What is Hippotherapy?

What is hippotherapy?

First of all, hippo = HORSE! Not hippopotamus! (Therapeutic use of a hippopotamus would be quite interesting though)

[“hippos” in Greek means “horse”]

“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 to engage sensory, neuromotor and cognitive systems to achieve functional outcomes. In conjunction with the affordances of the equine environment and other treatment strategies or tools, hippotherapy is part of a patient’s integrated plan of care.” (American Hippotherapy Association)

Basically, a hippotherapy session will run exactly how a traditional therapy session would run, but the kid (or adult) is on a horse!

Why does Hippotherapy work?

I’m going to try to put it into my own words, however if you would like to see the background research that the AHA provides click here.

There are many [MANY] types of stimulation that people can receive from riding horses:

  • Deep pressure stimulation from sitting on the horse and bouncing.
  • Having their feet in the stirrups provides stimulation to the bottom of the feet thus providing pressure and stimulation to the rest of the lower extremity joints.
  • Vestibular input to the brain (awareness of body parts in space).
    • Speed of the horses gait, walking in specific patterns (like large or small circles), and walking up and down hills.
  • Sensory stimulation – horses are pretty soft if you didn’t know!
  • Horses are also provide a lot of motivation! I have never met a child (or person) that wasn’t excited to see a horse. This motivation really encourages children to participate in therapy.

When a child’s body is receiving this sensory stimulation, it helps prepare their bodies for more complex, higher order tasks.

“Why not just put them on a swing, or bounce on a trampoline?”

I see these things as temporary fixes.

During my time shadowing in pediatric facilities, whenever the child became fussy or started to throw a tantrum during the session, the therapist would have to stop, place them in the swing and swing them until they calmed down.

During hippotherapy, they are constantly receiving that sensory input that allows them to focus on more complex tasks, because they do not have to get off the horse to continue with therapy.

Every therapist I’ve met who works with hippotherapy, and every parent I’ve met who has a child in hippotherapy, cannot say enough how much of a difference they see in their kiddos after their sessions. Especially when they compare it to a traditional clinic setting.

Certification Process

In the United States, we have the American Hippotherapy Association (AHA), which specializes in educating licensed healthcare professional, such as PTs, OTs and SLPs, on involving horses in therapy services.

Through the AHA, there are two foundational courses: Level I Hippotherapy Treatment Principles and Level II Hippotherapy Treatment Principles. They also offer continuing education classes and training for specific treatment areas.

There are then two separate certification exams regulated by the American Hippotherapy Certification Board (the certifying body of the AHA):

  • AHCB Certification Exam – “an entry level exam that validates those individuals who demonstrate basic educational achievement in the field.” (AHCB, 2018)
    • Exam Fee: $350; $250 for AHA Members
    • 150 MC Q’s – 3 hours
  • Hippotherapy Clinical Specialist Exam – “an advanced examination that validates the clinician’s extensive knowledge, clinical reasoning, and expertise in the field.” (AHCB, 2018)
    • Exam Fee: $375; $275 for AHA Members
    • 250 MC Q’s – 4 hours

Click here to see the differences in the certifications.

Why am I interested in Hippotherapy?

I started taking riding lessons at age 5 until about age 12 (not gonna lie, I was that ‘horse girl’ in school… I know, I know). I have always had a passion for horses, and for a while in high school I wanted to become an equine veterinarian. Of course, you all know the route I chose, but I always wished that somehow I could incorporate horses into my life.

Well, hello hippotherapy! Besides my love for horses, hippotherapy is actually an evidence-based tool that helps thousands of children and adults with so many varying disabilities. OT and horses? Obviously this is the field for me.

After volunteering at a local hippotherapy clinic here in St. Augustine, and really getting to see how hippotherapy works and the direct impact that it has on the lives of children with disabilities, it has only further motivated me to pursue a certification once I am a licensed OT.


I hope that this blog educated, encouraged and sparked your interest! This is a huge passion of mine and not many people know about the therapeutic use of horses and the amazing impact they can have on so many lives.


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