Comparing hippotherapy and therapeutic/adaptive riding


What’s the difference? And which is the best fit for my child?

Hippotherapy (the treatment strategy we’re known for) and therapeutic/adaptive riding (an activity we do not offer) are very different, but both have their place. The question is, what are you looking for?

Here’s a brief overview

  • Hippotherapy, because it is integrated into physical, occupational, or speech therapy, is part of a one-on-one medical treatment. It focuses on specific patient outcomes like being able to crawl, transition from sitting to standing, walk, throw a ball, button a shirt with minimal assistance, or draw a straight line. A doctor’s prescription is required and treatment, depending upon your insurance benefits, is generally covered by health insurance. Learn more.
  • Therapeutic/adaptive riding is a recreational activity – like basketball, baseball, horseback riding, ballet, or art – that has been adapted for those with special needs. It often takes place in semi-private or group sessions and goals tend to be related to riding skills, confidence- and relationship-building, and emotional well-being. Learn more.
To the untrained eye, hippotherapy looks quite straightforward, but there’s a great deal going on beneath the surface.

The therapists are considering the conformation and movement of the therapy horses, the treatment strategies performed while on the horse, and the horses’ different gaits and schooling patterns.

It’s a complex but worthwhile puzzle, one that provides tremendous benefits for the kiddos.

A closer look

Looking for a more details? They’re right here.


  • One-on-one physical, occupational, or speech therapy, prescribed by a physician and delivered by a licensed therapist in conjunction with a horse handler and a specially-screened and -trained therapy horse.  
  • The goal is for professional treatment to improve neurological functioning in cognition, body movement, organization, and attention levels. The focus is on achieving individual therapeutic goals like sitting up, walking, being able to go up and down steps, or dress and undress independently. 
  • A medical plan of care is established for each patient and progress is periodically reassessed to determine the need for ongoing services. Treatment, depending upon the facility, generally occurs year-round until the client meets discharge criteria.
  • Because the horse’s movement is essential to assist in meeting therapy goals, horses are specifically selected for their temperament, size, and the type of movement they provide for the client.
  • There is direct hands-on participation by the therapist at all times. The treating therapist continually assesses and modifies therapy based on the client’s responses.
  • Equine-assisted physical, occupational, or speech therapy is reimbursable by most medical insurance carriers.

Hippotherapy is an integral part of physical and occupational therapy at Children’s TherAplay. Is it a good fit for your child? Find out. 

Therapeutic / Adaptive Riding 

  • Recreational horseback riding lessons adapted for individuals with special needs. 
  • Completed by a professional horseback riding instructor in conjunction with volunteers.
  • Many people participate in therapeutic/adaptive riding as a recreational activity or for confidence-building. The emphasis is on horsemanship, proper riding position, and rein skills, not functional therapeutic goals. 
  • Riding skills are generally taught on a group basis with the instructor responding to the group as a whole in addition to fostering individual success.
  • This activity, depending upon the facility, generally runs in eight- to twelve-week “sessions.”
  • Horses are selected based on temperament rather than quality of movement. 
  • There is occasional hands-on assistance by the riding instructor and/or volunteers, but the instructor usually teaches from the center of the arena.
  • As an adaptive/recreational sport or activity, not therapy, it is not covered by insurance.

Because we are a medical facility, this is not something we offer. However, we frequently make appropriate referrals to therapeutic/adaptive riding centers where children can participate in horseback riding lessons adapted to their needs. 

Looking for a therapeutic/adaptive riding instructor or facility? We suggest those affiliated with Professional Association of Therapeutic Horsemanship (PATH) International.

Learn more

Lauryn’s surprising us all. When she does something new, especially gross or fine motor, we know that it’s because of [physical and occupational therapies at] Children’s TherAplay that she’s growing in those areas.”

—Lauryn's mom, Jennifer

Get to know kiddo Lauryn

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