A rider who cannot talk sometimes first learns the power of words while riding. The instructor takes the rider's hands and taps the horse's mane to the words "Walk on."

A rider who is autistic might overcome some sensory issues, first by touching and grooming the horse and then working up to riding. The power of mutual trust is developing, too.

"She shuffled, almost as if she were unsure of her feet. Because of the curvature of her spine, I couldn't see her face," says Judy. "Not even a year later, she walks into the barn taller, holding her head up higher."

While Amy has no formal diagnosis, her mom, Pat Sciancalepore of Sussex, N.J., says Amy is considered globally delayed, meaning she has problems with fine and gross motor skills, speech and neurological development.

Since she's been riding, though, Pat notices Amy's hamstrings are looser, making it easier for Amy to bend and pick something up, or climb the stairs. Some of her words are easier to understand.

"The horse overlays normal movement patterns onto a body that can't experience it on its own," says Marilyn Jones, a physical therapist who does early intervention work in New Jersey and teaches hippotherapy at Winslow Therapeutic Center in Warwick. "The sensation is transmitted through the pelvis, up the trunk and almost tricks the brain into learning normal movement."

According to the American Hippotherapy Association, the therapeutic benefits of the horse were recognized as early as 460 B.C. But it wasn't until the early '50s that someone in Europe took that theory a step further and made it a tool for improving the lives of people with disabilities.

Two categories of riding have evolved: hippotherapy and therapeutic riding. While there is some overlap, hippotherapy is a medical treatment in which a physical therapist, occupational therapist or speech therapist works with a person on the horse to achieve functional goals. Because there is a therapist involved, hippotherapy is more expensive ($75 a half-hour at Winslow, for example, although some insurance companies reimburse).

With therapeutic riding, an instructor who has acquired additional certification works with a rider who is at least 4 years old. At an average cost of $40 per session, the goal is to improve the balance, strength and stamina required to ride. As with Amy, there is often an overall improvement in the underlying disability as riding ability improves.

Whether riding with a therapist or certified therapeutic riding instructor, the key player is the horse. The ideal therapy horse needs to be sound - strong and healthy with a good temperament, says Marilyn.

"Therapy horses work harder than horses used with able-bodied riders," Marilyn says, because the horse is constantly making corrections to keep the disabled rider in the saddle.

While the cost of riding may seem steep, horses are expensive. They eat a lot. They require regular shoeing, regular vet attention. They have to be groomed frequently and the stalls need cleaning.

Winslow estimates it spends at least $500 per month per horse for its 24 horses. In many places, the business rarely pays for itself but is, instead, a labor of love.

All local programs depend on volunteers who fill in the gaps, whether it's walking alongside the horses during riding sessions or helping take care of the horses.

"There is no piece of equipment that can duplicate this rhythmic, repetitive, multidimensional movement so similar to the human gait," Marilyn says. "To be one with such a large creature and to communicate with that creature is amazing."

that is why therapeutic riding can be as effective for a child with autism as with an adult who's been in an auto accident - or for those coping with a gamut of afflictions in between.

While his mom, Heidi Martin, says he is not severely affected by his cerebral palsy, she credits the riding with helping Ryan make big strides in walking. Today, he attends a typical preschool - and can climb the stairs to its second-floor location.

Alexandra Nordland commutes weekly from Yonkers to Winslow's state-of-the-art indoor/outdoor center in Warwick with her 3-year-old daughter Siobhan.

Siobhan has Rett syndrome, a neurodevelopment disorder found predominantly in females that is sometimes mistaken for autism or cerebral palsy. Two of Siobhan's doctors, a neurologist and a specialist in Delaware, swear by hippotherapy.

"It's like she's trapped in her body," says Alexandra, who has given up her job to devote all her time to Siobhan's rigorous multitherapy schedule.

"But I believe that actively engaging people on a horse who spend most of their time passively in a stroller or wheelchair helps them spiritually," she says.

Since 1969, NARHA has been promoting equine-facilitated therapy and activity programs in the United States and Canada. Today, there are more than 670 NARHA centers. It is also one of several organizations that certifies instructors.

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