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Therapists, volunteers and graduate students interact with a child in the UAMS hippotherapy program. Image by Bryan Clifton

Dean Society’s Grant Supports Hippotherapy Research

Dec. 23, 2024 | One mother saw her son smile for the first time in two years, while another mother now has conversations with her son, who was never expected to ever speak.

Both stories are outcomes of hippotherapy, a therapeutic tool using horses that is now available to clients of the Speech-Language Pathology program at the University of Arkansas for Medical Sciences (UAMS). It uses the natural gait and movement of a horse to provide motor and sensory input to clients.

Working with the Benton-based nonprofit Harmony in Hooves hippotherapy facility, Sarah Allen, MCD, assistant professor of Audiology and Speech Pathology in the UAMS College of Health Professions, provides supervised clinical experiences to the program’s graduate students using hippotherapy with clients. This clinical rotation teaches them how to integrate speech-language therapy with a unique therapeutic approach.

Many of the clients whom Allen and the students help have childhood apraxia of speech, a motor planning disorder.

“The brain knows the message it wants to say, but when it tries to send the command to the muscles, it gets confused as to how to do that,” Allen said. “You’re stimulating their nervous system and their brain by having them ride the horse and all that entails.”

Modern hippotherapy originated in Europe in the 1950s and then came to the United States. In addition to therapy for apraxia, Allen said she has used it to help clients with oral feeding disorders, problems with executive functions, reading and expressive language. Occupational and physical therapists also have used hippotherapy for decades to treat people with an even wider array of problems.

Seven years ago, Olivia Brewster, the mother of 9-year-old Wyatt, first brought her son to see Allen, who was then in private practice. Wyatt had been diagnosed with Christianson syndrome, a rare genetic disorder that affects only a few hundred people worldwide. Physicians told Brewster her son would never speak, but she hoped Allen could help. After a few months, Allen suggested giving hippotherapy a chance alongside what she and Wyatt were doing in the more traditional clinic.

“He loved it from the very beginning, and he would tire out quickly, so he would jostle around. They would let him lie down on the horse some, too, and it would calm him. At around the age of 3, he was doing better,” Brewster said.

In hippotherapy, the client sits bareback on the horse with a side walker on either side to keep them steady, while a third person leads the horse around an enclosure. That lead is responsible for setting the pace, adjusting the movement of the horse and making sure there’s nothing ahead of the horse to alert it and cause problems.

Allen said the positive effects of the stimulation from riding last about three days on average, so clinical therapy sessions are scheduled within that timeframe to take advantage of that opportunity. After several sessions, sometimes a client reaches a plateau, and Allen said then it becomes advisable to take 10 to 12 weeks off before resuming hippotherapy.

Wyatt is now 9, and the effect has been greater than anything Brewster imagined at the start.

“He has so much language now that they are working on articulation,” Brewster said. “He’s able to carry on full conversations, not just out of necessity. He averages five or six words per sentence. It makes a big difference in how I interact with him. He can tell me things that happen, not just things he needs.”

She said Wyatt loves being around the horses, helps brush them and that gives him a sense of purpose.

“We can talk at length about the science, but the fact is there is a child there bonding with that horse,” Allen said. “They say, ‘My horse is Lucky’ or ‘My horse is Merlin.’ It’s because they have that personal connection to this therapy tool. I think that plays a part. I can’t prove it, but I think it is there as a factor.”

Allen said one reason she joined UAMS and decided to move to academia is that she and Dana Moser, Ph.D., would like to scientifically research why hippotherapy works for speech.

Moser is an associate professor and director of the Communications Sciences and Disorders Master’s program in Speech-Language Pathology.

A recent grant from the college’s Dean’s Society is intended to provide some seed funding for the project and a possible springboard to additional research grants. Research has been done into why hippotherapy works as a tool in occupational and physical therapy but very little into its use in speech therapy.

“We have lots of interventions that can improve communication, and it can be a lot of hard work,” Moser said. “What Sarah has described, interaction and input from the horse facilitates that growth curve. That is what we are interested in researching. If we can make that therapy more effective and faster, who doesn’t want that?”

Collen Zaller, a graduate student pursuing a Master of Science in Communication Sciences and Disorders, has worked with Allen and clients at Harmony in Hooves and said the experience was a rich one for her.

“It was fantastic for me as a student to be able to see the holistic picture and put all the pieces together,” she said. “We do that in the clinic, but it’s such a powerful tool, the movement of the horse, to dive right into therapy. It’s such an effective way to get into therapy.”

One reason Zaller entered the field was because of the concern she had about disparities in health care.

“It’s opened my mind to the value of having animals and that relationship with the animal as a part of it,” Zaller said. “I wish more kids could have access to it and that there were more funds to support equity in that way. That’s what I hope for in the future.”

Since she started using hippotherapy in 2008, Allen said she has used it with about 50 clients, and only two of those showed little improvement after the experience.

One client who came to Allen for speech therapy was an autistic man, 18, who was capable of some speech until he was 16. After an adverse reaction to a medication and some time in a catatonic state, he regained conscious awareness but was still unable to speak. His first time on a horse was different though.

“He rode all around the arena and just smiled, laughed and had the best time,” Allen said. “He gets off. I told him one way to thank the horse is to pet them. He looks at me like I am crazy, and I started petting the horse, then he started. He ran both hands down the horse’s neck. His mom said he had never touched an animal.”

Allen said she was very excited by that, pointed it out to the mother and called it a breakthrough. The mother was stoic and told Allen it was nothing. When Allen started to gently argue with her, she noticed a tear rolling down the mother’s cheek.

Allen recalled her response: “She said, ‘I haven’t seen my son smile in two years. He hasn’t had a moment of enjoyment. He just laughed. We will be back next week.’”

Since then, the man has regained all the ability to speak that he had before the adverse reaction.