This document discusses the need for more evidence-based research on the effects of hippotherapy on communication and language disorders in speech-language pathology. It provides a brief overview of hippotherapy and its recognized use by various therapy associations. Although limited research specifically examines impacts on speech and language, the literature from physical and occupational therapy demonstrates positive effects in areas like sensory integration and motor skills that relate to foundations for communication. These findings provide theoretical support for hippotherapy as an intervention approach in speech-language pathology by targeting domains like oral-motor function, respiration, and cognition, but more experimental research is still warranted.

1. Juliette Koepp & Elizabeth Gatti, Supervisor: Kathleen Holman, M.A., CCC-SLP
Department of Communication Sciences and Disorders, Elmhurst College
SPEECH-LANGUAGE PATHOLOGY AND HIPPOTHERAPY:
THE NEED FOR EVIDENCE-BASED LITERATURE
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Introduction
According to the American Hippotherapy
Association (AHA), hippotherapy refers to the use
of the horse as a treatment strategy by physical
therapists (PTs), occupational therapists (OTs),
and speech-language pathologists (SLPs) to
address body structure, function, activity
restrictions, and participation limitations in clients
(2013). Currently, hippotherapy is being used in 24
different countries and is recognized by the
American Physical Therapy Association, American
Occupational Therapy Association, and the
American Speech Language and Hearing
Association (AHA, 2000). In hippotherapy, the
client is affected by the multi-dimensional
movements of the horse by sitting on the horse’s
back (Macauley & Gutierrez, 2004). Research in
the fields of PT and OT have found hippotherapy
to be effective for individuals who have a wide
range of disabilities, including autism spectrum
disorder, cerebral palsy, cerebrovascular accident
stroke, developmental delay, Down syndrome,
multiple sclerosis, muscular dystrophy, spinal cord
injuries, and traumatic brain injuries (Granados &
Agís, 2011). However, limited evidence-based
literature is found on the effects of hippotherapy on
communication and language disorders.
Figure 1: SLP with child during
Hippotherapy
Limited SLP Literature,
Although…
Three boys with language learning disabilities
received one hour of hippotherapy for a total of
six weeks (Macauley & Gutierrez, 2004).
Parent questionnaires reported improvement in
the children’s receptive and expressive
language abilities, as well as their motivation,
attention, and self-concept as a result of
hippotherapy. The authors expressed the need
for further research in this area.
PT/OT Literature Supporting
Hippotherapy
Correlation to Speech-Language
Pathology
Sensory integration à Increased expressive output
Postural control à Improved respiratory muscle strength, chest
expansion, and respiratory pressure
Head and trunk stability à Increased respiratory strength
Gross motor à Increased receptive language
Respiratory and oral motor function à Integrated activity of neural systems responsible for
speech
Participation and engagement à Increased social and cognitive skills
Receptive communication, specifically multistep
directions
à Language development
Self-esteem à Increased verbal expression
Cognitive functions à Speech development
Cerquozzi, Cerquozzi & Darragh, 2012; Whalen & Case-Smith,
2012; Champagne & Dugas, 2010; Zadnikar & Kastrin, 2011;
Shurtleff, Standeven, & Engsberg, 2009; Champagne & Dugas,
2010; Ajzenman, Standeven, & Shurtleff, 2013; Nobrega de Melo &
Cruz de Lucerna, 2007; Cerquozzi, Cerquozzi, & Darragh, 2012
Preis & McKenna, 2014; Teodori, Negri, Cruz, & Marques, 2011;
Jandt, da Sil Caballero Junior, & Dias, 2011; Belmonte, 2013; Kertoy,
Law, Kinh, Petrenchik, & Rosenbaum, 2008; Washington, 2010;
Ohala, 1990; McClean & Tasko, 2002; Wadman, Durkin, & Conti-
Ramsden, 2008; Nijland, Terband, & Maaseen, 2015; Collison,
Munson, & Carney, 2004
Cognition
Foundation for
Communication
/Language
Theoretical Support
for Hippotherapy
Head
stability Oral-motor
function
Self-esteem
Trunk
stability
Gross
motorSensory
integration
Respiratory
function
Postural control
Social
participation
Conclusions
Benefits of hippotherapy found in the OT and PT literature show positive effects in areas responsible for
physical, cognitive, and social functions needed for speech and language. Hippotherapy led to
improvements in sensory integration, postural control, head and trunk stability, motor skills, social
participation, respiratory function, cognitive skills, self-esteem and receptive communication improvement,
specifically multi-step directions in individuals with various disorders. These results are applicable to the
field of speech-language pathology. It should be noted that the majority of the literature showing the
benefits of hippotherapy were case studies that used qualitative measures rather than experimental. More
experimental studies need to be completed in order to show evidence of the positive effects of
hippotherapy in the area of speech and language.
Figure 2: Theoretical Support for Hippotherapy for
Speech and Language Therapy