Hippotherapy (hippo is Greek for horse) continues to gain recognition in our profession, but several misconceptions exist about this approach used by speech-language pathologists and other clinicians. Hippotherapy is a treatment tool—it is not a type of treatment. Compare it to using a swing or ball or other similar tool in sessions.
Also used by occupational therapists and physical therapists, the tool involves placing clients on horses while providing intervention. The approach aims to engage sensory, neuromotor, and cognitive systems to enhance outcomes, according to the American Hippotherapy Association (AHA). A number of peer-reviewed sources explore the use of equine movement in treatment for a variety of disorders.
Untangling the terminology
Don’t confuse hippotherapy with adaptive horseback riding lessons, also known as therapeutic horseback riding. In fact, while SLPs face scope-of-practice infringement issues on a variety of fronts, we need to understand—and explain to clients or potential clients—that treatment provided by SLPs differs vastly from riding lessons provided by adaptive/therapeutic riding instructors.
A variety of terms—such as “horse therapy,” “equine therapy,” “equine-assisted therapy,” and “equine-assisted therapies and activities” further exacerbate confusion surrounding this issue. Simply using accurate terminology to describe the different services and activities involving horses to treat people with special needs goes a long way to protect consumers. AHA developed a comprehensive terminology document to help consumers and professionals to address this issue.
Only SLPs, along with occupational or physical therapists working within their scope of practice, who complete appropriate continuing education can use hippotherapy as a treatment tool. There are no licensed “hippotherapists” in the United States.
Incorporating this tool in treatment
When an SLP uses hippotherapy with a client, it’s one of many interventions incorporated into their treatment plan. As with any treatment tool, SLPs use evidence-based practice guidelines and strong clinical reasoning when determining the appropriateness of using hippotherapy for any given client. As noted by ASHA Past President Gail Richard in a letter to AHA, “While ASHA does not endorse particular treatment programs, products, or procedures, hippotherapy is one of many treatment techniques that may be used by SLPs, provided that SLPs have the necessary education, training, and expertise, and abide by the profession’s Code of Ethics.”
An SLP with the appropriate training can use hippotherapy to effectively facilitate the neuromotor systems that support speech and language skills. As SLPs, we know lack of neuromotor integrity in a client’s general motor control, postural control, respiratory efficiency, and/or sensory processing can negatively affect speech and language skills.
With each stride of the horse, a client receives sensory input through vestibular, tactile-proprioceptive, and visual systems, which can help in a variety of ways. For example, treatment including horses can positively boost clients’ attention and motivation, resulting in a more productive session. The equine environment is rich in natural communication contexts and opportunities for addressing language deficits.
For SLPs interested in this dynamic treatment tool, AHA offers standardized continuing education on the safe and effective use of hippotherapy as a treatment tool. The American Hippotherapy Certification Board (AHCB) provides two levels of continuing education certification: an entry-level AHCB certification and advanced Hippotherapy Clinical Specialist/HPCS.
AHA also offers a variety of resources for SLPs and other licensed therapy professionals who want to learn more about this treatment tool.
Ruth Dismuke-Blakely, MS, CCC- SLP, HPCS, is president of Skyline Therapy Services Edgewood in New Mexico, and an American Hippotherapy Association faculty member. firstname.lastname@example.org
Neita Miller, MS, CCC-SLP, HPCS, works at Skyline Therapy Services Edgewood and is a member of the American Hippotherapy Association research committee. email@example.com
Tina M. Rocco MA, CCC-SLP, HPCS, founded Speech-Language Pathology in Motion in Islandia, New York. She is an affiliate of ASHA Special Interest Group 11, Administration and Supervision. Rocco is also the American Hippotherapy Association board president and chair of the AHA Ethics & Advocacy committee. firstname.lastname@example.org