy also improves the cognitive skills that a kid needs to more fully participate in social situations and school. It’s an excellent option for children dealing with autism, ADHD, or anything that affects their physical or neurological condition.

Hippotherapy is an additional tool that can give a helpful boost to the occupational goals we’ve set together for your child. The rhythmic movements from sitting atop a gently walking horse stimulate and strengthen certain nerve functions. Balancing and riding builds muscle strength, balance, and coordination. Performing various functions with the horse (like leading them on their reins) develops the child’s fine motor skills, a key goal of OT. Finally, the ongoing interaction with their horse provides opportunities for your child to boost their social and language abilities. It all takes place in an outdoor setting that reduces anxiety and allows them to feel a greater sense of control over their life. 

Your pediatrician can provide some insights, but we’re happy to answer your questions about adding hippotherapy to your child’s occupational therapy treatment.

That’s mainly determined both by the goals we set together and how your child is progressing toward them. We’ll build a schedule that best addresses those goals and takes into account your child’s unique personality. For some kids, sometimes “less is more.”

Most of our kids do an occupational/hippotherapy session an average of once a week over a period of six to twelve weeks. There are some kids who work with us every other week.

Sometimes in the case of a short-term goal, we’ll do an intensive push, working together several times a week for a limited period. For kids who are making slow and steady progress, but need a bit less pressure, a monthly session may be a better option. We create a schedule tailored specifically to your child and their needs.

We design the work to be fun and engaging for your child. At every point along the way, we see how they’re moving forward (or where they may be a little bit stuck); all of that information provides a more realistic way to determine how long they’ll benefit from occupational and hippotherapy sessions.

We know your child will have lots of questions! Use some version of these words to describe the therapies, and remember to keep it simple.

“Occupational therapy is about practicing and getting better at the kinds of skills that will make your daily life easier. You’ll master things like buttons, crayons, utensils, and things that make playing with your friends more fun. You’ll also discover new ways to be more comfortable in school and to make your homework and classwork a little easier.”

[Here’s how hippotherapy factors into it]. “People have used horses for many things over the years, but in this case, the horse is going to be your special helper. Riding on them will make you stronger and teach you lots of new things. There will be many nice people to help you. You’ll be outside or doing neat things inside a barn. It’s fun, and you’ll become special friends with your horse!”

We’ve worked with so many children over the years. If you’re still stumped, reach out; we can help with answers that really resonate with their questions.

In the most general sense, occupational therapy is meant to make performing the skills of everyday life (such as getting dressed, feeding themself, focusing in school) easier to accomplish. By mastering these things, a child becomes more confident and independent.

Some of these goals are achieved by building up certain physical abilities, like fine motor skills. However, occupational therapy also builds behavior and cognitive skills, helping a child to better process sensory information. This can help them engage more comfortably in their social interactions or to manage their emotions. Occupational therapy uses fun games, toys, and activities to achieve these goals.

Hippotherapy can be a great addition in helping to reach the goals of occupational therapy. The natural walking gait of a horse stimulates neural activity, building on what’s being done in regular OT and strengthening brain connections. Related actions—like handling the reins or working with a brush—further develop fine motor skills.

Additional goals of hippotherapy include developing strength, especially in the trunk area. Those particular muscles assist in things like sitting up and overall posture. Improvements in balance and coordination are also goals of hippotherapy, as well as creating an overall sense of body awareness.

The addition of hippotherapy to occupational activities can be a game changer. Working with the horse builds brain connections and the physical strengths that can make occupational therapy even more successful.

We consider our work with your child and your family as a “partnership.” Your role is essential.

The first place you help is by giving us insight into your child: what excites and motivates them? What do they love most? How do they handle challenges and frustrations? This kind of information is invaluable in structuring a therapy plan that works best for their personality.

Once we begin therapy, it’s very helpful for you to observe the work. This allows you to share in your child’s excitement and accomplishments, and to see it through their eyes.

We frequently give our families activities they can do at home to practice and build on the skills that your child is developing in therapy. Being consistent in practicing these skills is essential. Encouraging every small step forward is also important. Cheer them on!

Your therapist also relies on you as a line of communication. Letting us know of achievements (or any small setbacks) helps us keep your child’s treatment moving forward in a positive way.

Both forms of therapy share the goal of making the physical processes around daily life easier and more comfortable for your child. Both work to build their independence and confidence through improved physical strength, motor and cognitive skills. 

There are some subtle differences in how they achieve those goals.

Pediatric Occupational Therapy  This form of therapy is focused on helping your child more easily navigate the ordinary activities of daily life. This can include things like learning to work a zipper, hold a pencil or bottle, manipulate their toys, or better manage utensils at the dinner table.

Pediatric occupational therapy can also provide activities that ease a child past any little “hiccups” in their development, such as challenges in developing hand-eye coordination. Strengthening fine motor skills in their hands and arms is typically emphasized. Because of that, this form of therapy is also useful for a child who uses assistive devices like a wheelchair; occupational therapy can teach them better ways to navigate their daily life at school or home.

Occupational therapy also helps with behavior-related life skills. It teaches a child strategies that help them better focus in school, manage their emotions, or be more comfortable interacting with others. This is helpful for kids who deal with autism or ADHD.

Pediatric Physical Therapy  This practice is focused on strengthening the physical body overall including muscles, balance, and coordination. We work to help your child to move their body in easier and more comfortable ways.

Physical therapy focuses on building those bigger muscles that make things like sitting up, walking, running, or jumping easier. It can help a baby who’s having a little trouble holding up their head or rolling over. It can help a toddler who seems a bit less steady than expected. It’s a great help to a child dealing with muscular dystrophy or cerebral palsy to better coordinate and work their body.

Simply put, pediatric physical therapy builds the kind of physical strength and coordination that allows your child to better engage in the activities of life.

Typically, sessions are once a week. However, we design an appropriate schedule around the goals that we’ve set together for your child.

As the therapist and the equine team work with your child, we’re monitoring their progress. After several sessions, we’ll have a better idea of what kind of schedule works best for achieving the targets. It may be more appointments, it may be fewer; the bottom line is that we adapt the schedule to your child’s unique needs and personality.

We always want your child’s experience to be positive and productive so they look forward to the next session!

We’ll keep you fully informed on any suggested schedule adjustments so that you can maintain your family calendar.

Because equine-assisted therapy is considered a “tool” under the umbrella of occupational therapy, it’s likely that insurance will cover it. However, as with any policy, there may be some exceptions. These aren’t always so obvious in your policy documents or on the company’s website, so it’s a good idea to contact your carrier.  Talking to your pediatrician about this can also prove useful.

We’re also here to help. We deal with insurance carriers, Medicaid, and HMOs all the time and know the particulars. Please feel free to reach out with your questions. We’re happy to share our experience in this area.