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Hippotherapy: How Horses Can Help with Sensory Integration

Hippotherapy: How Horses Can Help with Sensory Integration

Occupational therapy with horses? Yes, it’s true. Growing up with horses, I lit up when I heard that I could merge my career as an occupational therapist with my love for these animals. The benefits of hippotherapy (therapy with horses), can actually help with sensory integration, motor skills, and more?

Hippotherapy is a type of occupational therapy that uses horses to help kids with a variety of physical, sensory, emotional, and social challenges.

Today, we’ll be focusing on the sensory benefits.

At first, I was skeptical. Sure, horses are relaxing, but can they actually be great for therapy? Motor movements, sensory integration, balance, coordination. There was no way that riding a horse could improve all of those skills.

I’m happy to say that I was quickly proven wrong.

Kids with cerebral palsy who struggled to stay balanced were suddenly sitting taller when on a horse. Kids with sensory seeking tendencies were soothed by the rhythmic sensory input they got from the horse’s gait. Kids that struggled with anxiety found a relaxing outlet and began opening up about their feelings.

Wow. Just wow. If I didn’t love horses before, I really loved them now.

As I mentioned, hippotherapy can be beneficial for a wide variety of kiddos, whether they struggle with motor deficits or emotional trauma. We’ll dive into those topics in the future but, as we love all things sensory here, we’ll focus on the sensory benefits of hippotherapy today.

What’s the Difference Between Hippotherapy and Therapeutic Riding?

When occupational therapists use hippotherapy, they are relying on the benefits of the horse to enhance their clients’ treatment. The focus is on effective therapy, not on horseback riding. As we’ll chat about later on, horseback riding offers a lot of treatment benefits. Hippotherapy uses the horse as a tool to progress towards the therapy goals that are being worked on.

On the other hand, therapeutic riding cares more about the horseback riding than the therapy. There are many therapeutic riding centers that have trained professionals available to help those with disabilities ride horses.

The purpose is not to work towards any specific treatment goal, but to enjoy and learn the skill of horseback riding.

The Sensory Experience of Horse Back Riding

Before we dive into the specific sensory benefits of hippotherapy, let’s talk about what’s going on from a sensory standpoint whenever we jump on a horse.


Our balance system! When a kiddo is riding a horse, they need to engage their core to stay upright, understand where their center of gravity is, and continually “right” themselves and reposition as the horse moves. The vestibular work that can be done on a horse is hard to reproduce elsewhere. We’ll discuss this later on, but kiddos with vestibular challenges can find hippotherapy to be really exhausting given how taxing it is on their system.


Our body awareness! Horseback riding provides a lot of great sensory input. The ups and downs, the swaying, the force of each step, the pressure from the saddle—the sensory input that kiddos receive during hippotherapy can be really regulating for our sensory seekers.


Our sense of sight! There are so many sensory experiences to focus on in hippotherapy, that vision can often be forgotten. It’s one of the best though! Think about how much there is to see while riding a horse. I remember some great games of I Spy with kiddos on horseback. If you want to work on basic visual skills, use an arena that isn’t too visually stimulating. If you want to increase the challenge though, pick a trail with lots of sights.


Our sense of hearing! Is there ever a downside to nature sounds? Given that kiddos spend so much time inside these days, it’s likely that the auditory stimulation they receive during hippotherapy is unique and something they don’t experience on a regular basis.


Our sense of smell! As with auditory, is there ever a downside to nature smells? Well, many of you will say yes, many nature smells are awful. Horse poop isn’t the best smell around. But, these smells are absolutely great for sensory work!


Our sense of touch! There are so many great textures to touch when horseback riding! The leather of the saddle, the hair of the horse, the plastic of the helmet. As with the olfactory and auditory systems, horseback riding offers so many new tactile sensations that aren’t available in daily activities.

The Benefits of Hippotherapy for Sensory Integration

Now that we know how many sensory experiences a kiddo can have during hippotherapy, let’s dive into the specifics of how hippotherapy can benefit each sensory system and sensory integration in general.

Vestibular Benefits of Hippotherapy

Anyone who has ridden a horse has also lost their balance riding a horse. While this loss of balance is usually small for most of us, it’s a wake-up call of, “oh, I actually have to pay attention to my balance while I’m up here.” For kiddos who struggle with balance to begin with, this wake-up call can be pretty big.

When a horse walks, the rider’s pelvis is put through the same motions as walking. This can be so incredibly useful for kiddos who can’t walk independently, as it familiarizes their bodies with some of the same mechanics. Not only do their pelvises experience this fundamental movement pattern, their core muscles activate and they must continually work to find the center of gravity.

While this sounds chaotic, horses walk in a rhythmic and repetitive motion. Although kiddos are constantly readjusting in order to stay balanced, the consistent movement of the horse allows for some predictability.

If you’re looking for a way to engage the vestibular system, hippotherapy is a great choice. Keep in mind though that hippotherapy can be really exhausting for kiddos with vestibular challenges, as they are forced to use muscles they don’t often use and do movements they aren’t familiar with. This is why it is so beneficial, but also why it’s so exhausting.

Proprioceptive Benefits of Hippotherapy

It’s amazing to see a sensory seeker get on a horse and suddenly calm down. Now, I’m not saying that this sudden calmness is solely due to the proprioceptive input. When kiddos jump on a horse, they tend to get mesmerized by everything around them and are distracted by the sheer novelty of the experience.

That said, the proprioceptive benefits of hippotherapy are nothing to sniff at. Every time a horse takes a step, the rider is jolted a bit. With each up and down movement, there’s strong proprioceptive input.

For sensory seekers who are constantly jumping, swinging, pushing, and pulling, the steps of a horse can be really regulating and give them the input they need.

Visual Benefits of Hippotherapy

The top of a horse is a great platform from which to see the world. For kiddos that need more assistance with their visual skills, ride in an enclosed arena where you can control the visual stimulation coming in. If you’re working with a kiddo who is more advanced, head out on a trail and play a riveting game of nature I Spy.

It’s no surprise that every activity is visual in some sense.

Whether we’re working with kiddos on a puzzle in the clinic or on an obstacle course in the backyard, there are countless ways to focus on the visual aspects of our therapeutic activities.

The thing that’s unique about hippotherapy is the vantage point. How often does a kiddo get to see the world from so high up? Therapists can use the height of the horse to their advantage to help kiddos work on visual skills they aren’t exposed to from the ground.

Auditory Benefits of Hippotherapy

There are so many new and amazing sounds to listen to when horseback riding. The stomping of the hooves, the snorting of the horse, the swoosh of the tail, and all of the sounds from the surrounding environment offer great opportunities to work on auditory skills.

In addition to the auditory novelty of horseback riding, this is also a great chance to work on specific auditory treatment plans. I used to know a kiddo who would listen to his Integrated Listening System while on top of the horse. While the ILS was beneficial by itself, horseback riding gave us a great way to make sessions more dynamic and valuable.

Olfactory Benefits of Hippotherapy

Bring on the nature smells! I’m not saying that the olfactory benefits of hippotherapy are pleasant but, bad smells can have their value too. For kiddos that are especially sensitivity to certain smells, hippotherapy can be a great chance to get used to smells that many not be so appealing.

Take in a big sniff and know that exposure to a variety of different smells, good and bad, can help our kiddos become accustomed to the sensory world around them.

Tactile Benefits of Hippotherapy

Animals are fantastic for tactile work. No matter how course their fur may feel, kiddos can’t seem to resist petting adorable animals. There are so many new and usual textures that show up during a horseback riding session. Kiddos can get so much benefit from touching the horse, the saddle, the reins, and any of the nature elements they stumble upon during the session.

What I especially love about the tactile experience of hippotherapy is how different it is from the tactile treatments that kiddos normally experience. Put away the slime, the sensory bins, and the sand boxes and let the kiddos simply feel the natural world around them. If we think beyond the experience of riding, we can give kiddos so many great tactile experiences when they help groom, feed, and take care of the horses.

Hippotherapy can have so many therapeutic benefits for our kiddos with sensory processing challenges. As you saw above, simply jumping on a horse instantly engages all of the senses, which is a dream for sensory integration work. To find a clinic that offers hippotherapy near you, check out the American Hippotherapy Association’s list.

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Diana Fitts is a certified and licensed Occupational Therapist who specializes in sensory processing disorders and autism. Check out my About page to read my story and get a free therapy journal page to record your kiddo’s sessions!

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