What is Occupational Therapy?

The term “occupation” refers to what humans “occupy” themselves with in daily life. For a child, daily occupations may include dressing, feeding, handwriting, focusing at school. Occupational therapy helps people be as independent and successful as possible in their everyday activities, or occupations. Occupational therapists provide individualized evaluations to determine goals, customized intervention to improve the individual’s ability to perform daily activities and goal assessment. Some of the most common skills we target are fine motor skills such as handwriting, gross motor skills like coordinating a jumping jack and sensory integration skills such as focusing and regulating emotions.  

According to the American Occupational Therapy Association (AOTA), “Occupational therapists help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills and providing supports for older adults experiencing physical and cognitive changes.”

What is Unique about Occupational Therapy at Kids & Horses?

Kids & Horses offers a unique variation to occupational therapy by incorporating hippotherapy. Hippotherapy is a treatment strategy that utilizes the movement of a horse to help achieve functional goals. The pelvis of a human moves back and forth (anterior-posterior), side-to-side (lateral) and round-and-round (rotation). So does the pelvis of a horse! When a person rides on the back of a horse, their body experiences a similar motion to walking. This simulation has been shown to help people with disabilities who could not walk, be able to walk.

Equine movement challenges core strength, balance, strength, flexibility and provides sensory input. Activities are incorporated to promote increased sensory integration, coordination, fine motor skills, visual perceptual skills, social skills and so much more. The rhythmical and repetitive motion provides sensory input which is very effective in helping individuals with sensory integration challenges such as Autism, ADHD, Sensory Processing Disorder, Fetal Alcohol Syndrome, Fragile X Syndrome, speech-language delays, behavior challenges and other developmental disabilities. The therapist can grade the level of sensory input to the client by varying the horse’s gait, maneuvering the horse in certain patterns and altering the positioning of the rider.

While astride the back of a horse, clients engage in a wide variety of activities to address their individualized goals. For example, reaching out of their base of support to drop a ring down a pole works to increase balance and strength. Placing clothespins in their horse’s mane facilitates improved fine motor skills. Riding backward provides increased vestibular input and completing a multi-step activity promotes increased focus.

Typically, half of each occupational therapy session is spent utilizing hippotherapy as a treatment strategy. The other half occurs in the sensory gym, filled with fun therapy toys and equipment. During “gym time,” traditional occupational therapy techniques are utilized. Sensory integration, fine motor, gross motor and self-care skills are targeted through purposeful play. During this time, the occupational therapist and families also collaborate to problem-solve challenges and develop strategies for home and school. All 60 minutes of occupational therapy can be offered in the gym if hippotherapy is determined to be unsafe for an individual (i.e. uncontrolled seizures or atlantoaxial instability present in Down Syndrome), the client is under the age of 2, if the individual does not wish to ride, when the horses have scheduled vacations and/or on inclimate weather days.

“ Samuel talks most about two things: He loves riding and grooming (equally so) Doc or Apollo and doing the tasks he is set to do on the horse that day, and he loves sitting in Amy’s rice bucket and fishing out items. He loves “his” horses!”

Samuel's Mom

What is the frequency?

Occupational therapy sessions are most commonly 60 minutes, once per week. Typically, the first 30 minutes are dedicated to traditional treatment techniques in the gym on-site and 30 minutes of goal-directed activities on horseback.

What is the Cost?

We are in-network with Medicaid, Hometown Health, Blue Cross Blue Shield and Prominence. Private in-network insurance plans typically require co-pays and cover the rest after deductibles have been met. Out-of-network insurance plans may be able to be billed out-of-network. Some insurance plans do not cover therapy services or have limitations. In this case, you may talk to the therapist about what would be the best payment option for you. 

How do I start?

If you or a loved one is interested in occupational therapy at Kids & Horses, please complete our Prospective Client Form. You may also email info@kidsandhorses.org or call 775-267-1775.

Annie Struemph

Annie Struemph

Annie grew up in Missouri and became interested in occupational therapy while volunteering in high school at a school for children with developmental disabilities. While there she encountered loving OTs and enjoyed the fun sessions spent engaging children in tasks aimed at increasing their independence within their daily life. Throughout college at Notre Dame, Annie continued exploring this population and future career by volunteering weekly early on Saturday mornings at a facility that provided adaptive riding and therapy utilizing equine movement – a true labor of love considering the early hours required! Before her last year of college, Annie was able to explore OT in India while on scholarship for a summer, a time she values deeply because of the cultural experiences she took part in. The school for children with developmental disabilities was really progressive in India which has only come to accept these children in more recent years. After college, Annie moved to the Navajo reservation in Arizona where she became a volunteer teacher at a small school. While there she experienced OT in a school setting and saw the benefits and challenges students can face – all the while enjoying the West via hiking and the many state parks. Annie then pursued her Master’s in occupational therapy degree at Rush University in Chicago. She continued to pursue hippotherapy through an internship outside Chicago. Upon graduating, she moved to Tahoe to enjoy the beauty outside of the Midwest and has loved living here for the past year and a half. She has worked full-time in a hospital setting and part-time in a rehab facility before taking on a pediatric role incorporating hippotherapy as a treatment tool with Highest Potential Therapy. In her free time, she enjoys being outside, hiking, skiing, and paddle boarding, spending time with friends and reading science fiction and historical fiction novels.


According to the American Hippotherapy Association (AHA), “The term hippotherapy refers to how occupational therapy, physical therapy, and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement to engage sensory, neuromotor, and cognitive systems to achieve functional outcomes.  In conjunction with the affordances of the equine environment and other treatment strategies, hippotherapy is part of a patient’s integrated plan of care.” The American Physical Therapy Association (APTA)American Occupational Therapy Association (AOTA) and American Speech and Hearing Association (ASHA) accept and endorse hippotherapy as a treatment strategy. A list of research studies on the effectiveness of hippotherapy as a treatment tool for physical therapy, occupational therapy and speech-language pathology can be found here.

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