Developmental delay affects about one in five Australian children, presenting a range of physical, cognitive, social and communication challenges that can impact everyday life. Families navigating early intervention options often use physiotherapy to support gross motor development, posture and movement patterns. However, there is a growing interest in complementary approaches that engage children in different environments. One such approach is equine-assisted physiotherapy: a therapeutic practice that uses the movement of horses to support physical and neurological development.

In Australia, equine-assisted therapy is gaining momentum as researchers and clinicians explore its potential to enhance outcomes for children with developmental delays. By combining the clinical expertise of physiotherapists with the natural gait and rhythm of horses, this unique intervention is helping some children achieve goals that once felt out of reach.

Equine-assisted physiotherapy, or hippotherapy, uses a horse's movement to support motor function, balance, coordination and posture.
 

• Hippotherapy refers specifically to the use of equine movement by a licensed physiotherapist, occupational therapist or speech pathologist.
• Therapeutic riding is more recreational, often led by trained instructors, where the emphasis is on enjoyment and participation rather than clinical goals.

In equine-assisted physiotherapy, the horse's gait provides a unique movement that closely mimics the motion of the human pelvis during walking. This movement stimulates the rider’s postural reflexes, promoting improvements in core stability, pelvic alignment and balance reactions.

Children are not simply placed on the horse. They are engaged in therapeutic tasks, games and exercises while mounted, under the guidance of a physiotherapist. As well as the physical benefits, the sensory experience of being outdoors, connecting with the animal, and enjoying play-based therapy also offers plenty of benefits. There is plenty of research supporting this:

• Equine-Assisted Therapy and Psychomotor Development: A 2020 study titled "Effect of an Equine Therapy Program on Psychomotor Development in Children Belonging to the School Integration Program" evaluated the impact of equine therapy on children with special educational needs. The study found significant improvements in psychomotor development after an 18-week program.
• Scoping Review on Equine-Assisted Therapies: A 2024 scoping review examined the mental health and well-being benefits of equine-assisted therapies for autistic children and adolescents. The review highlighted positive outcomes in areas such as social interaction and emotional regulation.

In Queensland, the Equine Assisted Therapy Australia program has partnered with allied health professionals to deliver tailored sessions for children with varying degrees of developmental delay. They conducted a small pilot study, which involved four children aged 8 to 10 years with post-traumatic stress symptoms, and four therapy horses. Over a 12-day intervention, including six consecutive days of riding and grooming, the researchers measured salivary cortisol levels to assess stress responses. The findings suggest that equine-assisted therapy may have beneficial effects on stress reduction in children.

Clinics such as RDA (Riding for the Disabled Association) centres offer physiotherapy-led sessions tailored to NDIS participants. In many of these programs, clinicians have observed:

• Improved head and trunk control in children.
• Increased social interaction and participation in children with communication delays.
• Enhanced coordination and upper limb use through guided riding activities.

So, how does it work?

Integrating equine-assisted physiotherapy involves collaboration between trained physiotherapists, equine professionals, and support staff. While it may look like play, every movement and task is carefully planned to promote specific therapeutic outcomes.

Sessions typically run for 30–45 minutes and may take place weekly or fortnightly, depending on the child’s needs and program availability. Each session includes:

• Mounting and warm-up: The child is supported onto the horse and introduced to basic riding movements.
• Targeted exercises: Activities such as reaching, turning, or riding without stirrups are used to challenge balance and coordination.
• Cool-down and dismount: Ending with gentle riding or stretching activities to reinforce relaxation and postural control.

While the benefits of equine-assisted physiotherapy are increasingly recognised, access to these services in Australia can be limited. While it is offered through a growing number of centres through NDIS-supported therapy programs, services are more concentrated in regional and semi-rural areas, where access to equestrian facilities is possible. Children living in inner-city or remote regions may face challenges accessing programs.

Despite the support available through NDIS, there are restrictions too. As a result, some families still face out-of-pocket costs, particularly where travel is involved. But, at the same time, there are plenty of potential areas for development:

• Telehealth partnerships to support regional clinicians in integrating equine interventions safely and effectively.
• NDIS innovation grants to fund pilot programs or expand existing services.

Equine-assisted physiotherapy offers a powerful, play-based approach to support children with developmental delays. For many children, it provides a unique opportunity to develop motor skills, build confidence, and engage in therapy in a way that feels less clinical and more enjoyable. By expanding access, investing in training, and advocating for broader funding support, we can help ensure more Australian children have the chance to benefit from the therapeutic power of horses.