Equine-assisted (Horse) Therapy for Children and Teens

Many parents and caregivers have been interested in Equine-assisted Therapy for their children. This therapeutic treatment has significant results and is growing quickly. It has many benefits as well as being just plain fun. Horse therapy is available to children and teens with a variety of healthcare needs however, there are some points to consider when providing this therapy for a child or teen with paralysis.


Much like dogs, horses like people and want to interact with them. Horses are very in tune with humans and their emotions. They can sense happiness, fear, and physical needs among other emotional and physical feelings.

Horse therapy is provided by individuals who are educated in the treatment. These individuals have skills in assessments and advancing treatment sessions at the appropriate pace. They will introduce the child/teen to the horse, and create an interaction and eventual bond, before moving to riding. They also can direct a pleasant parting at the end of each treatment and at the conclusion of the therapy program.

The benefits of horse therapy are many. Creating a bond with a living animal is very powerful. Riding can help improve balance, breathing, posture, and muscle strength. Muscles, especially at the zone of transition (level of paralysis) can become stronger. The bouncing of the ride can shake the bladder which helps reduce infection and the bowel which assists in faster bowel programs. Mental health is promoted through confidence.

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Before moving forward with equine-assisted therapy, you will want to look in your community for a location that will fit your child’s needs. There are a surprising number of possibilities in most areas so you may even have a choice of therapists and locations. Before signing up, be sure to drive by the facility and take a tour. This will help with assessing if the area is truly accessible for the needs of your child.

Talk with the horse therapist. Make sure they are certified which provides a level of understanding of the therapy. Be sure to tell the therapist about your child’s specific needs. Talk about the functional abilities of your child. You may want to express difficulty or lack of movement in particular parts of their body, level of understanding, and interest. Make them aware if your child uses a urinary collection device just to be sure it does not become dislodged or kinked.

Skin care is always an issue and will be so when riding the horse. Pressure dispersing cushions should be used in the saddle area, if there are back, abdominal, head, or arm supports. The first ride may be short so you can perform a skin check. Remember horse rides are bouncy making friction injury an issue.

If your child uses mechanical ventilation, specifically ask how this is handled. Ask if you can be present to handle autonomic dysreflexia if that is an issue and provide the Christopher and Dana Reeve Paralysis Foundation’s Pediatric Autonomic Dysreflexia wallet card just to make sure this medical emergency is clearly understood. 

Depending on your payor source, equine-assisted therapy may be covered. You will need to check with your nursing case manager or call the number on the back of your card to check for this benefit. Your child’s healthcare professional may need to write a prescription and a letter of medical necessity.

Talk with your child/teen about their participation. Be sure they understand what will happen at the sessions so they can be clear about how it works. Everyone has preferences in life some will be eager to participate while others may be hesitant. If you know other children/teens that may be interested, you can see if they can participate in the same time frame. Horses and friends, yippee.

About the Author - Nurse Linda

Linda Schultz, Ph.D., CRRN is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

Nurse Linda

The opinions expressed in these blogs are the author's own and do not necessarily reflect the views of the Christopher & Dana Reeve Foundation.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, ACL/HHS, or the U.S. Government.