14/04/2026

LYFE TUESDAY | APR 14, 2026

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Malaysian Paper

@thesundaily @t

Ű BY AMEEN HAZIZI

F OR some children with autism, even a typical therapy setting can be a lot to handle – the lighting, the noise, the expectation to sit still and respond on cue. What is meant to help can sometimes feel like just another thing to push through. Green Apple Hippotherapy co-founder and consultant paediatrician Dr Ali Azman Minhaj looks at it from a different angle. “The question is not about what is wrong with the child. The question is what environment allows the child’s nervous system to settle enough for progress to happen,” said Ali. In some cases, that environment is not a clinic at all. It is outdoors, on the back of a moving horse. Horse movement to regulate brain It sounds unusual at first, but the reasoning is fairly straightforward. When a horse walks, its movement closely mirrors how the human body moves when walking. There is a rhythm to it, but also a mix of motion – forward, side to side and up and down – all happening together. “The horse moves exactly like a human being walks. That produces the best type of movement to regulate the brain,” said Ali. That regulation matters more than anything else. Without it, learning becomes difficult. “Movement is the best way to regulate the brain. When the brain is regulated, the child is prepared for learning.” In most therapies, these systems are trained separately. Balance in one exercise, coordination in another. On a horse, they are all being engaged at once, without the child having to think about it. “In occupational therapy or physiotherapy, you work on these systems one at a time. On a horse, you activate them all at once.” Why it works differently The difference shows up quite quickly. Children who struggle to stay seated in a classroom often manage to stay on a horse for an entire session. The body is already engaged, so attention follows more naturally. “Children with autism cannot regulate their brain. So it is very difficult for them to learn in the normal way,” added Ali. Once that initial barrier is lowered, other things begin to fall

Autism therapy on horseback Autistic children often respond to movement-based therapy more naturally than static settings.

o Helping children regulate their brain with movement

into Communication improves, responses become more consistent and physical control gets better. Not every child responds the same way, and the progress is not always even. “The data tells us that hippotherapy consistently supports sensory regulation for most children, but not all. That is an honest finding and an important one.” He is careful to position it as part of a wider approach. “Hippotherapy works best as one component within a broader therapy plan alongside speech therapy, place.

Each horse is trained to remain composed around noise, movement and sudden reactions.

props in the process. “The horses are part of the team. They play a very big role in what we do.” Setting expectations There is a tendency to look at any therapy through the lens of results: How fast it works, how much it changes. Ali is direct about expectations. “Autism is not a disease. It is lifelong. There is no cure, but children can improve with consistent intervention and support.” Hippotherapy is one part of that process. It does not replace other forms of therapy, and it does not work the same way for every child. What it does offer is a different starting point. Instead of pushing a child to adapt to a system, it adjusts the environment so the child can settle first.

anymore,” Iliza added. The impact

occupational therapy or behavioural intervention.” What parents tend to notice first The early changes are not always dramatic, but they are noticeable. Calm is usually the first thing parents talk about. After a session, there is often a window where the child is more settled, easier to engage and less overwhelmed by things that would normally trigger a reaction. Sleep tends to improve too. Co-founder Iliza Ikhbal, who is Ali’s wife and handles the equestrian side of the programme, saw this with her own son. “When we started hippotherapy, all the sensory issues began to regulate very quickly,” she said. Before that, managing his sensory needs was constant work. “I had to do body brushing and joint compression every day. After hippotherapy, I did not have to do it

carried

into

daily life. “One session a week was enough to keep him calm. There were no meltdowns in school.” Over time, that stability made other things possible. He is now able to function in a mainstream learning environment and handle more on his own. Connecting with horses Not all of it comes down to movement. “Most of the kids naturally connect with the horse. The horse does not judge them, so they feel comfortable,” added Iliza. That matters more than it sounds. For children who are often corrected or redirected, being around something that simply responds instead of judging can make a difference. The horses are not treated as

Ali (left) and Iliza combine medical expertise and equestrian knowledge in hippotherapy. – ALL PICS BY AMEEN HAZIZI/THESUN