Hippotherapy: Teaching Strategies for Students with Autism

The growing and exciting field of hippotherapy is making frequent headlines these day. Hippotherapy (“hippo” means “horse” in Greek) involves using the horse as a treatment tool to accomplish therapeutic objectives such as improving balance, strength and motor coordination. Autism hippotherapy teaching strategies may also focus on promoting communication, sensory regulation and the emotional bond between student and horse that motivates children to perform skill building tasks. Unlike therapeutic riding, therapists do not focus on teaching riding skills.

Hippotherapy differs from other types of equine-assisted therapies in that only registered occupational, physical and speech therapists incorporate it into treatment plans. They use the horse as a tool much like a therapy ball is used to develop strength and balance. Of course, as responsive, moving and exciting living beings- horses, can motivate and stimulate the client in unique ways. This is especially true with children who are on the autism spectrum.

Children with autism typically experience deficits in language, sensory processing and reading social cues. Individuals with high functioning autism, also called Asperger's Syndrome may be very bright and have normal speech development; yet, struggle with social skills and sensory issues.

Being on a horse addresses many of these needs. The horse provides strong sensory stimulation to muscles and joints (called proprioception), impacts the balance and movement sense detected by sensory receptors in the inner ear (called the vestibular system) and provides varied tactile (touch) experiences as the rider hugs or pats the horse. The therapist addresses communication goals by asking the rider to follow simple or multi-step directions such as “turn to face backward and give me high five”. The rider is encouraged to communicate directions to the horse to “go” or “whoa” by using words, sign language or pointing to pictures. In addition, pulling on the reins indicates stop and a kick tells the horse to get going!

Clients are taught to relate appropriately to the horse with gentle pats; hitting or flinging are not tolerated. The consequences of inappropriate behaviors are easy to implement. The horse stops. Good behavior is rewarded with short trots or a favored activity such as playing basketball. The movement of the horse can be used as a reinforcer to engage in less preferred activities. For example, to encourage hand use-the therapist can stop the horse, ask the child to place a ring on a stack and then walk again, repeating this sequence several times. When the task is completed the child may be rewarded with fast movement.

Higher functioning clients learn how to engage in goal directed conversations with the therapists as they learn complex warm up exercises or how to perform vaulting moves such as kneeling or standing on the horse. Vaulting is gymnastics on a horse. These autism teaching activities develop memory, strength and coordination and they are a lot of fun.

Although research on the efficacy of hippotherapy is limited, there are many anecdotal stories from parents. They often see improved communication, speech and coordination. This is all wonderful news. Furthermore, as children with disabilities discover that they can enjoy a sport that few of their peers can ever dream of experiencing they learn that they have special abilities. Only a horse (or an elephant in Thailand) can help them do that!